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Employer
1390 Ridgeview Dr, Allentown, PA 18104 · EIN 23-2180878 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $78,077
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Companion Life Insurance | Hays Companies, Inc. | 13 | Comp not disclosed Premium $1,384 |
| Dental | United Concordia Insurance Company | Hays Companies, Inc. | 2323 | $1,179 0.2% of $693,722 |
| Vision | Metropolitan Life Insurance Company | Hays Companies, Inc. | 2042 | $6,285 5.0% of $125,699 |
| Life | Lincoln National Life Insurance Company | Hays Companies Inc | 2056 | $54,761 6.3% of $868,398 |
| Life | Lincoln National Life Insurance Company | Brown & Brown Ins Services Inc | 2056 | $15,852 1.8% of $868,398 |
| Legal | Legal Resources | Hays Companies, Inc. | 141 | Comp not disclosed Premium $34,502 |
| Stop-loss | HM Life Insurance Company | Brown & Brown Insurance Services, I | 1269 | Comp not disclosed Premium $803,921 |
| Stop-loss | HM Life Insurance Company | Hays Companies Inc | 1269 | Comp not disclosed Premium $803,921 |
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.
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Baker Tilly Us, LLP | Auditor | Comp not disclosed | — |
| Merrill Lynch, Pierce, Fenner And S | Brokerage | Comp not disclosed | — |
| Highmark Inc | Claims Processor | Comp not disclosed | — |