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Employer
8 W Market St, Wilkes-Barre, PA 18701 · EIN 23-2034089 · Aug 1, 2024 to Jul 31, 2025
Plan year 2024
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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 $65,894
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Usi Insurance Services (Ri) | 158 | $51,609 4.0% of $1,294,374 |
| Medical | Standard Insurance Company | Usi Insurance Services (Ri) | 26 | $1,386 14.3% of $9,665 |
| Medical | Standard Insurance Company | Simkiss & Block | 26 | $905 9.4% of $9,665 |
| Dental | The Guardian Life Insurance Company Of America | Usi Insurance Services (Ri) | 73 | $4,982 8.4% of $59,176 |
| Vision | Vision Service Plan | Usi Insurance Services (Ri) | 67 | $849 6.6% of $12,789 |
| Life | Standard Insurance Company | Usi Insurance Services (Ri) | 90 | $1,390 16.7% of $8,331 |
| Life | American Heritage Life Insurance Company | Usi Ins Services LLC | 12 | $83 1.3% of $6,627 |
| Life | American Heritage Life Insurance Company | Kulikauskas Jane | 12 | $33 0.5% of $6,627 |
| Life | American Heritage Life Insurance Company | Wiesmore Gregory | 12 | $33 0.5% of $6,627 |
| Life | American Heritage Life Insurance Company | Peterson Douglas C | 12 | $33 0.5% of $6,627 |
| Other | Standard Insurance Company | Usi Insurance Services (Ri) | 30 | $1,177 17.1% of $6,872 |
| Other | Standard Insurance Company | Usi Insurance Services (Ri) | 90 | $3,414 18.0% of $19,000 |
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.