Employer
Brechbill And Helman Construction Co., Inc.
1115 Sheller Avenue, Chambersburg, PA 17201 · EIN 25-1156439 · Mar 1, 2024 to Feb 28, 2025
Plan year 2024
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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 $1,276
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 29 | Comp not disclosed Premium $123,506 |
| Stop-loss | Crum & Forster | — | 29 | Comp not disclosed Premium $27,621 |
| Dental + Vision | Capital Advantage Assurance Company | — | 43 | Schedule A not provided |
| Life | Dearborn Life Insurance Company | Consolidated Benefits Inc | 40 | $1,276 17.9% of $7,130 |
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.
Visible subtotal $29,868
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $14,630 | $340.23 |
| Strickler Agency, Inc. (Chambersbur | Broker | $10,457 | $243.19 |
| Capital Bluecross | Admin | $4,027 | $93.65 |
| Revivehealth, Inc. | Carrier | $754 | $17.53 |