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Employer
118 Springwood Drive, Lebanon, PA 17042 · EIN 46-1473476 · Jan 1, 2024 to Dec 31, 2024
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 $26,593
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pannsylvania | Mcconkey Benefits & Financial Servi | 172 | $1,227 2.6% of $46,483 |
| Dental | Delta Dental Of Pannsylvania | Centerstone Insurance And Financial | 172 | $384 0.8% of $46,483 |
| Vision | Vision Benefits Of America | Mcconkey Benefits & Financial Servi | 107 | $697 8.0% of $8,719 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 80 | $6,679 20.8% of $32,123 |
| Life | United Of Omaha Life Insurance Company | Benefitmall | 80 | $965 3.0% of $32,123 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 80 | $827 2.6% of $32,123 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 81 | $5,092 14.6% of $34,939 |
| Other | United Of Omaha Life Insurance Company | Benefitmall | 81 | $1,048 3.0% of $34,939 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 81 | $716 2.0% of $34,939 |
| Critical Illness | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 29 | $1,108 13.6% of $8,122 |
| Critical Illness | United Of Omaha Life Insurance Company | Benefitmall | 29 | $244 3.0% of $8,122 |
| Critical Illness | United Of Omaha Life Insurance Company | Gi George Parent Lp | 29 | $132 1.6% of $8,122 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 54 | $1,045 14.3% of $7,330 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Benefitmall | 54 | $220 3.0% of $7,330 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Gi George Parent Lp | 54 | $138 1.9% of $7,330 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Mcconkey Benefits & Finanical Servi | 44 | $4,811 18.3% of $26,244 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Benefitmall | 44 | $788 3.0% of $26,244 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Gi George Parent Lp | 44 | $472 1.8% of $26,244 |
| Stop-loss | Everest Reinsurance Company | — | 118 | Comp not disclosed Premium $126,020 |
| Stop-loss | Avalon Insurance Company | — | 124 | Comp not disclosed Premium $453,306 |
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 $30,393
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Mcconkey Benefits & Financial Servi | Broker | $42,178 | $319.53 |
| The Benecon Group | Broker | $1,832 | $13.88 |
| Benefitmall | Admin | $8,620 | $65.30 |
| Highmark | Admin | $-22,237 | $-168.46 |