Employer
Associated Clinical Laboratories, Lp
1526 Peach Street, Erie, PA 16501 · EIN 25-1533746 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $38,554
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark New York | Usi Insurance Services (Ri) | 47 | $13,052 3.7% of $356,933 |
| Medical | Aetna Life Insurance Co. | Usi Insurance Services (Ri) | 185 | $5,000 0.2% of $2,445,569 |
| Vision | Vision Benefits Of America | — | 177 | Comp not disclosed Premium $10,970 |
| Life | Unitedhealthcare Insurance Company | Usi Insurance Services (Ri) | 285 | $20,256 12.3% of $165,282 |
| Accidental Death & Dismemberment | Federal Insurance Company | Insurance Management Company | 340 | $246 16.7% of $1,473 |
Schedule C
Additional compensation
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.