Employer
Clover Farms Dairy Co.
P. O. Box 14627, Reading, PA 19612 · EIN 23-0478795 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $15,545
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark | — | 8 | Comp not disclosed Premium $123,810 |
| Dental | Delta Dental Of Pennsylvania | — | 561 | Comp not disclosed |
| Vision | Vision Benefits Of America | — | 269 | Comp not disclosed Premium $20,520 |
| Life | Madison National Life Insurance Company | North American Benefits Company | 280 | $7,318 8.5% of $86,098 |
| Life | Madison National Life Insurance Company | Tompkins Insurance | 280 | $5,142 6.0% of $86,098 |
| Life | Madison National Life Insurance Company | Emerson Reid LLC | 280 | $712 0.8% of $86,098 |
| Other | Kansas City Life Insurance Company | Tompkins Insurance | 38 | $1,343 15.0% of $8,954 |
| Other | Kansas City Life Insurance Company | North American Benefits Company | 38 | $761 8.5% of $8,954 |
| Other | Kansas City Life Insurance Company | Emerson Reid LLC | 38 | $269 3.0% of $8,954 |
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.
No Schedule C parties in this year.