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Employer
P.O. Box 435, Emigsville, PA 17318 · EIN 23-3009384 · Mar 1, 2025 to Feb 28, 2026
Plan year 2025
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Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $19,424
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | National Vision Administrators, LLC | Mcconkey Benefits & Financial Servi | 131 | $676 10.0% of $6,757 |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Supplemental | Aflac | Mcconkey Benefits & Financial Servi | 20 | $650 4.9% of $13,265 |
| Supplemental | Aflac | C A Lupp Inc | 20 | $473 3.6% of $13,265 |
| Supplemental | Aflac | Ryan Barnes | 20 | $193 1.5% of $13,265 |
| Supplemental | Aflac | Anthony S Almodovar | 20 | $119 0.9% of $13,265 |
| Supplemental | Aflac | Nicholas Mason Starr | 20 | $65 0.5% of $13,265 |
| Supplemental | Aflac | Shelley S Gwin | 20 | $48 0.4% of $13,265 |
| Supplemental | Aflac | Jeffrey Charles Chubb | 20 | $23 0.2% of $13,265 |
| Supplemental | Aflac | Elizabeth F Bohlender | 20 | $20 0.2% of $13,265 |
| Supplemental | Aflac | Michelle Kelly | 20 | $20 0.2% of $13,265 |
| Supplemental | Aflac | Justin P Abraham | 20 | $9 0.1% of $13,265 |
| Supplemental | Aflac | Matthew G Berger | 20 | $7 0.1% of $13,265 |
| Supplemental | Aflac | Ryan K Goldberg | 20 | $1 0.0% of $13,265 |
| Supplemental | Aflac | Angela Umosella | 20 | $1 0.0% of $13,265 |
| Supplemental | Aflac | Darren Dwayne Riddle | 20 | $1 0.0% of $13,265 |
| Stop-loss | Avalon Insurance Company | — | 81 | Comp not disclosed Premium $435,300 |
Schedule C
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 $25,007
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| United Concordia Companies | Admin | $9,447 | $72.11 |
| Mcconkey Benefits & Financial Serv | Broker | $27,724 | $342.27 |
| The Benecon Group, LLC | Broker | $956 | $11.80 |
| Benefit Mall | Admin | $5,954 | $73.51 |
| Capital Bluecross | Admin | $-19,074 | $-235.48 |