T-Mobile Puerto Rico, LLC Health Plan — Form 5500 plan (T-Mobile Puerto Rico, LLC)
Plain-English plan summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, T-Mobile Puerto Rico, LLC Health Plan is a benefit plan reported by T-Mobile Puerto Rico, LLC under EIN 66-0649631 and plan number 501. The latest loaded filing year is 2023. The filing reports 785 participants and not reported in the loaded dataset in end-of-year plan assets, where available in the loaded dataset.
Key reported metrics
- Plan sponsor
- T-Mobile Puerto Rico, LLC
- EIN
- 66-0649631
- Plan number
- 501
- Plan type
- 2
- Location
- Bellevue, WA
- Latest filing year
- 2023
- Participants
- 785
- End-of-year plan assets
- not reported in the loaded dataset
Form 5500 filing history
| Filing year | Participants | Schedules | Filing |
|---|---|---|---|
| 2023 | 785 | C | 20240521161426NAL0001525235001 |
Reported financial statement
This plan is loaded, but Schedule H / I financial-statement detail is not present for it in the current loaded dataset.
Service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. | Year |
|---|---|---|---|---|
| Optum Rx, Inc. | PHARMACY BENEFIT MANAGEME | $2,385,529 | $10,516 | 2023 |