Employer
Cobys Family Services
444 Murry Hill Circle, Lancaster, PA 17601 · EIN 23-2128881 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
Covered lives: 178
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 $10,422
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Metropolitan Life Insurance Company | The Hess Agency | 178 | $6,286 9.1% of $69,321 |
| Dental | Metropolitan Life Insurance Company | Emerson Rogers LLC | 178 | $4,136 6.0% of $69,321 |
| Vision | National Vision Administrators LLC | — | 52 | Comp not disclosed Premium $5,860 |
| EAP | Quest Behavioral Health, Inc. | — | 60 | Comp not disclosed Premium $1,468 |
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 $42,378
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Hess Agency | Broker | $9,384 | $52.72 |
| The Benecon Group, LLC | Broker | $2,706 | $15.20 |
| Pci (Pa Chamber Insurance) | Broker | $1,663 | $9.34 |
| Capital Advantage Assurance Company | Admin | $28,625 | $160.81 |