Form 5500 · Employee benefit plan · SAN FELIPE PUEBLO, NM
SAN FELIPE PUEBLO ENTERPRISES
SAN FELIPE PUEBLO ENTERPRISES of SAN FELIPE PUEBLO, NM is a 378-participant arts, entertainment and recreation employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is HUB INTERNATIONAL INSURANCE SVCS. Coverage is written through BLUECROSS BLUESHIELD OF NEW MEXICO and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 85-0210848 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision, life, disability and stop-loss.
The medical plan carries stop-loss coverage, which usually signals a self-funded health plan with insured protection against large claims.
Reported premium across the insured contracts is $732,206, with $27,759 in disclosed broker commissions — about 3.8% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL INSURANCE SVCS is the broker of record on 3 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SYMETRA LIFE INSURANCE COMPANY | Life, Disability | 460 | December | $256,658 | $20,085 |
| DELTA DENTAL OF NEW MEXICO | Dental | 442 | December | $114,974 | $5,038 |
| VISION SERVICE PLAN | Vision | 288 | December | $31,292 | $1,340 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 378 | December | $13,685 | $1,296 |
| BLUECROSS BLUESHIELD OF NEW MEXICO | Health, Stop-loss | 0 | December | $315,597 | $0 |
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