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Employer
490 Railroad Avenue, Shiremanstown, PA 17011 · EIN 54-2092491 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $14,748
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Benefits Of America | Engle, Hambright & Davies, Inc. | 263 | $1,056 5.0% of $21,113 |
| Life | Reliance Standard Life Insurance Company | Engle, Hambright & Davies, Inc. | 252 | $4,305 15.0% of $28,699 |
| AD&D | Reliance Standard Life Insurance Company | Engle Hambright & Davis Inc. | 87 | $239 15.0% of $1,591 |
| Other | Reliance Standard Life Insurance Company | Engle, Hambright & Davies, Inc. | 226 | $2,312 15.0% of $15,415 |
| Other | Reliance Standard Life Insurance Company | Engle, Hambright & Davies, Inc. | 100 | $1,057 8.9% of $11,836 |
| Supplemental | Aflac | Sanford A. Stuchell | 46 | $671 2.6% of $26,035 |
| Supplemental | Aflac | Brandt, Inc. | 46 | $496 1.9% of $26,035 |
| Supplemental | Aflac | David R. Ponta | 46 | $309 1.2% of $26,035 |
| Supplemental | Aflac | Gerald L. Walsh | 46 | $220 0.8% of $26,035 |
| Supplemental | Aflac | David W. Brandt | 46 | $211 0.8% of $26,035 |
| Supplemental | Aflac | Anthony S. Almodovar | 46 | $159 0.6% of $26,035 |
| Supplemental | Aflac | Robert A. Anderson | 46 | $124 0.5% of $26,035 |
| Supplemental | Aflac | Cynthia L. Jay | 46 | $117 0.4% of $26,035 |
| Supplemental | Aflac | Stacey G. Helbig | 46 | $82 0.3% of $26,035 |
| Supplemental | Aflac | Jeffrey R. Stauffer | 46 | $78 0.3% of $26,035 |
| Supplemental | Aflac | Jd Luedtke Inc. | 46 | $51 0.2% of $26,035 |
| Supplemental | Aflac | Ca Lupp Inc. | 46 | $49 0.2% of $26,035 |
| Supplemental | Aflac | Matthew G. Berger | 46 | $35 0.1% of $26,035 |
| Supplemental | Aflac | Daniel R. Judy | 46 | $30 0.1% of $26,035 |
| Supplemental | Aflac | Timothy E. Miller | 46 | $24 0.1% of $26,035 |
| Supplemental | Aflac | Irene E. Brooks | 46 | $23 0.1% of $26,035 |
| Supplemental | Aflac | Mark D. Barbier | 46 | $23 0.1% of $26,035 |
| Supplemental | Aflac | Randall Sims | 46 | $15 0.1% of $26,035 |
| Supplemental | Aflac | James W. Wotherspoon Jr. | 46 | $15 0.1% of $26,035 |
| Supplemental | Aflac | Kl Good Benefits | 46 | $13 0.0% of $26,035 |
| Supplemental | Aflac | Cristian Apalaghie | 46 | $12 0.0% of $26,035 |
| Supplemental | Aflac | Darren D. Riddle | 46 | $12 0.0% of $26,035 |
| Supplemental | Aflac | Marilyn Brannen | 46 | $12 0.0% of $26,035 |
| Supplemental | Aflac | Dianne L. Martin | 46 | $8 0.0% of $26,035 |
| Supplemental | Aflac | Angela Massarelli | 46 | $8 0.0% of $26,035 |
| Supplemental | Aflac | David W. Ranck | 46 | $7 0.0% of $26,035 |
| Supplemental | Aflac | Jason E. Ferger | 46 | $5 0.0% of $26,035 |
| Supplemental | Aflac | Ryan K. Goldberg | 46 | $5 0.0% of $26,035 |
| Supplemental | Aflac | Christopher A. Lupp | 46 | $3 0.0% of $26,035 |
| Supplemental | Aflac | Martin E. Bystrom | 46 | $2 0.0% of $26,035 |
| Supplemental | Aflac | Dianne L. Martin | 46 | $1 0.0% of $26,035 |
| Supplemental | Continental American Insurance Company | Engle, Hambright & Davies, Inc. | 67 | $1,728 5.6% of $30,945 |
| Supplemental | Continental American Insurance Company | C.A. Lupp, Inc. | 67 | $851 2.8% of $30,945 |
| Supplemental | Continental American Insurance Company | Richard C. Defalco | 67 | $153 0.5% of $30,945 |
| Supplemental | Continental American Insurance Company | Anthony S. Almodovar | 67 | $153 0.5% of $30,945 |
| Supplemental | Continental American Insurance Company | Timothy W. Worthy, Jr. | 67 | $33 0.1% of $30,945 |
| Supplemental | Continental American Insurance Company | David H. Johnson | 67 | $32 0.1% of $30,945 |
| Supplemental | Continental American Insurance Company | Elizabeth F. Bohlender | 67 | $6 0.0% of $30,945 |
| Supplemental | Continental American Insurance Company | Susan R. Mcsherry | 67 | $3 0.0% of $30,945 |
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.