Employer
Certified Carpet Services, Inc.
1865 Columbia Ave, Lancaster, PA 17603 · EIN 23-1630052 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 7
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 | Avalon Insurance Company | — | 5 | Comp not disclosed Premium $35,692 |
| 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 $9,416
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $6,927 | $989.57 |
| Assured Partners (Central Pa) | Broker | $2,277 | $325.29 |
| Capital Bluecross | Admin | $212 | $30.29 |