Form 5500 · Employee benefit plan · ROSWELL, NM
HOLSUM, INC
HOLSUM, INC of ROSWELL, NM is a 99-participant mining and energy extraction employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is UNIVERSAL INSURANCE ADVISORS. Coverage is written through BLUE CROSS BLUE SHIELD and 5 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 85-0164944 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 6 insured contracts covering health, vision and life; the largest, with BLUE CROSS BLUE SHIELD, covers 9 people.
Reported premium across the insured contracts is $100,243, with $407 in disclosed broker commissions — about 0.4% of premium.
The health contract's policy period ended in November, while at least one ancillary line renews in March — the plan is on a split renewal cycle.
UNIVERSAL INSURANCE ADVISORS is the broker of record on 4 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing — BLUE CROSS BLUE SHIELD, COMPCARE HEALTH SERVICES INSURANCE CORPORATION (G0423), BLUE CROSS & BLUE SHIELD OF WISCONSIN (BCBSW)(G0422) and STANDARD INSURANCE COMPANY among them — with BLUE CROSS BLUE SHIELD writing the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY | Life | 101 | November | $2,221 | $266 |
| ANTHEM LIFE INSURANCE COMPANY (G1400) | Life | 101 | March | $1,124 | $141 |
| BLUE CROSS & BLUE SHIELD OF WISCONSIN (BCBSW)(G0422) | Health, Vision | 115 | November | $3,704 | $0 |
| BLUE CROSS BLUE SHIELD | Health | 9 | June | $87,591 | $0 |
| DEARBORN NATIONAL LIFE INSURANCE CO | Life | 4 | January | $866 | $0 |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (G0423) | Health | 115 | November | $4,737 | — |
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