Form 5500 · Employee benefit plan · PENACOOK, NH
ROSS EXPRESS LLC
The filing calls this plan ROSS EXPRESS LLC HEALTHCARE 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 ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. and 1 other carrier. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 61-1867549 · plan 502 · plan year 2025, filed Nov 4, 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.
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 2 insured contracts covering health and vision; the largest, with ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC., covers 243 people.
Reported premium across the insured contracts is $2,918,594, with $66,642 in disclosed broker commissions — about 2.3% 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.
THE ROWLEY AGENCY LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. and MATTHEW THORNTON HEALTH PLAN, INC..
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | Health, Vision | 243 | Feb 1, 2025 | $2,268,640 | $49,487 |
| MATTHEW THORNTON HEALTH PLAN, INC. | Health | 69 | Feb 1, 2025 | $649,954 | $17,155 |
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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