Employer
Bbs Grocery Outlet, Lp
569 Camargo Rd, Quarryville, PA 17566 · EIN 23-2505510 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 105
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 $15,791
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 62 | Comp not disclosed Premium $324,402 |
| Medical | Principal Life Insurance Company | Ap Benefit Advisors LLC | 105 | $3,489 10.3% of $33,842 |
| Medical | Principal Life Insurance Company | Gis Benefits Inc | 105 | $2,999 8.9% of $33,842 |
| Medical | Principal Life Insurance Company | Gis Benefits Inc DBA Boon Chapman | 105 | $99 0.3% of $33,842 |
| Medical | Principal Life Insurance Company | Ap Benefit Advisors LLC | 105 | $56 0.2% of $33,842 |
| AD&D | The Lincoln National Life Insurance Company | Ap Benefit Advisors LLC | 33 | $3,764 18.2% of $20,674 |
| AD&D | The Lincoln National Life Insurance Company | Gis Benefits Inc | 33 | $1,328 6.4% of $20,674 |
| AD&D | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 33 | $1,034 5.0% of $20,674 |
| Critical Illness | The Lincoln National Life Insurance Company | Ap Benefit Advisors LLC | 7 | $642 24.7% of $2,601 |
| Critical Illness | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 7 | $78 3.0% of $2,601 |
| Critical Illness | The Lincoln National Life Insurance Company | Gis Benefits Inc | 7 | $73 2.8% of $2,601 |
| Other | The Lincoln National Life Insurance Company | Ap Benefit Advisors LLC | 21 | $1,352 17.3% of $7,830 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 21 | $485 6.2% of $7,830 |
| Other | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 21 | $392 5.0% of $7,830 |
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 $69,928
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $60,580 | $576.95 |
| Assured Partners (Central Pa) | Broker | $26,712 | $254.40 |
| Capital Bluecross | Admin | $-17,364 | $-165.37 |