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Employer
2175 Bumble Bee Hollow Rd, Mechanicsburg, PA 17055 · EIN 25-1215682 · Jan 1, 2025 to Dec 31, 2025
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 $9,106
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Crum & Forster | — | 43 | Comp not disclosed Premium $245,685 |
| Life | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 59 | $2,034 14.7% of $13,791 |
| Life | United Of Omaha Life Insurance Company | Onedigital Premier Services | 59 | $690 5.0% of $13,791 |
| Other | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 59 | $2,637 19.7% of $13,394 |
| Other | United Of Omaha Life Insurance Company | Onedigital Premier Services | 59 | $670 5.0% of $13,394 |
| Other | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 59 | $2,294 14.7% of $15,615 |
| Other | United Of Omaha Life Insurance Company | Onedigital Premier Services | 59 | $781 5.0% of $15,615 |
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 $53,403
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $48,173 | $816.49 |
| Onedigital (Philadelphia) | Broker | $18,305 | $310.25 |
| Capital Bluecross | Admin | $-13,075 | $-221.61 |