Employer

Baker Tilly Virchow Krause, LLP

1200 Abington Executive Park, Clarks Summit, PA 18411 · EIN 39-0859910 · Jan 1, 2020 to Dec 31, 2020

Plan year 2020

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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 $136,983

Coverage	Carrier	Broker	Lives	Direct comp
Medical	Group Health Cooperative Of South Central Wisconsin	Lockton Companies, LLC	158	$39,734 4.8% of $823,505
Medical	Quartz Health Benefit Plans Corporation	—	225	Comp not disclosed Premium $1,377,871
Medical	Dean Health Plan	Lockton Companies, LLC	309	$20,934 1.3% of $1,562,461
Dental	Delta Dental Of Wisconsin	—	2912	Comp not disclosed Premium $2,052,915
Vision	Wyssta Insurance Company Inc	—	2665	Comp not disclosed Premium $34,350
Life	Reliance Standard Life Insurance Company	Lockton Companies, LLC	3680	$5,000 0.9% of $574,951
Life	Reliance Standard Life Insurance Company	Lockton Companies, LLC	825	$29,271 10.7% of $273,820
Life	Reliance Standard Life Insurance Company	Aon Consulting, Inc.	825	$14,742 5.4% of $273,820
Medical Benefits Abroad	Cigna Health And Life Insurance Company	Lockton Companies, LLC	1	$1,745 10.0% of $17,450
Accidental Death & Dismemberment	Reliance Standard Life Insurance Company	Lockton Companies, LLC	1360	$3,671 10.6% of $34,649
Accidental Death & Dismemberment	Reliance Standard Life Insurance Company	Aon Consulting, Inc.	1360	$1,882 5.4% of $34,649
Critical Illness	Reliance Standard Life Insurance Company	Lockton Companies, LLC	353	$10,017 14.3% of $69,875
Critical Illness	Reliance Standard Life Insurance Company	Aon Consulting, Inc.	353	$4,987 7.1% of $69,875
Other	Reliance Standard Life Insurance Company	Lockton Companies, LLC	3684	$5,000 0.8% of $661,179

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.

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