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Employer
52 Gettysburg Pike, Mechanicsburg, PA 17055 · EIN 83-0351068 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $22,745
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 205 | Comp not disclosed Premium $716,702 |
| Dental | Guardian | Brown & Brown Of Pennsylvania | 350 | $15,739 33.6% of $46,815 |
| Dental | Guardian | Cbiz Benefits & Ins. Services | 350 | $-37 -0.1% of $46,815 |
| Vision | Capital Advantage Assurance Company | Brown & Brown Of Pennsylvania | 282 | $4,510 7.4% of $61,289 |
| Life | Unitedhealthcare Insurance Company | — | — | Schedule A not provided |
| Tricare Supplement | Hartford Accident And Life Insurance Company | Brown & Brown Of Pennsylvania | 53 | $2,533 4.1% of $62,034 |
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 $136,334
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pa | Broker | $81,632 | $233.23 |
| The Benecon Group, LLC | Broker | $32,092 | $91.69 |
| United Healthcare | Admin | $11,462 | $32.75 |
| Connectcare 3 | Patient Advocate | $11,148 | $31.85 |