Form 5500 · Employee benefit plan · LEWISVILLE, TX
ROVIN, INC.
The filing calls this plan ROVIN, INC. EMPLOYEE BENEFIT PLAN.
ROVIN, INC. of LEWISVILLE, TX is a small hospitality and food service employer whose insured group plan is on public record in its Form 5500 filing. Its broker of record is HENSLEY INSURANCE SOLUTIONS. Coverage is written through US BENEFITS INSURANCE SERVICES, LLC and 2 other carriers. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 75-1778305 · plan 501 · plan year 2026, filed Jul 8, 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.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 and stop-loss; the largest, with US BENEFITS INSURANCE SERVICES, LLC, covers 96 people.
The filing declares health, dental, vision, life and disability. Dental, vision, life and disability appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $800,142, with $45,319 in disclosed broker commissions — about 5.7% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| US BENEFITS INSURANCE SERVICES, LLC | Stop-loss | 96 | May 1, 2026 | $779,576 | $45,319 |
| CIGNA PPO | Health | — | May 1, 2026 | $20,473 | $0 |
| FIRST HEALTH PPO | Health | — | May 1, 2026 | $93 | $0 |
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.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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