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Employer
Po Box 559, Route 61, Schuylkill Haven, PA 17972 · EIN 23-2817586 · Dec 1, 2024 to Nov 30, 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 $10,352
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Unimerica Insurance Company | — | — | Comp not disclosed Premium $2,690 |
| Stop-loss | Crum & Forster | — | — | Comp not disclosed Premium $25,673 |
| Medical | Highmark, Inc. | Lisa Marie Gehring | 28 | $8,424 3.2% of $263,115 |
| Dental | Delta Dental Of Pennsylvania | Patriot Growth Insurance Services | 34 | $1,034 10.0% of $10,338 |
| Vision | Vision Benefits Of America | Patriot (Power-Kunkle Group, Inc.) | 23 | $117 7.7% of $1,524 |
| Life | American United Life Insurance Company | Patriot (Power-Kunkle Group, Inc.) | 31 | $514 6.6% of $7,776 |
| Life | American United Life Insurance Company | Patriot Growth Ins Services | 31 | $263 3.4% of $7,776 |
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 $433
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $243 | $7.15 |
| Patriot (Power-Kunkle Group) | Broker | $227 | $6.68 |
| Capital Blue Cross | Admin | $-37 | $-1.09 |