Form 5500 · Employee benefit plan · PENACOOK, NH
ROSS EXPRESS LLC
The filing calls this plan PREPAID DENTAL CARE PLAN.
ROSS EXPRESS LLC of PENACOOK, NH files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is THE ROWLEY AGENCY LLC. Coverage is written through DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC.. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 61-1867549 · plan 501 · plan year 2025, filed Nov 4, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
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
The filing discloses a single insured line, dental, through DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC., covering 470 people.
Reported premium across the insured contracts is $145,397, with $5,007 in disclosed broker commissions — about 3.4% of premium.
The most recent policy period ended in January, and the plan year ends January 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | Dental | 470 | Feb 1, 2025 | $145,397 | $5,007 |
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.
Reported to OSHA
Reported to OSHA for 2025: 355 employees, 26 recordable cases, 474 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
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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