Employer
Brethren Village
3001 Lititz Pike, Lititz, PA 17543 · EIN 23-1425014 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 234
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 $16,810
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health Unimerica Insurance Company | — | 202 | Comp not disclosed Premium $505,258 |
| Life | Aul Oneamerica | The Benecon Group | 234 | $16,733 16.6% of $100,953 |
| Life | Colonial Life & Accident Insurance Company | Ap Benefit Advisors LLC | 1 | $26 1.8% of $1,474 |
| Life | Colonial Life & Accident Insurance Company | Vincent J Rowan | 1 | $24 1.6% of $1,474 |
| Life | Colonial Life & Accident Insurance Company | Cathy Good | 1 | $20 1.4% of $1,474 |
| Life | Colonial Life & Accident Insurance Company | William E Good | 1 | $7 0.5% of $1,474 |
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 $109,665
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group LLC | Brokers | $29,900 | $143.75 |
| Lr Webber | Brokers | $29,515 | $141.90 |
| Assured Partners (Central Pa) | Brokers | $11,960 | $57.50 |
| ConnectCare3 | Patient Advocate | $10,136 | $48.73 |
| The Benecon Group | Broker | $2,481 | $10.60 |
| Delta Dental Of Pennsylvania | Admin | $25,673 | $109.71 |