| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OLYMPIC AGENCY INC3 | PMB 370,1353 CARR.19 GUAYNABO, PR 00966 | TRIPLE S SALUD INC. | $286K | $0 | $286K | 3.75% |
| CGF INSURANCE LLC3 | CAPARRA OFFICE CENTER AVE. GONZALEZ GUISTI SUITE 202 GUAYNABO, PR 009683011 | TRIPLE S SALUD INC. | $0 | $0 | $0 | 0.00% |
| OLYMPIC AGENCY INC3 | 9150 S DADELAND BLVD SUITE 1008 MIAMI, FL 331567843 | UNITED HEALTHCARE INSURANCE COMPANY | $77K | $0 | $77K | 4.04% |
| OLYMPIC AGENCY INC3 | PMB 370,1353 CARR.19 GUAYNABO, PR 00966 | TRIPLE S SALUD INC. | $51K | $0 | $51K | 3.75% |
| CGF INSURANCE LLC3 | CAPARRA OFFICE CENTER AVE. GONZALEZ GUISTI SUITE 202 GUAYNABO, PR 009683011 | TRIPLE S SALUD INC. | $0 | $0 | $0 | 0.00% |
| INNOVA INSURANCE3 | PMB 234 AVE. ESMERALDA 405 SUITE 2 GUAYNABO, PR 00969 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $64K | $0 | $64K | 20.00% |
| INNOVA INSURANCE3 | PMB 234 AVE. ESMERALDA 405 SUITE 2 GUAYNABO, PR 00969 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $43K | $0 | $43K | 20.00% |
| N/A3 | — | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| INNOVA INSURANCE3 | PMB 234 AVE. ESMERALDA 405 SUITE 2 GUAYNABO, PR 00969 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $0 | $11K | 20.00% |
| INNOVA INSURANCE3 | PMB 234 AVE. ESMERALDA 405 GUAYNABO, PR 00969 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | — |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 2,296 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 436 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,732 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | TRIPLE S SALUD INC. | 1,825 | $11.0M |
| Dental(2 contracts) | TRIPLE S SALUD INC. | 1,825 | $9.0M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,296 | $322K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,296 | $217K |
| Prescription drug(2 contracts) | TRIPLE S SALUD INC. | 1,825 | $9.0M |
| Other(4 contracts, 2 carriers) | TRIPLE S SALUD INC. | 2,296 | $9.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,296 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.