Form 5500 · Employee benefit plan · MESA, AZ
MESA FULLY FORMED, LLC.
MESA FULLY FORMED, LLC.'s employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is MJ INSURANCE. Coverage is written through BLUE CROSS BLUE SHIELD OF ARIZONA and 2 other carriers. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-1260137 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA | Health, Dental | 142 | February | $46,243 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 191 | February | $4,750 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Vision | 133 | February | $1,312 |
Questions
Who is MESA FULLY FORMED, LLC.'s benefits broker?
Per its most recent Form 5500 Schedule A, MESA FULLY FORMED, LLC.'s broker of record is MJ INSURANCE.
What insurance carrier does MESA FULLY FORMED, LLC. use?
MESA FULLY FORMED, LLC.'s benefit plan is written through BLUE CROSS BLUE SHIELD OF ARIZONA, among 3 disclosed carriers.
When does MESA FULLY FORMED, LLC.'s group plan renew?
The most recent Schedule A policy period for MESA FULLY FORMED, LLC. ended in February. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from MESA FULLY FORMED, LLC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.