Roxul USA Inc.
Overview
Roxul USA Inc. sponsors a self-funded health plan that covered 710 participants in plan year 2025, about the same as the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, vision, short-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 710 · prior year 702
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Roxul USA Employee Welfare Benefits Plan, plan 513 (710 participants)
- Broker compensation
- $122K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Prudential Insurance Company of America | Life, Long-term disability | 739 | $559K | $66K |
| Reliastar Life Insurance Company | Critical Illness, Accident | 745 | $229K | $53K |
| Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co. | Vision | 1,239 | $49K | $3K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 710 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2025
- Plan sponsor
- Roxul USA Inc.
- Sponsor EIN
- 99-0378111
- Plan number
- 513
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 99-0378111 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Roxul USA Retirement and Savings Plan
- Type
- 401(k) plan
- Participants
- 1,038
About this data
Source: Roxul USA Inc.'s Form 5500 filing for plan year 2025 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with Roxul USA Inc..