Form 5500 · Employee benefit plan
HVPH MOTOR CORPORATION
The filing calls this plan HVPH MOTOR CORPORATION EMPLOYEE BENEFIT PLAN.
HVPH MOTOR CORPORATION is a 237-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CGF INSURANCE LLC. Coverage is written through TRIPLE S SALUD, INC. and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 66-0579755 · plan 501 · plan year 2024, filed Oct 7, 2025
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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
Also declared: other welfare.
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 244 people.
Reported premium across the insured contracts is $1,980,652, with $108,338 in disclosed broker commissions — about 5.5% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
CGF INSURANCE LLC is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including TRIPLE S SALUD, INC., UNIVERSAL LIFE INSURANCE COMPANY 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 | 244 | Jan 1, 2025 | $1,649,687 | $65,344 |
| UNIVERSAL LIFE INSURANCE COMPANY | Life, Disability | 510 | Jan 1, 2025 | $203,577 | $30,537 |
| UNIVERSAL LIFE INSURANCE COMPANY | — | 510 | Jan 1, 2025 | $61,406 | $9,211 |
| DELTA DENTAL OF PUERTO RICO, INC. | Dental | 244 | Jan 1, 2025 | $65,982 | $3,246 |
Premium and claims on this contract
TRIPLE S SALUD, INC., contract SP0003754. For the contract year on this filing, the carrier reported $1,649,687 in premium earned and $1,468,876 in claims incurred. Dividing one by the other gives 89%.
- TRIPLE S SALUD, INC., contract SP0003754 reported $65,344 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.
Other plans filed by this employer
How this plan compares
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