Employer
Cloister Flooring, Inc.
100 Durlach Road, Ephrata, PA 17522 · EIN 23-3032119 · May 1, 2024 to Apr 30, 2025
Plan year 2024
Covered lives: 25
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 | HM Life Insurance Company | — | 25 | Comp not disclosed Premium $129,355 |
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 $19,283
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $9,827 | $393.08 |
| Harding Yost Insurance Associates | Broker | $9,450 | $378.00 |
| Capital Bluecross | Carrier | $6 | $0.24 |