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Employer
22025 Route 14 N, Troy, PA 16947 · EIN 46-1672029 · Jul 1, 2024 to Jun 30, 2025
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 $44,328
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Of Omaha Life Insurance Company | Hub International | 97 | $7,113 12.9% of $55,010 |
| Vision | United Of Omaha Life Insurance Company | Hub International | 82 | $2,105 16.1% of $13,083 |
| Life | United Of Omaha Life Insurance Company | Hub International | 137 | $4,042 20.6% of $19,579 |
| Life | United Of Omaha Life Insurance Company | Ea Legacy LLC | 137 | $979 5.0% of $19,579 |
| Life | United Of Omaha Life Insurance Company | Hub International | 36 | $3,324 20.9% of $15,907 |
| Life | United Of Omaha Life Insurance Company | Ea Legacy LLC | 36 | $795 5.0% of $15,907 |
| Other | United Of Omaha Life Insurance Company | Hub International | 137 | $7,306 20.7% of $35,281 |
| Other | United Of Omaha Life Insurance Company | Ea Legacy LLC | 137 | $1,764 5.0% of $35,281 |
| Other | United Of Omaha Life Insurance Company | Hub International | 137 | $4,470 20.6% of $21,666 |
| Other | United Of Omaha Life Insurance Company | Ea Legacy LLC | 137 | $1,083 5.0% of $21,666 |
| Accident | United Of Omaha Life Insurance Company | Hub International | 53 | $3,235 20.5% of $15,772 |
| Accident | United Of Omaha Life Insurance Company | Ea Legacy LLC | 53 | $789 5.0% of $15,772 |
| Critical Illness | United Of Omaha Life Insurance Company | Hub International | 45 | $2,385 20.8% of $11,471 |
| Critical Illness | United Of Omaha Life Insurance Company | Ea Legacy LLC | 45 | $574 5.0% of $11,471 |
| Hospital Indemnity | United Of Omaha Life Insurance Company | Hub International | 40 | $3,653 25.7% of $14,224 |
| Hospital Indemnity | United Of Omaha Life Insurance Company | Ea Legacy LLC | 40 | $711 5.0% of $14,224 |
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.