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Employer
15 Grumbacher Road, York, PA 17406 · EIN 23-1544725 · 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 $61,596
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Highmark Inc. | — | 637 | Comp not disclosed Premium $37,738 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 402 | $17,658 14.3% of $123,595 |
| Life | United Of Omaha Life Insurance Company | Benefitmall | 402 | $3,710 3.0% of $123,595 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 402 | $2,357 1.9% of $123,595 |
| AD&D | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 122 | $12,945 20.3% of $63,674 |
| AD&D | United Of Omaha Life Insurance Company | Benefitmall | 122 | $1,911 3.0% of $63,674 |
| AD&D | United Of Omaha Life Insurance Company | Gi George Parent Lp | 122 | $1,509 2.4% of $63,674 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 66 | $7,865 18.8% of $41,738 |
| Other | United Of Omaha Life Insurance Company | Beneitmall | 66 | $1,252 3.0% of $41,738 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 66 | $713 1.7% of $41,738 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 101 | $9,264 19.9% of $46,505 |
| Other | United Of Omaha Life Insurance Company | Benefitmall | 101 | $1,395 3.0% of $46,505 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 101 | $1,017 2.2% of $46,505 |
| Stop-loss | Avalon Insurance Company | — | 328 | Comp not disclosed Premium $1,655,283 |
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 $349,939
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Mcconkey Benefits & Financial Servi | Broker | $3,193 | $5.01 |
| Delta Dental Of Pennsylvania | Admin | $25,485 | $40.01 |
| United Of Omaha Life Insurance Comp | Admin | $14,418 | $22.63 |
| Mcconkey Benefits & Financial Serv | Broker | $93,840 | $262.86 |
| The Benecon Group, LLC | Broker | $4,080 | $11.43 |
| Highmark | Admin | $183,691 | $514.54 |
| Benefitmall | Admin | $25,232 | $70.68 |