Employer
Calvary Fellowship Homes, Inc.
502 Elizabeth Dr, Lancaster, PA 17601 · EIN 23-1606038 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 76
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 $7,025
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | — | 9 | Comp not disclosed Premium $28,051 |
| Vision | National Vision Administrators | Ap Benefit Advisors | 11 | $445 10.0% of $4,448 |
| Life | Transamerica Life Insurance Company | — | 1 | Comp not disclosed Premium $3,400 |
| AD&D | United Of Omaha Life Insurance Company | Ap Benefits Advisors LLC | 15 | $1,282 21.5% of $5,958 |
| Other | United Of Omaha Life Insurance Company | Ap Benefits Advisors LLC | 16 | $2,853 18.6% of $15,334 |
| Critical Illness; Vol | United Of Omaha Life Insurance Company | Ap Benefits Advisors LLC | 7 | $723 24.1% of $3,005 |
| Accident Voluntary | United Of Omaha Life Insurance Company | Ap Benefit Advisors | 8 | $526 20.4% of $2,574 |
| Voluntary | United Of Omaha Life Insurance Company | Ap Benefits Advisors LLC | 13 | $1,196 18.1% of $6,623 |
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $48,198 |
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 $6,236
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Assured Partners (Central Pa) | Broker | $5,145 | $67.70 |
| The Benecon Group | Broker | $2,470 | $32.50 |
| Lr Webber | Broker | $973 | $12.80 |
| ConnectCare3 | Patient Advocate | $588 | $7.74 |
| Capital Bluecross | Admin | $-2,940 | $-38.68 |