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Employer
P.O. Box 10019, 1001 Clairton Blvd., Pleasant Hills, PA 15236 · EIN 25-1432920 · Jul 1, 2024 to Jun 30, 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 $130,528
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | Tracey & Associates, LLC | 322 | $77,440 3.3% of $2,354,503 |
| Medical | American Fidelity Assurance Company | Pennsylvania Auto Assoc Ins Agy Inc | 7 | $994 7.5% of $13,199 |
| Medical | American Fidelity Assurance Company | American Fidelity Assurance Co. | 7 | $351 2.7% of $13,199 |
| Medical | American Fidelity Assurance Company | American Fidelity Assurance Co. | 130 | $9,571 3.5% of $273,428 |
| Medical | American Fidelity Assurance Company | Paa Services, Inc. | 130 | $9,364 3.4% of $273,428 |
| Medical | American Fidelity Assurance Company | American Fidelity Assurance Company | 25 | $3,709 6.2% of $59,524 |
| Medical | American Fidelity Assurance Company | Paa Services, Inc. | 25 | $1,875 3.1% of $59,524 |
| Dental + Vision | Upmc Health Benefits | Tracey & Associates, LLC | 324 | $15,893 9.4% of $168,858 |
| Life | The Lincoln National Life Insurance Company | Coury Health Services, LLC | 258 | $765 6.1% of $12,608 |
| Life | The Lincoln National Life Insurance Company | National Benefit Center | 258 | $72 0.6% of $12,608 |
| Life | The Lincoln National Life Insurance Company | Coury Health Services, LLC | 104 | $9,102 15.0% of $60,679 |
| Life | The Lincoln National Life Insurance Company | National Benefit Center | 104 | $266 0.4% of $60,679 |
| Accident, Cancer | American Fidelity Assurance Company | Paa Services, Inc. | 8 | $699 5.4% of $12,985 |
| Accident, Cancer | American Fidelity Assurance Company | American Fidelity Assurance Company | 8 | $366 2.8% of $12,985 |
| Other | The Lincoln National Life Insurance Company | National Benefit Center | — | $61 |
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.