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Employer
621 Hunt Valley Circle, New Kensington, PA 15068 · EIN 26-0792273 · Jun 1, 2021 to May 31, 2022
Plan year 2021
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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 $12,774
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 135 | Comp not disclosed Premium $340,137 |
| Dental | Highmark Inc. | Henderson Brothers Inc. | 108 | $4,431 11.7% of $37,740 |
| Vision | Vision Benefits Of America | Henderson Brothers Inc. | 169 | $326 3.5% of $9,445 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 256 | $1,879 7.0% of $27,014 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 61 | $2,996 10.0% of $29,957 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 141 | $1,322 10.0% of $13,222 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 182 | $1,820 4.8% of $37,958 |
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 $50,815
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $20,354 | $79.51 |
| Henderson Brothers, Inc. | Broker | Comp not disclosed | — |
| Highmark, Inc. | Admin | $25,241 | $98.60 |
| Connectcare 3 | Patient Advocate | $5,220 | $20.39 |