| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JESUS M. ROSARIO NARVAEZ | COND. PARQUE DE LA VISTA 1280 JUAN BAIZ ST., APT 330C SAN JUAN, PR 00924 | MCS LIFE INSURANCE COMPANY | $328K | $19K | $347K | 105.87% |
| OWNER'S RISK INSURANCE MANAGEMENT | PO BOX 191730 SAN JUAN, PR 009191730 | FIRST MEDICAL HEALTH PLAN INC. | $190K | $9K | $199K | 104.88% |
| LUIS R. SOLER VAZQUEZ | 1219 AVE. MAGDALENA APT. 405 SAN JUAN, PR 009071743 | FIRST MEDICAL HEALTH PLAN INC. | $158K | $8K | $165K | 104.91% |
| JESUS M. ROSARIO NARVAEZ | COND. PARQUE DE LA VISTA 1280 CALLE JUAN BAIZ APT. 330C SAN JUAN, PR 00924 | FIRST MEDICAL HEALTH PLAN INC. | $98K | $5K | $103K | 104.91% |
| LUIS R. SOLER VAZQUEZ | 1219 AVE. MAGDALENA APT. 405 SAN JUAN, PR 009071743 | FIRST MEDICAL HEALTH PLAN INC. | $97K | $5K | $101K | 104.91% |
| JESUS M. ROSARIO NARVAEZ | COND. PARQUEE DE LA VISTA I 1280 CALL EJUAN BAIZ APT. 330C SAN JUAN, PR 00924 | DELTA DENTAL OF PUERTO RICO, INC. | $62K | $2K | $65K | 103.50% |
| LUIS R. SOLER VAZQUEZ | COND. LORES 1209 AVE. MAGDALENA APT. 405 SAN JUAN, PR 00907 | DELTA DENTAL OF PUERTO RICO, INC. | $62K | $2K | $65K | 103.50% |
| LUIS R. SOLER VAZQUEZ | COND. LORES 1219 AVE. MAGDALENA APT. 405 SAN JUAN, PR 00907 | DELTA DENTAL OF PUERTO RICO, INC. | $11K | $775 | $12K | 107.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EFRAIN SOTO DE JESUS EIN 58-3548158 EMPLOYEE | Employee (plan) Service code 30 | URB. SANTA JUANITA D-65 CALLE ESPANA BAYAMON, PR 00956 | $56K |
| YOLANDA LANDRAU RAMOS EIN 58-1650227 EMPLOYEE | Employee (plan) Service code 30 | URB. SANTA ROSA 31-5 CALLE 28 BAYAMON, PR 00959 | $33K |
| AIDA L. ORTIZ RODRIGUEZ EIN 58-1415086 EMPLOYEE | Employee (plan) Service code 30 | URB. SUMMIT HILLS 562 CALLE TORRECILLA SAN JUAN, PR 00920 | $32K |
| VICTOR M. ORTEGA RAMON EIN 58-4205792 EMPLOYEE | Employee (plan) Service code 30 | URB VILLA BORINQUEN 405 CALLE DUERO SAN JUAN, PR 00920 | $19K |
| HOSPITAL HIMA SAN PABLO BAYAMON EIN 66-0465905 NONE | Other services Service code 49 | PO BOX 236 BAYAMON, PR 00961 | $17K |
| DOCTOR'S CENTER HOSPITAL SAN JUAN EIN 66-0686840 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $16K |
| OVIDIO RUIZ HERNANDEZ EIN 58-3518920 INDEPENDENT CPA | Legal Service code 29 | PO BOX 3266 CAROLINA, PR 00984 | $15K |
| DOCTOR'S CENTER HOSPITAL BAYAMON EIN 66-0265947 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $13K |
| LCDO. JOSE E. CARRERAS ROVIRA EIN 58-4109164 NONE | Legal Service code 29 | 352 CALLE DEL PARQUE SAN JUAN, PR 00912 | $13K |
| LABORATORIO CLINICO DEL MAR EIN 66-0549931 NONE | Other services Service code 49 | PO BOX 2221 MANATI, PR 00674 | $10K |
| JOSE OQUENDO DAVILA EIN 58-2379191 NONE | Other services Service code 49 | 2449 CALLE SANTA ELENA CANTERA SAN JUAN, PR 00915 | $9K |
| LABORATORIO CLINICO TOLEDO SANTURCE EIN 66-0543982 NONE | Other services Service code 49 | PO BOX 8901 PMB 147 HATILLO, PR 00659 | $7K |
| DOCTORS CENTER HOSPITAL MANATI EIN 66-0665951 NONE | Other services Service code 49 | PO BOX 30532 MANATI, PR 00674 | $7K |
| HOSPITAL WILMA N. VAZQUEZ EIN 66-0403210 NONE | Other services Service code 49 | PO BOX 7001 VEGA BAJA, PR 00694 | $6K |
| DENISSE MARTINEZ MENDEZ EIN 58-2810023 NONE | Other services Service code 49 | PO BOX 890 TOA ALTA, PR 00954 | $6K |
| MANATI MEDICAL CENTER EIN 66-0531550 NONE | Other services Service code 49 | PO BOX 1142 MANATI, PR 00674 | $5K |
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 | 726 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 726 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | MCS LIFE INSURANCE COMPANY | 45 | $870K |
| Dental(3 contracts, 2 carriers) | FIRST MEDICAL HEALTH PLAN INC. | 201 | $263K |
| Vision(3 contracts) | FIRST MEDICAL HEALTH PLAN INC. | 37 | $444K |
| Life insurance(2 contracts) | FIRST MEDICAL HEALTH PLAN INC. | 30 | $288K |
| Prescription drug(4 contracts) | FIRST MEDICAL HEALTH PLAN INC. | 37 | $543K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.