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Employer
8031 Avonia Road, Fairview, PA 16415 · EIN 98-0200798 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $55,590
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pennsylvania | — | 1036 | Schedule A not provided |
| Dental | Delta Dental Of Pennsylvania | — | 1036 | Schedule A not provided |
| Vision | Vision Service Plan | Huntington Insurance Inc. | 574 | $2,558 2.9% of $89,662 |
| Life | Life Insurance Company Of North America | Huntington Insurance Inc. | 805 | $11,035 4.6% of $237,487 |
| AD&D | Life Insurance Company Of North America | Huntington Insurance Inc. | 805 | $1,235 4.7% of $26,515 |
| Other | New York Life Insurance Company Of North America | Huntington Insurance Inc. | 805 | $8,451 4.6% of $182,349 |
| Other | Life Insurance Company Of North America | Huntington Insurance Inc. | 805 | $13,992 4.6% of $301,587 |
| Statutory Disability | New York Life Group Insurance Company Of Ny | Huntington Insurance Inc | 1 | $497 15.0% of $3,311 |
| Accident | Trustmark Insurance Company | Brandon Penko | 40 | $782 9.4% of $8,306 |
| Accident | Trustmark Insurance Company | Huntington Insurance Inc | 40 | $436 5.2% of $8,306 |
| Critical Illness | Trustmark Insurance Company | Brandon Penko | 31 | $2,289 12.9% of $17,746 |
| Critical Illness | Trustmark Insurance Company | Huntington Insurance Inc | 31 | $1,297 7.3% of $17,746 |
| Universal Life | Trustmark Insurance Company | Brandon Penko | 12 | $1,710 13.2% of $13,003 |
| Universal Life | Trustmark Insurance Company | Huntington Insurance | 12 | $945 7.3% of $13,003 |
| Hospital Indemnity | Trustmark Insurance Company | Brandon Penko | 22 | $895 9.7% of $9,255 |
| Hospital Indemnity | Trustmark Insurance Company | Huntington Insurance | 22 | $509 5.5% of $9,255 |
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.