Employer
2nd Ave Value Stores
4136 Blanche Road, Bensalem, PA 19020 · EIN 20-3199840 · Jul 1, 2021 to Jun 30, 2022
Plan year 2021
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $13,520
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Metropolitan Life Insurance Company | Employee Family Protection Inc | 127 | $3,815 23.6% of $16,160 |
| Medical | Metropolitan Life Insurance Company | Johnson, Kendall & Johnson Inc | 127 | $760 4.7% of $16,160 |
| Dental | The Guardian Life Insurance Company Of America | Johnson, Kendall & Johnson Inc | 219 | $7,635 7.9% of $97,209 |
| Vision | Vision Service Plan | Johnson, Kendall & Johnson Inc | 145 | $1,310 4.8% of $27,253 |
Schedule C
Additional compensation
Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.
No Schedule C parties in this year.