Loading employer…
Employer
4713 Old Gettysburg Rd., Mechanicsburg, PA 17055 · EIN 23-1730931 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $4,462
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 61 | Comp not disclosed Premium $459,146 |
| Dental | Delta Dental Of Pennsylvania | Mpb Risk Services, LLC | 50 | $2,750 10.0% of $27,500 |
| Vision | Capital Advantage Assurance Company | — | 109 | Comp not disclosed Premium $5,244 |
| Life | Reliance Standard Life Insurance Company | Mpb Risk Services, LLC | 11 | $22 13.8% of $160 |
| Life | Reliance Standard Life Insurance Company | Gis Benefits, Inc. | 11 | $10 6.3% of $160 |
| Life | Reliance Standard Life Insurance Company | Pci Insurance Agency | 11 | $2 1.3% of $160 |
| AD&D | Reliance Standard Life Insurance Company | Mpb Risk Services, LLC | 2 | $12 14.0% of $86 |
| AD&D | Reliance Standard Life Insurance Company | Gis Benefits, Inc. | 2 | $5 5.8% of $86 |
| AD&D | Reliance Standard Life Insurance Company | Pci Insurance Agency | 2 | $1 1.2% of $86 |
| Dependent And Supplemental Life | Reliance Standard Life Insurance Company | Mpb Risk Services, LLC | 1 | $210 13.7% of $1,528 |
| Dependent And Supplemental Life | Reliance Standard Life Insurance Company | Gis Benefits, Inc. | 1 | $88 5.8% of $1,528 |
| Dependent And Supplemental Life | Reliance Standard Life Insurance Company | Pci Insurance Agency | 1 | $19 1.2% of $1,528 |
| Other | Reliance Standard Life Insurance Company | Mpb Risk Services, LLC | 30 | $535 13.4% of $3,984 |
| Other | Reliance Standard Life Insurance Company | Gis Benefits | 30 | $233 5.8% of $3,984 |
| Other | Reliance Standard Life Insurance Company | Pci Insurance Agency | 30 | $63 1.6% of $3,984 |
| Other | Reliance Standard Life Insurance Company | Mbp Risk Services, LLC DBA Mpb Insu | 12 | $326 13.5% of $2,414 |
| Other | Reliance Standard Life Insurance Company | Gis Benefits, Inc. | 12 | $150 6.2% of $2,414 |
| Other | Reliance Standard Life Insurance Company | Pci Insurance Agency | 12 | $36 1.5% of $2,414 |
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.
Visible subtotal $28,974
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Mpb Risk Services, LLC | Broker | $19,008 | $174.39 |
| The Benecon Group | Broker | $14,084 | $129.21 |
| Connectcare 3 | Patient Advocate | $3,886 | $35.65 |
| Capital Blue Cross | Admin | $-8,004 | $-73.43 |