Employer
Collins Tool Corporation
3254 Old Stage Rd, Lewiston, PA 17044 · EIN 68-0578538 · Dec 1, 2022 to Nov 30, 2023
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 $1,656
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 5 | Comp not disclosed Premium $64,863 |
| Dental | Capital Advantage Assurance Company | Gunn Mowery, LLC | 7 | $835 10.0% of $8,347 |
| Life | Hartford Life And Accident | Gunn Mowery, LLC | 7 | $821 10.0% of $8,208 |
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 $19,466
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gunn-Mowery | Broker | $4,848 | $285.18 |
| The Benecon Group LLC | Broker | $3,241 | $190.65 |
| Capital Blue Cross | Admin | $10,625 | $625.00 |
| ConnectCare3 | Patient Advocate | $752 | $44.24 |