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Employer
2001 Industrial Highway, Eddystone, PA 19122 · EIN 23-2224212 · Mar 1, 2021 to Feb 28, 2022
Plan year 2021
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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 $9,222
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Aetna Health Of California, Inc. | — | 75 | Comp not disclosed Premium $969,468 |
| Dental | Metropolitan Life Insurance Company | Emerson Reid And Company Inc. | 74 | $1,546 7.5% of $20,538 |
| Dental | Metropolitan Life Insurance Company | Lyons Insurance Agency Inc. | 74 | $1,339 6.5% of $20,538 |
| Dental | Metropolitan Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 74 | $571 2.8% of $20,538 |
| Dental | Metropolitan Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 74 | $114 0.6% of $20,538 |
| Life | The Lincoln National Life Insurance Company | Lyons Insurance Agency Inc. | 8 | $607 15.0% of $4,044 |
| Life | The Lincoln National Life Insurance Company | Kistler Tiffany Ben Gen Agency LLC | 8 | $202 5.0% of $4,044 |
| Life | Provident Life And Accident Insurance Company | Triben Insurance Solutions Inc | 36 | $315 2.2% of $14,345 |
| Life | Provident Life And Accident Insurance Company | Beneserv, A Division Of Onedigital | 36 | $268 1.9% of $14,345 |
| Life | Provident Life And Accident Insurance Company | Tompkins Insurance | 36 | $38 0.3% of $14,345 |
| Life | Provident Life And Accident Insurance Company | Marsh & Mclennan Agency, LLC East | 36 | $3 0.0% of $14,345 |
| Life | Provident Life And Accident Insurance Company | Brian Lee Malley | 36 | $2 0.0% of $14,345 |
| Other | Hartford Life And Accident | Kistler Tiffany Ben Gen Agency LLC | 77 | $3,971 16.7% of $23,823 |
| Accident, Critical Illness | Unum Life Insurance Company Of America | Kistler Tiffany Ben Gen Agency LLC | 15 | $206 4.7% of $4,371 |
| Accident, Critical Illness | Unum Life Insurance Company Of America | Triben Insurance Solutions Inc | 15 | $24 0.5% of $4,371 |
| Accident, Critical Illness | Unum Life Insurance Company Of America | Beneserv, A Division Of Onedigital | 15 | $16 0.4% of $4,371 |
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.
No Schedule C parties in this year.