Employer
Bloomsburg Carpet Industries, Inc.
4999 Columbia Blvd, Bloomsburg, PA 17815 · EIN 23-2957330 · Oct 1, 2022 to Sep 30, 2023
Plan year 2022
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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 $4,591
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Geisinger Health Plan | Mcgriff Insurance Services Inc. | 221 | Comp not disclosed Premium $1,492,935 |
| Dental | United Concordia Life And Health Insurance Company | — | 221 | Comp not disclosed |
| Vision | Vision Benefits Of America | Mcgriff Insurance Services Inc. | 151 | $638 5.0% of $12,769 |
| Life | Companion Life Insurance Company | Insurance Specialties Inc | 171 | $3,953 18.5% of $21,396 |
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.
No Schedule C parties in this year.