Employer
Country Fair, Inc.
2251 East 30th Street, Erie, PA 16510 · EIN 25-1149799 · Jul 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $146
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Benefits Of America | Seubert & Associates Inc. | — | $95 1.3% of $7,299 |
| Vision | Vision Benefits Of America | The Hdh Group, Inc. | — | $51 0.7% of $7,299 |
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.
No Schedule C parties in this year.