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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Maria Banchs Plaza</PersonNm>
        <TitleTxt>Medical</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>124929</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Vanessa Cortes Torres</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>128803</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Jose L Torres Silva</PersonNm>
        <TitleTxt>Gynecologist</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>133573</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Ramiro Roman Diaz</PersonNm>
        <TitleTxt>Pediatrician</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>119920</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Gricel Emmanuelli Torres</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>110045</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Leonardo J Ramirez Mella</PersonNm>
        <TitleTxt>Md Internist</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>118656</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Jose V Hernandez Hernandez</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>114703</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Yadira S Rodriguez Vargas</PersonNm>
        <TitleTxt>Md Internist</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Julio E Melendez Hernandez</PersonNm>
        <TitleTxt>Gynecologist</TitleTxt>
        <AverageHoursPerWeekRt>37.5</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>111618</ReportableCompFromOrgAmt>
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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Joanne I Vargas Torres</PersonNm>
        <TitleTxt>Pharmacy Director</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>109099</ReportableCompFromOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Kelynette Feliciano Figueroa</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Diego J Alcala Ocasio</PersonNm>
        <TitleTxt>Pediatrician</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Gerardo Gonzalez De Jesus</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Maria E Gonzalez Marques</PersonNm>
        <TitleTxt>General Practitioner</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Miguel A Cintron Bermudez</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Lisandra Cordero Nieves</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Dra Ambar C Mirabal Ostolaza</PersonNm>
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      <ContractorCompensationGrp>
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          <BusinessName>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>PR</StateAbbreviationCd>
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      <ContractorCompensationGrp>
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          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>PR</StateAbbreviationCd>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>PR</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
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        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>PR</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>H E Development</PersonNm>
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        <ContractorAddress>
          <USAddress>
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            <CityNm>San Juan</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>13575665</GovernmentGrantsAmt>
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      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>13597127</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Premium Revenue - PR Health Reform</Desc>
        <BusinessCd>524114</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>43582978</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Net Patient Service Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>3977371</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Net Pharmacy Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>4127384</RelatedOrExemptFuncIncomeAmt>
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        <ExclusionAmt>0</ExclusionAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Wraparound Reimbursement</Desc>
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        <RelatedOrExemptFuncIncomeAmt>6638192</RelatedOrExemptFuncIncomeAmt>
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      <TotalOthProgramServiceRevGrp>
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      <GrantsToDomesticOrgsGrp>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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      <BenefitsToMembersGrp>
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      <CompCurrentOfcrDirectorsGrp>
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      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
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        <ManagementAndGeneralAmt>3724222</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>1041426</ProgramServicesAmt>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>1214430</ProgramServicesAmt>
        <ManagementAndGeneralAmt>314877</ManagementAndGeneralAmt>
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      </PayrollTaxesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>676144</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>68677</ManagementAndGeneralAmt>
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      <FeesForServicesLobbyingGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
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      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
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        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <ProgramServicesAmt>1064216</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1142047</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>9523</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6919</ManagementAndGeneralAmt>
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      </OfficeExpensesGrp>
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        <ProgramServicesAmt>103454</ProgramServicesAmt>
        <ManagementAndGeneralAmt>976483</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
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        <ExplanationTxt>Effective December 1, 2009 the Institution adopted the FASB ASC 740-10 (formerly FASB interpretation No. 48 Accounting for Uncertainty in Income Taxes) which clarifies the accounting for uncertainty in income taxes recognition in an organization's financial statements in accordance with FASB ASC 740. Under the provisions for this interpretation, the organization is required to evaluate their income tax positins each year to determine whether the organization's tax position is more likely than not to be sustained if examined by applicable taxes authority.</ExplanationTxt>
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        <PersonNm>Dra Pilar E Silva Melendez</PersonNm>
        <TitleTxt>Gynecologist</TitleTxt>
        <BaseCompensationFilingOrgAmt>154928</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>154928</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the Executive Director is determined and approved by the government Board. The compensations is established based on experience, qualifications and performance, in additions it is compared with the compensation of other executives in similar positions in Puerto Rico.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective November 1st, 2013 the Organization established an Executive Deferred Compensation Plan, a non-qualified deferred compensation plan covering eligible senior management as defined in the Plan Adoption Agreement. The Plan is designed and operates in accordance with regulations under the Puerto Rico Internal Revenue Code, as amended and is not subject to the provisions of the Employee Retirement Income Security Act of 1974 (ERISA).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Executive deferred compensation plan is accrued based on the institution's excess program income as stated in the adoption plan agreement.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000005" softwareId="18007995" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by personnel of tax department by the external audit firm from the accounting records, other tax information and date used to prepare the audited financial statement. Once it is prepared, the Form is submitted to the top management (including personnel of Finance Department with suitable knowledge and skills to review and evaluate the form) for review and discussion of doubts with audit's firm personnel. Once discussed and all doubts all cleared with the audit firm, the Executive Director present and discuss the form with the Governing Board for approval. Once approved by the Board the firm is electronically submitted to the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has a conflict of interest policy which is monitored by the top management and the Governing Board. An annual conflict of interest declaration is required by the members of the board as well as every employee of the Organization. Top management and the Governing Board monitor the conflict of interest policy by analyzing sensitive transactions and contractual information and by requiring employees to disclose their relationship with third parties. The policy is also enforced through seminars and conferences to officers and key personnel.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation of Directors and Officers are primarily determined by the Executive Director based on experience, qualifications, performance and by using comparable statistically data from job positions in Puerto Rico. Once the compensation is determined it is presented to the Governing Board for approval.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents such as the conflict of interest policy and audited financial statements might be available for public inspection at the administrative office of the Organization under the supervision of and Official of the Organization. The availability of such documents may depend on the purpose of requesting such information.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>