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Employer
1601 Sycamore Road, Montoursville, PA 17754 · EIN 13-3272568 · Jan 1, 2024 to Dec 31, 2024
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 $201,718
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Cigna Health And Life Insurance Company | Edgewood Partners Insurance Center | 12 | $8,886 10.0% of $88,858 |
| Medical | Delta Dental Of New Jersey, Inc. | Edgewood Partners Insurance Center | 1213 | $24,476 3.9% of $627,399 |
| Medical | Alpha Dental Programs, Inc. | Edgewood Partners Insurance Center | 16 | $180 5.0% of $3,570 |
| Medical | Kaiser Foundation Health Plan Inc | Edgewood Partners Insurance Center | 197 | $61,618 3.4% of $1,835,499 |
| Medical | Kaiser Foundation Health Plan Inc. | Edgewood Partners Insurance Center | 6 | $1,342 2.3% of $59,261 |
| Vision | Eyemed Vision Care | Edgewood Partners Insurance Center | 1031 | $6,850 10.3% of $66,467 |
| Life | Prudential Insurance Company Of America | Edgewood Partners Insurance Center | 1038 | $87,697 16.6% of $529,781 |
| Life | Prudential Insurance Company Of America | Img | 1038 | $212 0.0% of $529,781 |
| Accidental Injury | Life Insurance Company Of North America | Edgewood Partnes | 125 | $3,604 16.2% of $22,275 |
| Critical Illness | Life Insurance Company Of North America | Edgewood Partners | 110 | $6,853 16.8% of $40,754 |
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.