2023 Form 5500 filing — T-Mobile Puerto Rico, LLC Health Plan
Plain-English filing 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, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20240521161426NAL0001525235001) for T-Mobile Puerto Rico, LLC Health Plan, reported by T-Mobile Puerto Rico, LLC under EIN 66-0649631 and plan number 501. It reports 785 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240521161426NAL0001525235001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- T-Mobile Puerto Rico, LLC
- EIN
- 66-0649631
- Plan number
- 501
- Location
- Bellevue, WA
- Participants
- 785
- Schedules available
- Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
This 2023 filing is loaded, but detailed Schedule H/I financial figures are not present for it in the current loaded dataset. Participant counts and filing identity above are reported; asset and contribution detail comes from the financial schedules where filed.
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Optum Rx, Inc. | PHARMACY BENEFIT MANAGEME | $2,385,529 | $10,516 |