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Employer
104 Commerce Blvd., Lawrence, PA 15055 · EIN 25-1369567 · Sep 1, 2024 to Aug 31, 2025
Plan year 2024
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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 $34,610
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | — | 308 | Comp not disclosed Premium $1,912,832 |
| Dental | United Concordia Insurance Company | Henderson Brothers Inc. | 306 | $7,753 9.4% of $82,762 |
| Vision | Vision Benefits Of America | Henderson Brothers Inc. | 156 | $1,490 10.0% of $14,899 |
| Life | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 107 | $5,311 7.0% of $76,333 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 107 | $4,036 5.3% of $76,333 |
| Life | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 267 | $875 5.7% of $15,280 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 267 | $622 4.1% of $15,280 |
| Other | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 122 | $1,609 8.7% of $18,590 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 122 | $1,045 5.6% of $18,590 |
| Other | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 122 | $2,928 5.0% of $58,145 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 122 | $1,981 3.4% of $58,145 |
| Other | Highmark, Inc. | — | 208 | Comp not disclosed Premium $429,249 |
| Critical Illness | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 37 | $2,807 14.9% of $18,829 |
| Critical Illness | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 37 | $1,776 9.4% of $18,829 |
| Accident | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 45 | $1,159 14.9% of $7,758 |
| Accident | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 45 | $726 9.4% of $7,758 |
| Hospital Indemnity | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 11 | $297 14.3% of $2,083 |
| Hospital Indemnity | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 11 | $195 9.4% of $2,083 |
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.
No Schedule C parties in this year.