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Employer
443 Valley View Rd, Newmanstown, PA 17073 · EIN 23-2043141 · 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 $57,198
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 161 | $1,202 4.8% of $25,028 |
| Medical | Metropolitan Life Insurance Company | Gis Benefits Inc. | 161 | $1,475 5.9% of $25,028 |
| Medical | Metropolitan Life Insurance Company | Brackbill Benefits LLC | 161 | $3,604 14.4% of $25,028 |
| Medical | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 141 | $779 4.9% of $15,907 |
| Medical | Metropolitan Life Insurance Company | Gis Benefits Inc. | 141 | $961 6.0% of $15,907 |
| Medical | Metropolitan Life Insurance Company | Brackbill Benefits LLC | 141 | $2,336 14.7% of $15,907 |
| Dental + Vision | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 385 | $8,162 3.7% of $221,843 |
| Dental + Vision | Metropolitan Life Insurance Company | Gis Benefits Inc. | 385 | $13,184 5.9% of $221,843 |
| Dental + Vision | Metropolitan Life Insurance Company | Brackbill Benefits LLC | 385 | $25,495 11.5% of $221,843 |
| Managed Organ/Tissue Transplant Benefit Program | United Healthcare Insurance Company | — | 650 | Comp not disclosed Premium $32,158 |
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.