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Employer
1454 Baltimore St. Suite A, Hanover, PA 17331 · EIN 20-3970647 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $55,695
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | Brown & Brown Insurance Services | 175 | $6,515 10.8% of $60,507 |
| Medical | Principal Life Insurance Company | Strategic Non-Medical Solutions | 175 | $2,734 4.5% of $60,507 |
| Medical | Principal Life Insurance Company | Brown & Brown Insurance Agency | 175 | $1,350 2.2% of $60,507 |
| Voluntary Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Accident | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Accident | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Accident | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Voluntary Accident | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | — | Schedule A not provided |
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.
Visible subtotal $33,932
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $2,239 | $27.64 |
| Highmark Blue Shield (Central) | Admin | $31,693 | $391.27 |