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Employer
1226 Stefko Blvd, Bethlehem, PA 18017 · EIN 23-1740766 · 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 $2,538
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 27 | Comp not disclosed Premium $19,546 |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Life | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | 28 | Comp not disclosed Premium $151,413 |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Life | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
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.
Visible subtotal $54,404
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $31,616 | $1,170.96 |
| Employee Benefit Consultants | Broker | $1,590 | $58.89 |
| Capital Bluecross | Admin | $318 | $11.78 |
| ConnectCare3 | Patient Advocate | $289 | $10.70 |
| The Benecon Group | Broker | $10,661 | $380.75 |
| Employee Benefit Consultants | Broker | $9,930 | $354.64 |