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Employer
P.O. Box 5900, Harrisburg, PA 17110 · EIN 23-1669823 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $46,673
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | Conrad Siegel Inc. | 69 | $26,048 2.8% of $925,963 |
| Medical | Upmc Health Options | Conrad Siegel Inc. | 32 | $11,872 2.7% of $442,920 |
| Medical | Upmc Health Options | Conrad Siegel Inc. | 5 | $1,824 3.9% of $46,745 |
| Medical | Upmc Health Options | Conrad Siegel Inc. | 1 | $384 2.0% of $19,364 |
| Medical | Upmc Health Options | Conrad Siegel Inc. | — | $96 7.4% of $1,290 |
| Medical | Upmc Health Options | Conrad Siegel Inc. | 1 | $160 3.8% of $4,214 |
| Dental | Capital Advantage Assurance Company | Conrad Siegel Inc. | 97 | $5,768 10.0% of $57,676 |
| Vision | Upmc Health Benefits | Conrad Siegel Inc. | 80 | $488 4.0% of $12,351 |
| Vision | Upmc Health Benefits | Conrad Siegel Inc. | 5 | $32 3.9% of $827 |
| Vision | Upmc Health Benefits | Conrad Siegel Inc. | — | $1 7.1% of $14 |
| Life | Unum Life Insurance Company Of America | — | 125 | Comp not disclosed Premium $65,429 |
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.