Employer
Blue Cloud Pediatric Surgery Centers, LLC
182 Industrial Road, Glen Rock, PA 17327 · EIN 81-2751795 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
View
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 $81,633
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | Psa Insurance & Financial Inc | 296 | $31,464 2.5% of $1,262,100 |
| Medical | Capital Advantage Assurance Company | Psa Financial | 296 | $14,736 1.2% of $1,262,100 |
| Medical | Principal Life Insurance Company | Psa Insurance & Financial Partners | 302 | $35,433 10.0% of $353,730 |
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.