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Employer
510 Sycamore St, Nazareth, PA 18064 · EIN 24-0654010 · 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 $51,793
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $1,003 |
| Stop-loss | HM Life Insurance Company | — | 479 | Comp not disclosed Premium $1,060,440 |
| Vision | Capital Advantage Assurance Company | — | 711 | Comp not disclosed Premium $27,484 |
| Life | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Life Insurance Company Of North America | — | — | Schedule A not provided |
| AD&D | Federal Insurance Company | — | — | 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 |
| Accident, Cancer | Aflac | Bethany L Anderson | 155 | $5,838 5.4% of $108,217 |
| Accident, Cancer | Aflac | Quentin C Kent | 155 | $1,630 1.5% of $108,217 |
| Accident, Cancer | Aflac | Denton E Quick | 155 | $1,135 1.0% of $108,217 |
| Accident, Cancer | Aflac | Joseph B Mcginty Jr | 155 | $714 0.7% of $108,217 |
| Accident, Cancer | Aflac | William M Knott | 155 | $583 0.5% of $108,217 |
| Accident, Cancer | Aflac | Kymberly G Knott | 155 | $531 0.5% of $108,217 |
| Accident, Cancer | Aflac | Edward Mrowka Jr | 155 | $505 0.5% of $108,217 |
| Accident, Cancer | Aflac | Isabella Rose Andrews | 155 | $496 0.5% of $108,217 |
| Accident, Cancer | Aflac | Stephen D Bissell | 155 | $450 0.4% of $108,217 |
| Accident, Cancer | Aflac | Jacqueline M Eberz | 155 | $396 0.4% of $108,217 |
| Accident, Cancer | Aflac | Justin P Abraham | 155 | $334 0.3% of $108,217 |
| Accident, Cancer | Aflac | Wendy M Boone | 155 | $288 0.3% of $108,217 |
| Accident, Cancer | Aflac | Deanne Lynn Harman | 155 | $247 0.2% of $108,217 |
| Accident, Cancer | Aflac | John B Lacaria | 155 | $177 0.2% of $108,217 |
| Accident, Cancer | Aflac | Randall Sims | 155 | $173 0.2% of $108,217 |
| Accident, Cancer | Aflac | Kevin W Krepinevich | 155 | $109 0.1% of $108,217 |
| Accident, Cancer | Aflac | James Elder Brooks | 155 | $84 0.1% of $108,217 |
| Accident, Cancer | Aflac | Matthew G Berger | 155 | $72 0.1% of $108,217 |
| Accident, Cancer | Aflac | Jne Inc | 155 | $66 0.1% of $108,217 |
| Accident, Cancer | Aflac | Daniel R Judy | 155 | $60 0.1% of $108,217 |
| Accident, Cancer | Aflac | Irene E Brooks | 155 | $56 0.1% of $108,217 |
| Accident, Cancer | Aflac | Darren D Riddle | 155 | $27 0.0% of $108,217 |
| Accident, Cancer | Aflac | Jayne D Harmon | 155 | $19 0.0% of $108,217 |
| Accident, Cancer | Aflac | Ryan K Goldberg | 155 | $19 0.0% of $108,217 |
| Accident, Cancer | Aflac | Dianne L Martin | 155 | $19 0.0% of $108,217 |
| Accident, Cancer | Aflac | Angela Massarelli | 155 | $17 0.0% of $108,217 |
| Accident, Cancer | Aflac | Harry D Wagner | 155 | $17 0.0% of $108,217 |
| Accident, Cancer | Aflac | Financial Products Inc | 155 | $15 0.0% of $108,217 |
| Accident, Cancer | Aflac | Martin E Bystrom | 155 | $15 0.0% of $108,217 |
| Accident, Cancer | Aflac | Jeffrey C Grim | 155 | $15 0.0% of $108,217 |
| Accident, Cancer | Aflac | Christopher A Lupp | 155 | $11 0.0% of $108,217 |
| Accident, Cancer | Aflac | Quentin C Kent Ii | 155 | $7 0.0% of $108,217 |
| Accident, Cancer | Aflac | John D Sell | 155 | $6 0.0% of $108,217 |
| Accident, Cancer | Aflac | Mary Ellen Bell Greth | 155 | $5 0.0% of $108,217 |
| Accident, Cancer | Aflac | David W Ranck | 155 | $5 0.0% of $108,217 |
| Accident, Cancer | Aflac | Faith M Burris | 155 | $4 0.0% of $108,217 |
| EAP | Health Advocate Solutions Inc | — | — | Schedule A not provided |
| Telemedicine | Healthiest You | — | — | Schedule A not provided |
| Ny Std, Ny Pl | New York Life Group Insurance Company Of New York | — | — | 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 $-210,956
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Bsi Corporate Benefits, LLC | Broker | $153,251 | $215.54 |
| The Benecon Group | Broker | $75,064 | $105.58 |
| Innovu | Broker | $24,599 | $34.60 |
| United Concordia Companies, Inc. | Admin | $27,097 | $38.11 |
| ConnectCare3 | Patient Advocate | $26,064 | $36.66 |
| Lehigh Valley Business Conf On Hc | Broker Bonus | Comp not disclosed | — |
| Capital Advantage Assurance Company | Admin | $-517,031 | $-727.19 |