Employer
A.D. Moyer Lumber, Inc.
1200 East Philadelphia Avenue, Gilbertsville, PA 19525 · EIN 23-1549545 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company | — | 64 | Comp not disclosed Premium $565,207 |
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.
Visible subtotal $68,824
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Tompkins Insurance | Broker | $28,152 | $351.90 |
| The Benecon Group | Broker | $20,811 | $260.14 |
| Revivehealth, Inc. | Other | $10,192 | $127.40 |
| Independence Administrators (Ia) | Carrier | $9,669 | $120.86 |