Employer
Atlantic Concrete Products, Inc.
8900 Old Route 13, Tullytown, PA 19007 · EIN 23-1706049 · Apr 1, 2023 to Mar 31, 2024
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 $4,864
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Gerber Life Insurance Company | — | — | Schedule A not provided |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Madison National Life Insurance Company | Brown & Brown Of Pennsylvania | 25 | $2,888 17.6% of $16,442 |
| Other | Madison National Life Insurance Company | North American Benefits Company | 25 | $1,110 6.8% of $16,442 |
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.
Visible subtotal $84,066
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pennsylvania | Broker | $24,900 | $336.49 |
| Luminare Health Benefits | Admin | $52,464 | $708.97 |
| Delta Dental Of Pennsylvania | Admin | $6,702 | $90.57 |