401k Plan data: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO plan

MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 401k Plan overview

Plan Name	MOLINA SALARY SAVINGS PLAN OF PUERTO RICO
Plan identification number	001

MOLINA SALARY SAVINGS PLAN OF PUERTO RICO Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

MOLINA HEALTHCARE OF PUERTO RICO has sponsored the creation of one or more 401k plans.

Company Name: MOLINA HEALTHCARE OF PUERTO RICO

Employer identification number (EIN): 660817946

NAIC Classification: 524140

Additional information about MOLINA HEALTHCARE OF PUERTO RICO

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2015-09-03

Company Identification Number: 20151525868

More information about MOLINA HEALTHCARE OF PUERTO RICO

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOLINA SALARY SAVINGS PLAN OF PUERTO RICO

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2016-01-01 CHRISTINE SOTO 2018-06-28
001 2015-01-01

Plan Statistics for MOLINA SALARY SAVINGS PLAN OF PUERTO RICO

401k plan membership statisitcs for MOLINA SALARY SAVINGS PLAN OF PUERTO RICO

Measure Date Value
2022: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2022 401k membership
Total participants, beginning-of-year 2022-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 115
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 138
Total of all active and inactive participants 2022-01-01 253
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 253
Number of participants with account balances 2022-01-01 253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2021 401k membership
Total participants, beginning-of-year 2021-01-01 508
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 124
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 158
Total of all active and inactive participants 2021-01-01 282
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 4
Total participants 2021-01-01 286
Number of participants with account balances 2021-01-01 286
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2020 401k membership
Total participants, beginning-of-year 2020-01-01 618
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 193
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 314
Total of all active and inactive participants 2020-01-01 507
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 508
Number of participants with account balances 2020-01-01 508
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2019 401k membership
Total participants, beginning-of-year 2019-01-01 648
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 441
Number of other retired or separated participants entitled to future benefits 2019-01-01 176
Total of all active and inactive participants 2019-01-01 617
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 618
Number of participants with account balances 2019-01-01 618
2018: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2018 401k membership
Total participants, beginning-of-year 2018-01-01 684
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 559
Number of other retired or separated participants entitled to future benefits 2018-01-01 125
Total of all active and inactive participants 2018-01-01 684
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 685
Number of participants with account balances 2018-01-01 648
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2017 401k membership
Total participants, beginning-of-year 2017-01-01 642
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 684
Total of all active and inactive participants 2017-01-01 684
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 684
Number of participants with account balances 2017-01-01 684
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2016 401k membership
Total participants, beginning-of-year 2016-01-01 426
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 642
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 642
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 642
Number of participants with account balances 2016-01-01 642
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2015 401k membership
Total participants, beginning-of-year 2015-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 426
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 426
Number of participants with account balances 2015-01-01 426
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2022: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2022 401k membership
Total participants, beginning-of-year	2022-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	115
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	138
Total of all active and inactive participants	2022-01-01	253
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	253
Number of participants with account balances	2022-01-01	253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2021 401k membership
Total participants, beginning-of-year	2021-01-01	508
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	124
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	158
Total of all active and inactive participants	2021-01-01	282
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	4
Total participants	2021-01-01	286
Number of participants with account balances	2021-01-01	286
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2020 401k membership
Total participants, beginning-of-year	2020-01-01	618
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	193
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	314
Total of all active and inactive participants	2020-01-01	507
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	508
Number of participants with account balances	2020-01-01	508
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2019 401k membership
Total participants, beginning-of-year	2019-01-01	648
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	441
Number of other retired or separated participants entitled to future benefits	2019-01-01	176
Total of all active and inactive participants	2019-01-01	617
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	618
Number of participants with account balances	2019-01-01	618
2018: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2018 401k membership
Total participants, beginning-of-year	2018-01-01	684
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	559
Number of other retired or separated participants entitled to future benefits	2018-01-01	125
Total of all active and inactive participants	2018-01-01	684
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	685
Number of participants with account balances	2018-01-01	648
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2017 401k membership
Total participants, beginning-of-year	2017-01-01	642
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	684
Total of all active and inactive participants	2017-01-01	684
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	684
Number of participants with account balances	2017-01-01	684
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2016 401k membership
Total participants, beginning-of-year	2016-01-01	426
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	642
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	642
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	642
Number of participants with account balances	2016-01-01	642
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2015 401k membership
Total participants, beginning-of-year	2015-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	426
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	426
Number of participants with account balances	2015-01-01	426
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on MOLINA SALARY SAVINGS PLAN OF PUERTO RICO

Measure	Date	Value
2022 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-569,196
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,268,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,241,880
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$545,419
Value of total assets at end of year	2022-12-31	$4,633,734
Value of total assets at beginning of year	2022-12-31	$6,471,883
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$27,073
Total interest from all sources	2022-12-31	$3,533
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$128,926
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$128,926
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$299,702
Participant contributions at end of year	2022-12-31	$66,761
Participant contributions at beginning of year	2022-12-31	$83,905
Participant contributions at end of year	2022-12-31	$10,019
Participant contributions at beginning of year	2022-12-31	$10,983
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$179,420
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$11,612
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,838,149
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,633,734
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,471,883
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$1,004,919
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$6,189,214
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$3,533
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$3,544,849
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,247,074
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$234,105
Employer contributions (assets) at end of year	2022-12-31	$7,186
Employer contributions (assets) at beginning of year	2022-12-31	$8,361
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,241,880
Contract administrator fees	2022-12-31	$27,073
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	RODRIGUEZ-SANABRIA & CO, CPA'S, PSC
Accountancy firm EIN	2022-12-31	660757092
2021 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,666,595
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,057,157
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,035,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$771,779
Value of total assets at end of year	2021-12-31	$6,471,883
Value of total assets at beginning of year	2021-12-31	$5,862,445
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$21,928
Total interest from all sources	2021-12-31	$8,213
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$202,568
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$202,568
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$453,469
Participant contributions at end of year	2021-12-31	$83,905
Participant contributions at beginning of year	2021-12-31	$255,362
Participant contributions at end of year	2021-12-31	$10,983
Participant contributions at beginning of year	2021-12-31	$19,798
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$179,420
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$275,494
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$8,801
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$184,092
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$60,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$609,438
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,471,883
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$5,862,445
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$6,189,214
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,239,476
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$8,213
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$684,035
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$309,509
Employer contributions (assets) at end of year	2021-12-31	$8,361
Employer contributions (assets) at beginning of year	2021-12-31	$11,389
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$851,137
Contract administrator fees	2021-12-31	$21,928
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	RODRIGUEZ-SANABRIA & CO, CPA'S, PSC
Accountancy firm EIN	2021-12-31	660757092
2020 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,369,295
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,743,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,732,569
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,582,344
Value of total assets at end of year	2020-12-31	$5,862,445
Value of total assets at beginning of year	2020-12-31	$6,237,107
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$11,388
Total interest from all sources	2020-12-31	$19,680
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$100,877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$100,877
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$851,857
Participant contributions at end of year	2020-12-31	$255,362
Participant contributions at beginning of year	2020-12-31	$319,474
Participant contributions at end of year	2020-12-31	$19,798
Participant contributions at beginning of year	2020-12-31	$30,496
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$275,494
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$30,817
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$60,926
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$-1,282,430
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-374,662
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,862,445
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,237,107
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,239,476
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$5,863,557
Interest on participant loans	2020-12-31	$19,680
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,948,824
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$699,670
Employer contributions (assets) at end of year	2020-12-31	$11,389
Employer contributions (assets) at beginning of year	2020-12-31	$23,580
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$2,732,569
Contract administrator fees	2020-12-31	$11,388
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	CRUZ ALDECOA, PSC
Accountancy firm EIN	2020-12-31	660792071
2019 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$971,662
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$971,662
Total unrealized appreciation/depreciation of assets	2019-12-31	$971,662
Total unrealized appreciation/depreciation of assets	2019-12-31	$971,662
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$17,562
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$17,562
Total income from all sources (including contributions)	2019-12-31	$2,695,396
Total income from all sources (including contributions)	2019-12-31	$2,695,396
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$572,445
Total of all expenses incurred	2019-12-31	$572,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$555,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$555,261
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,723,734
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,723,734
Value of total assets at end of year	2019-12-31	$6,237,107
Value of total assets at end of year	2019-12-31	$6,237,107
Value of total assets at beginning of year	2019-12-31	$4,131,718
Value of total assets at beginning of year	2019-12-31	$4,131,718
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$17,184
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$17,184
Total interest from all sources	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$5,000,000
Value of fidelity bond cover	2019-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$907,545
Contributions received from participants	2019-12-31	$907,545
Participant contributions at end of year	2019-12-31	$319,474
Participant contributions at end of year	2019-12-31	$319,474
Participant contributions at beginning of year	2019-12-31	$200,008
Participant contributions at beginning of year	2019-12-31	$200,008
Participant contributions at end of year	2019-12-31	$30,496
Participant contributions at end of year	2019-12-31	$30,496
Participant contributions at beginning of year	2019-12-31	$32,953
Participant contributions at beginning of year	2019-12-31	$32,953
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$104,635
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$104,635
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$17,562
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$17,562
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,122,951
Value of net income/loss	2019-12-31	$2,122,951
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,237,107
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,237,107
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,114,156
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,114,156
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$5,863,557
Value of interest in pooled separate accounts at end of year	2019-12-31	$5,863,557
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,862,370
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,862,370
Interest earned on other investments	2019-12-31	$0
Interest earned on other investments	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$711,554
Contributions received in cash from employer	2019-12-31	$711,554
Employer contributions (assets) at end of year	2019-12-31	$23,580
Employer contributions (assets) at end of year	2019-12-31	$23,580
Employer contributions (assets) at beginning of year	2019-12-31	$36,387
Employer contributions (assets) at beginning of year	2019-12-31	$36,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$555,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$555,261
Contract administrator fees	2019-12-31	$17,184
Contract administrator fees	2019-12-31	$17,184
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CRUZ ALDECOA, PSC
Accountancy firm name	2019-12-31	CRUZ ALDECOA, PSC
Accountancy firm EIN	2019-12-31	660792071
Accountancy firm EIN	2019-12-31	660792071
2018 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$-253,306
Total unrealized appreciation/depreciation of assets	2018-12-31	$-253,306
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$17,563
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$1,757,409
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,077,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,056,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,999,867
Value of total assets at end of year	2018-12-31	$4,131,718
Value of total assets at beginning of year	2018-12-31	$4,434,484
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$20,999
Total interest from all sources	2018-12-31	$10,848
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$961,399
Participant contributions at end of year	2018-12-31	$200,008
Participant contributions at beginning of year	2018-12-31	$213,690
Participant contributions at end of year	2018-12-31	$32,953
Participant contributions at beginning of year	2018-12-31	$33,558
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$212,418
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$17,563
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-320,329
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,114,155
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,434,484
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$3,862,370
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$4,154,908
Interest earned on other investments	2018-12-31	$10,848
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$826,050
Employer contributions (assets) at end of year	2018-12-31	$36,387
Employer contributions (assets) at beginning of year	2018-12-31	$32,328
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,056,739
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$20,999
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	CRUZ ALDECOA
Accountancy firm EIN	2018-12-31	660792071
2017 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$478,477
Total unrealized appreciation/depreciation of assets	2017-12-31	$478,477
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$2,402,680
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$322,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$319,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,917,328
Value of total assets at end of year	2017-12-31	$4,434,484
Value of total assets at beginning of year	2017-12-31	$2,354,416
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,992
Total interest from all sources	2017-12-31	$6,875
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Assets. Real estate other than employer real property at end of year	2017-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$940,395
Participant contributions at end of year	2017-12-31	$213,690
Participant contributions at beginning of year	2017-12-31	$83,307
Participant contributions at end of year	2017-12-31	$33,558
Participant contributions at beginning of year	2017-12-31	$31,907
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$152,349
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$2,080,068
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,434,484
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,354,416
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Assets. partnership/joint venture interests at end of year	2017-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$4,154,908
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$2,211,465
Interest earned on other investments	2017-12-31	$6,875
Value of interest in master investment trust accounts at end of year	2017-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2017-12-31	$0
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2017-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-12-31	$0
Asset value of US Government securities at end of year	2017-12-31	$0
Asset value of US Government securities at beginning of year	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$824,584
Employer contributions (assets) at end of year	2017-12-31	$32,328
Employer contributions (assets) at beginning of year	2017-12-31	$27,737
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$319,620
Asset. Corporate debt instrument preferred debt at end of year	2017-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$0
Contract administrator fees	2017-12-31	$2,992
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CRUZ ALDECOA, PSC
Accountancy firm EIN	2017-12-31	660792071
2016 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$125,762
Total unrealized appreciation/depreciation of assets	2016-12-31	$125,762
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,937,391
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$145,949
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$145,339
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,810,835
Value of total assets at end of year	2016-12-31	$2,354,416
Value of total assets at beginning of year	2016-12-31	$562,974
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$610
Total interest from all sources	2016-12-31	$794
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$912,848
Participant contributions at end of year	2016-12-31	$83,307
Participant contributions at beginning of year	2016-12-31	$0
Participant contributions at end of year	2016-12-31	$31,907
Participant contributions at beginning of year	2016-12-31	$26,999
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$103,461
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,791,442
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,354,416
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$562,974
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Value of interest in pooled separate accounts at end of year	2016-12-31	$2,211,465
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$512,820
Interest on participant loans	2016-12-31	$794
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$794,526
Employer contributions (assets) at end of year	2016-12-31	$27,737
Employer contributions (assets) at beginning of year	2016-12-31	$23,155
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$145,339
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$610
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CRUZ ALDECOA, PSC
Accountancy firm EIN	2016-12-31	660792071
2015 : MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$615
Total unrealized appreciation/depreciation of assets	2015-12-31	$615
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$565,034
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,060
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,060
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$564,419
Value of total assets at end of year	2015-12-31	$562,974
Value of total assets at beginning of year	2015-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$0
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	No
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$282,555
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Participant contributions at end of year	2015-12-31	$26,999
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$47,986
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$562,974
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$562,974
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$0
Value of interest in pooled separate accounts at end of year	2015-12-31	$512,820
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$233,878
Employer contributions (assets) at end of year	2015-12-31	$23,155
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,060
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CRUZ ALDECOA, PSC
Accountancy firm EIN	2015-12-31	660792071

Form 5500 Responses for MOLINA SALARY SAVINGS PLAN OF PUERTO RICO

2022: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MOLINA SALARY SAVINGS PLAN OF PUERTO RICO 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

511936-P1

Policy instance

Insurance contract or identification number	511936-P1
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

511936-P1

Policy instance

Insurance contract or identification number	511936-P1
Number of Individuals Covered	26
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

119977

Policy instance

Insurance contract or identification number	119977
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

511936-P1

Policy instance

Insurance contract or identification number	511936-P1
Number of Individuals Covered	43
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

119977

Policy instance

Insurance contract or identification number	119977
Number of Individuals Covered	618
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

119977

Policy instance

Insurance contract or identification number	119977
Number of Individuals Covered	687
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

119977

Policy instance

Insurance contract or identification number	119977
Number of Individuals Covered	684
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

119977

Policy instance

Insurance contract or identification number	119977
Number of Individuals Covered	426
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

Potentially related plans

MOLINA SALARY SAVINGS PLAN OF PUERTO RICO [EIN = 134204626]

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See full terms and conditions

Company Name:	MOLINA HEALTHCARE OF PUERTO RICO
Employer identification number (EIN):	660817946
NAIC Classification:	524140

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2015-09-03
Company Identification Number:	20151525868