Form 5500 · Employee benefit plan · SAN JUAN
PBG PUERTO RICO LLC
The filing calls this plan PBG PUERTO RICO HEALTH AND WELFARE BENEFIT PLAN.
PBG PUERTO RICO LLC of SAN JUAN, PR files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is STRATEGIC NON-MEDICAL SOLUTIONS LLC. Coverage is written through METROPOLITAN LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 66-0914590 · plan 604 · plan year 2024, filed Oct 6, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: death benefits, 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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 5 insured contracts covering life and disability; the largest, with METROPOLITAN LIFE INSURANCE COMPANY, covers 126 people.
The filing declares life, disability, health, dental and vision. Health, dental and vision appear with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium is $125,726; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
STRATEGIC NON-MEDICAL SOLUTIONS LLC is the broker of record on 3 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 126 | Jan 1, 2025 | $66,124 | $0 |
| NYL GROUP INSURANCE COMPANY OF NEW YORK | Disability | 87 | Jan 1, 2025 | $42,949 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | — | 170 | Jan 1, 2025 | $9,813 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 97 | Jan 1, 2025 | $5,325 | $0 |
| NATIONAL UNION | — | 159 | Jan 1, 2025 | $1,515 | $0 |
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. The service providers are named on Schedule C of this filing. We publish company names only.
Other plans filed by this employer
How this plan compares
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