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 |
|---|---|---|---|
| MCS LIFE INSURANCE COMPANY EIN 66-0520918 NONE | Other services Service code 49 | PO BOX 71104 SAN JUAN, PR 00936 | $362K |
| FIRST MEDICAL HEALTH PLAN, INC. EIN 66-0537624 NONE | Other services Service code 49 | PO BOX 70264 SAN JUAN, PR 00936 | $241K |
| MAPFRE LIFE INSURANCE COMPANY EIN 66-0402309 NONE | Other services Service code 49 | PO BOX 70297 SAN JUAN, PR 00936 | $118K |
| DELTA DENTAL OF PR, INC. EIN 66-0436769 NONE | Other services Service code 49 | METRO OFFICE PARK 14 CALLE 2, SUITE 200 GUAYNABO, PR 00968 | $89K |
| TRIPLE-S SALUD EIN 66-0555677 NONE | Other services Service code 49 | PO BOX 71548 SAN JUAN, PR 00936 | $77K |
| EFRAIN SOTO DE JESUS EIN 58-3548158 EMPLOYEE | Employee (plan) Service code 30 | URB. CAMPO ALEGRE C-34 CALLE ROBLES BAYAMON, PR 00956 | $51K |
| DOCTORS CENTER HOSPITAL BAYAMON EIN 66-0264947 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $36K |
| AIDA L. ORTIZ RODRIGUEZ EIN 58-1415086 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 6843 SAN JUAN, PR 00914 | $34K |
| YOLANDA LANDRAU RAMOS EIN 58-1650227 EMPLOYEE | Employee (plan) Service code 30 | URB. SANTA ROSA CALLE 28 BLQ 31-5 BAYAMON, PR 00912 | $31K |
| VICTOR M. ORTEGA RAMON EIN 58-4205792 EMPLOYEE | Employee (plan) Service code 30 | URB. VILLA BORINQUEN 405 CALLE DUERO SAN JUAN, PR 00920 | $27K |
| LCDO. JOSE E. CARRERAS ROVIRA EIN 58-4109164 LEGAL ADVISOR | Legal Service code 29 | CALLE DEL PARQUE #352 MAIN FLOOR SAN JUAN, PR 00912 | $26K |
| DOCTORS CENTER HOSPITAL SAN JUAN EIN 66-0199045 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $22K |
| DOCTORS CENTER HOSPITAL MANATI EIN 66-0665951 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $22K |
| DOCTORS CENTER HOSPITAL SF CAROLINA EIN 66-0782101 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $21K |
| MARYCELIS TORRENS CORTIJO EIN 59-7187634 EMPLOYEE | Employee (plan) Service code 30 | URB. JARDINES DE RIO GRANDE BY-439 CALLE 74 RIO GRANDE, PR 00745 | $16K |
| ROSA M. VELEZ AVILES EIN 58-3208260 EMPLOYEE | Employee (plan) Service code 30 | URB. LA INMACULADA G-3 CALLE CRUZ TOA BAJA, PR 00949 | $16K |
| DR. DIEGO E. MEJIAS FRANQUI EIN 58-4847210 NONE | Other services Service code 49 | MIRADOR DEL PARQUE CALLE JUAN RODRIGUEZ #405 APT. 1001 SAN JUAN, PR 00918 | $14K |
| AMERICAN HERITAGE LIFE INSURANCE EIN 59-0781901 NONE | Other services Service code 49 | PO BOX 650514 DALLAS, TX 75265 | $14K |
| DR JESUS VELEZ FELICIANO EIN 58-4761819 NONE | Other services Service code 49 | URB VILLAS DE LEVITTOWN A19 CALLE 1 TOA BAJA, PR 00949 | $13K |
| HOSPITAL WILMA N. VAZQUEZ EIN 66-0403210 NONE | Other services Service code 49 | PO BOX 7001 VEGA BAJA, PR 00694 | $11K |
| AQUINO, DE CORDOVA, ALFARO & CO. EIN 66-0546032 NONE | Accounting (including auditing) Service code 10 | PO BOX 70262 SAN JUAN, PR 00936 | $11K |
| JESUS A. VIVAS GARCIA EIN 58-3125796 NONE | Other services Service code 49 | PO BOX 193002 SAN JUAN, PR 00919 | $8K |
| CHUBB INSURANCE COMPANY OF PR EIN 66-0600740 NONE | Other services Service code 49 | PO BOX 191249 SAN JUAN, PR 00919 | $6K |
| DEL PARQUE INC. LABORATORIO CLINICO EIN 66-0818474 NONE | Other services Service code 49 | PO BOX 8901 PMB 147 HATILLO, PR 00659 | $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 | 858 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 858 | 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.