Loading employer…
Employer
P. O. Box 2001, Wrightsville, PA 17368 · EIN 23-1744584 · Apr 1, 2024 to Mar 31, 2025
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $77,457
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | 220 | Comp not disclosed Premium $575,727 |
| Medical | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 86 | $2,889 15.6% of $18,549 |
| Medical | Metropolitan Life Insurance Company | Gis Benefits Inc | 86 | $999 5.4% of $18,549 |
| Medical | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 86 | $713 3.8% of $18,549 |
| Medical | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 86 | $143 0.8% of $18,549 |
| Medical | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 62 | $2,320 15.5% of $14,953 |
| Medical | Metropolitan Life Insurance Company | Gis Benefits Inc | 62 | $799 5.3% of $14,953 |
| Medical | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 62 | $571 3.8% of $14,953 |
| Medical | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 62 | $114 0.8% of $14,953 |
| Dental + Vision | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 432 | $20,578 11.8% of $174,517 |
| Dental + Vision | Metropolitan Life Insurance Company | Gis Benefits Inc | 432 | $9,586 5.5% of $174,517 |
| Dental + Vision | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 432 | $6,847 3.9% of $174,517 |
| Dental + Vision | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 432 | $1,370 0.8% of $174,517 |
| Critical Illness | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 33 | $2,845 15.8% of $17,968 |
| Critical Illness | Metropolitan Life Insurance Company | Gis Benefits Inc | 33 | $983 5.5% of $17,968 |
| Critical Illness | Metropolitan Life Insurance Company | Boon Chapman Benefit Administrators | 33 | $702 3.9% of $17,968 |
| Critical Illness | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 33 | $140 0.8% of $17,968 |
| Legal | Metlife Legal | — | 31 | Schedule A not provided |
| Supplemental | Aflac | Marilyn W Brannen | 117 | $15,664 11.1% of $141,147 |
| Supplemental | Aflac | William L Murray Jr | 117 | $4,953 3.5% of $141,147 |
| Supplemental | Aflac | Anthony S Almodovar | 117 | $2,950 2.1% of $141,147 |
| Supplemental | Aflac | Jason E Ferger | 117 | $673 0.5% of $141,147 |
| Supplemental | Aflac | Cynthia L Jay | 117 | $380 0.3% of $141,147 |
| Supplemental | Aflac | David C Sweigard | 117 | $261 0.2% of $141,147 |
| Supplemental | Aflac | Kenneth L Good | 117 | $229 0.2% of $141,147 |
| Supplemental | Aflac | Randall D Naftal | 117 | $138 0.1% of $141,147 |
| Supplemental | Aflac | Cristian Apalaghie | 117 | $101 0.1% of $141,147 |
| Supplemental | Aflac | Matthew G Berger | 117 | $99 0.1% of $141,147 |
| Supplemental | Aflac | Robert Anderson | 117 | $76 0.1% of $141,147 |
| Supplemental | Aflac | Darren D Riddle | 117 | $50 0.0% of $141,147 |
| Supplemental | Aflac | Daniel L Martin | 117 | $49 0.0% of $141,147 |
| Supplemental | Aflac | Ryan K Goldberg | 117 | $40 0.0% of $141,147 |
| Supplemental | Aflac | Angela Umosella | 117 | $28 0.0% of $141,147 |
| Supplemental | Aflac | Bonita Kline | 117 | $26 0.0% of $141,147 |
| Supplemental | Aflac | Gail T Holtzinger | 117 | $23 0.0% of $141,147 |
| Supplemental | Aflac | Christopher A Lupp | 117 | $21 0.0% of $141,147 |
| Supplemental | Aflac | Irene E Brooks | 117 | $19 0.0% of $141,147 |
| Supplemental | Aflac | Randall Sims | 117 | $18 0.0% of $141,147 |
| Supplemental | Aflac | Martin E Bystrom | 117 | $16 0.0% of $141,147 |
| Supplemental | Aflac | Julia Packman-Foley | 117 | $16 0.0% of $141,147 |
| Supplemental | Aflac | Richard J Purisky | 117 | $12 0.0% of $141,147 |
| Supplemental | Aflac | Daniel R Judy | 117 | $10 0.0% of $141,147 |
| Supplemental | Aflac | David W Ranck | 117 | $6 0.0% of $141,147 |
| Telemedicine | Revivehealth | — | — | 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 $2,417,522
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Ap Benefit Advisors | Broker | $103,752 | $240.17 |
| Capital Advantage Assurance Company | Admin | $2,313,770 | $5,355.95 |