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Employer
435 Devon Park Drive, Wayne, PA 19087 · EIN 26-2388225 · Jun 1, 2020 to May 31, 2021
Plan year 2020
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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 $30,062
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Aetna Life Insurance Co. | Kistler Tiffany Benefits Co | 210 | $5,760 0.4% of $1,601,904 |
| Dental | Delta Dental Of Pennsylvania | Patriot (Power-Kunkle Group, Inc.) | 200 | $7,235 10.9% of $66,213 |
| Vision | Vision Service Plan | Patriot (Power-Kunkle Group, Inc.) | 84 | $379 10.0% of $3,780 |
| Life | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 99 | $5,615 15.6% of $35,993 |
| AD&D | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 28 | $3,633 15.6% of $23,318 |
| Other | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 66 | $2,225 15.7% of $14,216 |
| Other | United Of Omaha Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 52 | $5,215 15.7% of $33,268 |
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 $11,428
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Power Kunkle Group Inc. | Broker | $5,989 | $28.52 |
| Power Kunkle Group Inc. | Broker | $5,439 | $25.90 |