Form 5500 · Employee benefit plan · IRVING, TX
RS WATER HOLDINGS, LLC
Public Form 5500 records show how RS WATER HOLDINGS, LLC of IRVING, TX, a administrative and support services employer, structures its employee benefits. Its broker of record is INSURICA INSURANCE SERVICES, LLC. Coverage is written through BLUECROSS BLUESHIELD OF TEXAS. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-5443411 · plan 501 · plan year 2025, filed Feb 26, 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.
The filing carries code 4S: this plan is filing again after previously being exempt.
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 158 people.
Reported premium across the insured contracts is $1,149,040, with $42,138 in disclosed broker commissions — about 3.7% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
At 78 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TEXAS | Health, Dental | 158 | Oct 1, 2025 | $1,149,040 | $42,138 |
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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