Employer
Century Spouting Company, Inc.
2147 S Market St, Elizabethtown, PA 17022 · EIN 23-1988684 · Jul 1, 2021 to Jun 30, 2022
Plan year 2021
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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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 25 | Comp not disclosed Premium $93,045 |
| Life | Principal Life Insurance Company | — | — | 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 $19,532
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Engle Hambright & Davies, Inc. | Broker | $9,668 | $386.72 |
| The Benecon Group, LLC | Broker | $6,089 | $243.56 |
| Capital Blue Cross | Admin | $2,792 | $111.68 |
| Connectcare 3 | Patient Advocate | $983 | $39.32 |