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Employer
201 S. Carver Street, Warren, PA 16365 · EIN 25-0426840 · 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 $60,287
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Gerber Life Insurance Company | — | — | Comp not disclosed Premium $399,457 |
| Dental | United Concordia Insurance Company | Seubert And Associates Inc. | 305 | $10,347 9.2% of $112,691 |
| Vision | Vision Service Plan | Seubert & Associates Inc. | 125 | $1,017 5.8% of $17,482 |
| Life | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 147 | $4,789 16.9% of $28,285 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 147 | $1,414 5.0% of $28,285 |
| Life | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 53 | $6,694 21.0% of $31,834 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 53 | $1,592 5.0% of $31,834 |
| Other | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 147 | $6,130 17.7% of $34,647 |
| Other | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 147 | $5,169 14.9% of $34,647 |
| Other | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 147 | $1,732 5.0% of $34,647 |
| Other | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 147 | $12,044 12.2% of $98,578 |
| Other | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 147 | $4,929 5.0% of $98,578 |
| Critical Illness | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 63 | $3,590 21.4% of $16,806 |
| Critical Illness | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 63 | $840 5.0% of $16,806 |
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.