Form 5500 · Employee benefit plan · PURCELL, OK
BLUEFIN WATER SOLUTIONS, LLC
The filing calls this plan BLUEFIN WATER SOLUTIONS, LLC EMPLOYEE BENEFITS PLAN.
Public Form 5500 records show how BLUEFIN WATER SOLUTIONS, LLC of PURCELL, OK, a retail employer, structures its employee benefits. Its broker of record is BLEUCHIP SOLUTIONS LLC. Coverage is written through BLUECROSS BLUESHIELD OF OKLAHOMA and 2 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 81-4317257 · plan 501 · plan year 2025, filed Jun 24, 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.
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 4 insured contracts covering health, dental, vision and life; the largest, with BLUECROSS BLUESHIELD OF OKLAHOMA, covers 192 people.
Reported premium across the insured contracts is $1,181,004, with $66,931 in disclosed broker commissions — about 5.7% of premium.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
BLEUCHIP SOLUTIONS LLC is the broker of record on all 4 contracts.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF OKLAHOMA, STARMOUNT LIFE INSURANCE COMPANY and UNUM LIFE INSURANCE COMPANY OF AMERICA. BLUECROSS BLUESHIELD OF OKLAHOMA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF OKLAHOMA | Health | 192 | Nov 1, 2025 | $1,052,941 | $52,697 |
| STARMOUNT LIFE INSURANCE COMPANY | Dental, Vision | 139 | Nov 1, 2025 | $76,870 | $7,979 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 127 | Nov 1, 2025 | $27,473 | $4,121 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 354 | Nov 1, 2025 | $23,720 | $2,134 |
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.
How this plan compares
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