Employer
Ainsworth, Inc.
203 Lynndale Court, Mechanicsburg, PA 17050 · EIN 04-3720368 · Dec 1, 2023 to Nov 30, 2024
Plan year 2023
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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 $2,852
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 16 | Comp not disclosed Premium $50,803 |
| Stop-loss | Avalon Insurance Company | — | 21 | Comp not disclosed Premium $68,265 |
| Dental | Sun Life Assurance Company Of Canada | — | — | Schedule A not provided |
| Life | Equitable Financial Life Insurance Company Of America | Gunn Mowery, LLC | 37 | $2,852 13.9% of $20,561 |
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 $13,224
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gunn-Mowery, LLC | Broker | $6,468 | $174.81 |
| The Benecon Group, LLC | Broker | $4,375 | $118.24 |
| Capital Blue Cross | Admin | $1,386 | $37.46 |
| ConnectCare3 | Patient Advocate | $982 | $26.54 |
| Young, Oakes, Brown & Co | Accounting | $13 | $0.35 |