Form 5500 · Employee benefit plan · ARTESIA, NM
THIRTEEN TWENTY LLC
The filing calls this plan THIRTEEN TWENTY LLC WELFARE BENEFIT PLAN.
THIRTEEN TWENTY LLC of ARTESIA, NM spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is HUB INTERNATIONAL INS. SVCS., INC.. Coverage is written through BLUECROSS BLUESHIELD OF NEW MEXICO and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-5217039 · plan 501 · plan year 2024, filed Aug 15, 2025
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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: death benefits.
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.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF NEW MEXICO, covers 87 people.
Reported premium across the insured contracts is $714,764, with $36,538 in disclosed broker commissions — about 5.1% 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 INS. SVCS., INC. is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF NEW MEXICO, COLONIAL LIFE & ACCIDENT INSURANCE COMPANY and NATIONWIDE LIFE INSURANCE COMPANY. BLUECROSS BLUESHIELD OF NEW MEXICO writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEW MEXICO | Health, Dental | 87 | Jan 1, 2025 | $665,443 | $27,916 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Life, Disability | 37 | Jan 1, 2025 | $44,234 | $7,810 |
| NATIONWIDE LIFE INSURANCE COMPANY | Vision | 57 | Jan 1, 2025 | $5,087 | $812 |
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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