Plan Snapshot
- Plan Sponsor: T-Mobile Puerto Rico, LLC Health Plan
- Sponsor EIN: 660649631
- Sponsor Address: 12920 SE 38TH ST, BELLEVUE, WA, 980061350
- Plan Type: 401(k)
- Plan Number: 501
- Total Participants: 812
- Total Assets: $0
Key Plan Design Features
- Auto-Enrollment: No
- Auto-Escalation: No
- Allows Roth Contributions: No
- Participant Loans: No
- Participant-Directed Investments: No
- ERISA Section 404(c) Fiduciary Safe Harbor: No
Plan Financials by Year
| Year | Participants | Total Assets | Employer Contrib. | Employee Contrib. |
|---|---|---|---|---|
| 2025 | 812 | $0 | $0 | $0 |
| 2024 | 748 | $0 | $0 | $0 |
| 2023 | 755 | $0 | $0 | $0 |
| 2022 | 785 | $0 | $0 | $0 |
Service Providers (Schedule C)
Vendors paid $5,000 or more for services to the plan, ranked by total compensation (direct + indirect fees).
| Provider Name | Role | Direct Compensation | Indirect Compensation | Total Fees |
|---|---|---|---|---|
| OTPTUM RX, INC | Other Service Provider | $2,547,325 | $9,389 | $2,556,714 |
| INTERNATIONAL REINSURANCE MANAGERS | Insurance Carrier | — | $149,640 | $149,640 |
Plan Fees & Expenses
Annual service provider fees and administrative expenses sourced from DOL Form 5500 filings.
- Total Service Provider Fees: $2,706,354
Historical Administrative Expenses
Breakdown of administrative expense categories reported on Form 5500 filings.
| Year | Total Admin Expenses | Investment Mgmt Fees | Contract Admin Fees | IQPA Audit Fees | Professional Fees |
|---|---|---|---|---|---|
| 2025 | — | — | — | — | — |
| 2024 | — | — | — | — | — |
| 2023 | — | — | — | — | — |
| 2022 | — | — | — | — | — |