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Employer
613 Baltimore Drive, Suite 300, Wilkes-Barre, PA 18702 · EIN 23-2490312 · Feb 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $78,884
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Thomas Groves | 139 | $28,800 2.5% of $1,171,799 |
| Medical | Highmark Inc. | The Equinox Agency LLC | 139 | $24,200 2.1% of $1,171,799 |
| Dental | The Guardian Life Insurance Company Of America | James R Nelligan & Associates | 157 | $12,129 12.9% of $94,112 |
| Vision | Vision Benefits Of America | Equinox Benefits Consulting | 156 | $522 2.6% of $19,822 |
| Life | Unum Life Insurance Company Of America | The Equinox Agency LLC | 153 | $8,635 13.3% of $65,049 |
| Life | Unum Life Insurance Company Of America | James R Nelligan & Associates | 153 | $3,584 5.5% of $65,049 |
| AD&D | Unum Life Insurance Company Of America | The Equinox Agency LLC | 23 | $635 10.0% of $6,351 |
| AD&D | Unum Life Insurance Company Of America | James R Nelligan & Associates | 23 | $318 5.0% of $6,351 |
| Accident, Critical Illness | American Heritage Life Insurance Company | Gettysburg Benefits Admin. Inc | 2 | $38 6.0% of $633 |
| Accident, Critical Illness | American Heritage Life Insurance Company | Creative Benefits, Inc | 2 | $23 3.6% of $633 |
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.