Employer
Buckno Lisicky & Company
645 Hamilton Street, Allentown, PA 18101 · EIN 23-2426656 · Jan 1, 2024 to Dec 31, 2024
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 $6,191
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 42 | Comp not disclosed Premium $148,600 |
| Dental + Vision | Capital Blue Cross | Bsi Corporate Benefits, Inc. | 47 | $2,525 9.9% of $25,512 |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
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 $55,570
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Bsi Corporate Benefits, LLC | Broker | $24,908 | $529.96 |
| The Benecon Group | Broker | $12,738 | $271.02 |
| Innovu | Broker | $2,172 | $46.21 |
| Capital Bluecross | Admin | $10,304 | $219.23 |
| ConnectCare3 | Patient Advocate | $2,765 | $58.83 |
| Hy Holdings Inc. | Admin | $2,683 | $57.09 |