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Employer
1611 Pond Road, Allentown, PA 18106 · EIN 23-2545253 · 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 $2,463
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 96 | Comp not disclosed Premium $304,269 |
| Vision | Eyemed Vision Care | Bsi Corporate Benefits, Inc. | 195 | $1,225 9.2% of $13,296 |
| Vision | Eyemed Vision Care | Bsi Corporate Benefits, Inc. | 195 | $1,225 9.2% of $13,296 |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | New York Life Group Insurance Company Of New York | — | — | Schedule A not provided |
| Telemedicine | Healthiest You | — | — | Schedule A not provided |
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 $265,856
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $67,423 | $345.76 |
| Bsi Corporate Benefits, LLC | Broker | $52,529 | $269.38 |
| Innovu | Broker | $5,882 | $30.16 |
| Highmark, Inc. | Admin | $116,568 | $597.78 |
| Hy Holdings Inc | Other | $13,253 | $67.96 |
| Proact | Admin | $5,288 | $27.12 |
| United Concordia Companies, Inc. | Admin | $4,913 | $25.19 |