Loading employer…
Employer
9927 Kistler Valley Road, Kempton, PA 19529 · EIN 26-1588079 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $8,160
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $22,354 |
| Medical | Capital Advantage Assurance Company | Patriot (Power-Kunkle Group, Inc.) | 23 | $7,499 4.3% of $173,212 |
| Dental | United Concordia Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 8 | $52 2.0% of $2,623 |
| Dental + Vision | Capital Advantage Assurance Company | Patriot (Power-Kunkle Group, Inc.) | 23 | $41 2.2% of $1,837 |
| Life | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 25 | $95 14.8% of $643 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 25 | $12 1.9% of $643 |
| Life | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 25 | $11 1.7% of $643 |
| Other | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 25 | $363 14.7% of $2,466 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 25 | $46 1.9% of $2,466 |
| Other | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 25 | $41 1.7% of $2,466 |
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 $2,595
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $1,893 | $75.72 |
| Patriot (Power-Kunkle Group, Inc.) | Broker | $378 | $15.12 |
| Capital Bluecross | Admin | $324 | $12.96 |