Form 5500 · Employee benefit plan · MERCEDES, TX
WESTERN LEATHER GOODS, INC.
The filing calls this plan WESTERN LEATHER GOODS, INC. MEDICAL AND DENTAL PLAN.
WESTERN LEATHER GOODS, INC. of MERCEDES, TX is a 127-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is SHEPARD & WALTON LIFINSUR AGNCY INC. Coverage is written through BLUECROSS BLUESHIELD OF TEXAS. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 74-1619043 · plan 501 · plan year 2025, filed May 22, 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
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 1 insured contract covering health and dental; the largest, with BLUECROSS BLUESHIELD OF TEXAS, covers 143 people.
Reported premium across the insured contracts is $525,632, with $43,417 in disclosed broker commissions — about 8.3% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TEXAS | Health, Dental | 143 | Nov 1, 2025 | $525,632 | $43,417 |
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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