Employer
David H Martin Excavating Inc
4961 Cumberland Highway, Chambersburg, PA 17202 · EIN 25-1564223 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $11,863
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 181 | Comp not disclosed Premium $558,213 |
| Dental + Vision | Capital Advantage Assurance Company | Harding-Yost Insurance Associates | 293 | $11,863 10.0% of $118,628 |
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.
Visible subtotal $178,619
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Harding-Yost Insurance Associates | Broker | $64,387 | $355.73 |
| The Benecon Group | Broker | $34,695 | $191.69 |
| Capital Blue Cross | Admin | $68,071 | $376.08 |
| ConnectCare3 | Patient Advocate | $11,466 | $63.35 |