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Employer
1800 Pennsylvania Ave. West, Warren, PA 16365 · EIN 25-0928077 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $63,730
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Granular Insurance Company | Strategic Benefit Resources | 263 | $36,433 7.0% of $520,468 |
| Dental | United Concordia Insurance Company | — | 279 | Comp not disclosed Premium $143,903 |
| Vision | Vision Benefits Of America | Stalwart Group Benefits LLC | 198 | $985 3.6% of $27,660 |
| Vision | Vision Benefits Of America | Leavitt Northeast Insurance, Inc. | 198 | $962 3.5% of $27,660 |
| Vision | Vision Benefits Of America | Manufacturer & Business Association | 198 | $548 2.0% of $27,660 |
| Life | United Of Omaha Life Insurance Company | Stalwart Insurance LLC | 288 | $1,418 6.7% of $21,296 |
| Life | United Of Omaha Life Insurance Company | Lr Webber | 288 | $712 3.3% of $21,296 |
| Life | Colonial Life & Accident Insurance Company | David E Hauck | 96 | $5,069 4.6% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | Arick Martin | 96 | $3,060 2.8% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | Timothy J Slater | 96 | $1,454 1.3% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | Usi Insurance Services (Ri) | 96 | $1,418 1.3% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | Stalwart Insurance LLC | 96 | $1,140 1.0% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | Lr Webber | 96 | $551 0.5% of $110,978 |
| Life | Colonial Life & Accident Insurance Company | William E Good | 96 | $9 0.0% of $110,978 |
| Other | United Of Omaha Life Insurance Company | Stalwart Insurance LLC | 275 | $5,294 3.4% of $156,408 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 275 | $520 0.3% of $156,408 |
| Other | United Of Omaha Life Insurance Company | Stalwart Insurance LLC | 288 | $3,440 8.0% of $43,141 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 288 | $717 1.7% of $43,141 |
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.