Form 5500 · Employee benefit plan · ALBUQUERQUE, NM
BLAKES LOTABURGER, LLC
The filing calls this plan BLAKES' LOTABURGER, LLC WELFARE BENEFIT PLAN.
BLAKES LOTABURGER, LLC of ALBUQUERQUE, NM files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is BROWN & BROWN INSURANCE SERVICE INC. Coverage is written through BLUECROSS BLUESHIELD OF NEW MEXICO and 1 other carrier. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 84-1619686 · plan 501 · plan year 2026, filed Jul 6, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
The filing carries code 4S: this plan is filing again after previously being exempt.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF NEW MEXICO, covers 164 people.
Reported premium across the insured contracts is $1,544,236, with $68,303 in disclosed broker commissions — about 4.4% of premium.
The most recent policy period ended in January, and the plan year ends January 31. Group contracts typically renew on that annual cycle.
BROWN & BROWN INSURANCE SERVICE INC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: BLUECROSS BLUESHIELD OF NEW MEXICO and PRINCIPAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEW MEXICO | Health | 164 | Feb 1, 2026 | $1,462,322 | $58,486 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental, Vision, Life, Disability | 134 | Feb 1, 2026 | $81,914 | $9,817 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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