No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAREB DEL ROSARIO NONE | Actuarial Service code 11 | AVE JESUS T PINERO 200 COND HATO REY PLAZA APT 1F SAN JUAN, PR 00927 | $40K |
| JONATHAN MALDONADO NONE | Other services Service code 49 | LUIS MUNOZ RIVERA 1002 OLIMPO PLAZA APT 309 SAN JUAN, PR 00927 | $18K |
| SIMPLE NET CORP EIN 66-0848621 NONE | Consulting (general) Service code 16 | URB VALENCIA CALLE TULIPAN 1 H3 BAYAMON, PR 00950 | $16K |
| JESUS FERNANDEZ MENDEZ NONE | Accounting (including auditing) Service code 10 | PO BOX 2412 GUAYNABO, PR 00970 | $12K |
| MARTINEZ-ALVAREZ MENENDEZ CORTADA EIN 66-0526531 NONE | Legal Service code 29 | PONCE DE LEON AVE 701 SUITE 407 SAN JUAN, PR 00907 | $11K |
| EVELYN PADILLA LOPEZ NONE | Other services Service code 49 | PO BOX 52324 TOA BAJA, PR 00949 | $11K |
| LOINAZ MARTIN PSC EIN 66-6056559 NONE | Legal Service code 29 | 1353 LUIS VIGOREAUX EVE PMB 486 GUAYNABO, PR 00966 | $10K |
| JAMINETTE RODRIGUEZ NONE | Other services Service code 49 | RR 4 BOX 2784 BAYAMON, PR 00956 | $7K |
| CARLOS PACHECO NONE | Consulting (general) Service code 16 | URB SANTIAGO #109 BOX A-42 LOIZA, PR 00772 | $6K |
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 | 442 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 442 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.