Employer
Capozzi Adler, P.C.
2933 North Front Street, Harrisburg, PA 17110 · EIN 23-2911821 · Mar 1, 2024 to Feb 28, 2025
Plan year 2024
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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 $1,399
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 27 | Comp not disclosed Premium $122,101 |
| Stop-loss | Crum & Forster | — | 25 | Comp not disclosed Premium $27,550 |
| Dental | The Guardian Life Insurance Company Of America | — | 17 | Schedule A not provided |
| Dental | The Guardian Life Insurance Company Of America | — | 17 | Schedule A not provided |
| Life | Unum Life Insurance Company Of America | — | — | Schedule A not provided |
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 $23,944
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $12,896 | $477.63 |
| Mpb Risk Services, LLC | Broker | $5,436 | $201.33 |
| Commonwealth Financial Group | Broker | $4,968 | $184.00 |
| Revivehealth, Inc. | Admin | $650 | $24.07 |
| Capital Bluecross | Admin | $-6 | $-0.22 |