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Form 5500 · Employee benefit plan · DORAL, FL

ROCA USA, INC.

The filing calls this plan ROCA USA, INC. MEDICAL PLAN.

ROCA USA, INC. of DORAL, FL files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is GALLAGHER BENEFIT SERVICES, INC.. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 73-1139950 · plan 502 · plan year 2025, filed Aug 13, 2026

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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.

All participants at the start of the year
100
Active at start of year
100
Active at end of year
107
Disclosed commissions
$57,925
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY107 of 100 participants
Dentalnot declared on this filing
Visionnot declared on this filing
Lifedeclared under plan 511
Disabilitydeclared under plan 511

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

The filing discloses a single insured line, health, through CIGNA HEALTH AND LIFE INSURANCE COMPANY, covering 107 people.

Reported premium across the insured contracts is $580,285, with $57,925 in disclosed broker commissions — about 10% 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.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
CIGNA HEALTH AND LIFE INSURANCE COMPANYHealth107Jan 1, 2026$580,285$57,925

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
ROCA USA, INC.
EIN 73-1139950

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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