Form 5500 · Employee benefit plan · BAYAMON
ALIVIA HEALTH NETWORK
The filing calls this plan ALIVIA HEALTH - HEALTH AND WELFARE PLAN.
Public Form 5500 records show how ALIVIA HEALTH NETWORK of BAYAMON, PR, a retail employer, structures its employee benefits. Its broker of record is FULCRO INSURANCE INC. Coverage is written through TRIPLE S SALUD, INC. and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 66-0858840 · plan 501 · plan year 2025, filed Jan 26, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
32 other employer plans in the U.S. have policy years ending in September. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, dental, life and disability; the largest, with TRIPLE S SALUD, INC., covers 413 people.
Reported premium across the insured contracts is $1,661,287, with $100,213 in disclosed broker commissions — about 6% of premium.
The health contract's policy period ended in September, while at least one ancillary line's policy period ended in June. The plan is on a split renewal cycle.
FULCRO INSURANCE INC is the broker of record on all 4 contracts.
4 carriers appear on the filing, including TRIPLE S SALUD, INC., TRIPLE-S VIDA, INC., HARTFORD LIFE AND ACCIDENT and DELTA DENTAL OF PUERTO RICO, INC.. TRIPLE S SALUD, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| TRIPLE S SALUD, INC. | Health | 413 | Oct 1, 2024 | $1,516,164 | $75,808 |
| TRIPLE-S VIDA, INC. | Disability | 624 | Jul 1, 2025 | $88,978 | $16,016 |
| HARTFORD LIFE AND ACCIDENT | Life | 654 | Jul 1, 2025 | $33,426 | $6,685 |
| DELTA DENTAL OF PUERTO RICO, INC. | Dental | 415 | Oct 1, 2024 | $22,719 | $1,704 |
Premium and claims on these contracts
TRIPLE S SALUD, INC., contract SP0006605. For the contract year on this filing, the carrier reported $1,516,164 in premium earned and $1,479,838 in claims incurred. Dividing one by the other gives 98%.
DELTA DENTAL OF PUERTO RICO, INC., contract 2411. For the contract year on this filing, the carrier reported $22,719 in premium earned and $17,531 in claims incurred. Dividing one by the other gives 77%.
- TRIPLE S SALUD, INC., contract SP0006605 reported $75,808 in retention.
- DELTA DENTAL OF PUERTO RICO, INC., contract 2411 reported $1,704 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
How this plan compares
Subscribers see how this compares with similar plans in this state. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
Renewal calendar
32 other employer plans in the U.S. are October 1 renewals (policy year ends September).
Their policy years end in September, like this plan’s, so most renew October 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
Claude & ChatGPT
Look up records from Claude or ChatGPT
Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.
Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both