Employer
Bank Of Bird-In-Hand
309 North Ronks Road, Bird In Hand, PA 17505 · EIN 32-0412177 · Oct 1, 2024 to Sep 30, 2025
Plan year 2024
Covered lives: 276
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 $41,226
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | Integrity Services And Solutions | 276 | $17,272 8.0% of $215,690 |
| Medical | Principal Life Insurance Company | Emerson Rogers LLC | 276 | $10,309 4.8% of $215,690 |
| Disability | Provident Life And Accident Insurance Company | Management Compensation Group | 21 | $11,731 43.0% of $27,257 |
| Disability | Provident Life And Accident Insurance Company | Nfp Insurance Services Inc | 21 | $1,892 6.9% of $27,257 |
| Disability | Provident Life And Accident Insurance Company | Management Compensation Group | 21 | $22 0.1% of $27,257 |
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 $142,238
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Integrity Services And Solutions | Broker | $65,056 | $235.71 |
| Capital Advantage Assurance Company | Contract Administrator | $77,182 | $279.64 |