Employer
Durex Coverings, Inc.
P. O. Box 639, Brownstown, PA 17508 · EIN 23-1655429 · Dec 1, 2023 to Nov 30, 2024
Plan year 2023
Covered lives: 81
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $17,334
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optumhealth | — | 36 | Comp not disclosed Premium $16,109 |
| Medical | Capital Advantage Assurance Company | Iag, Inc | 81 | $10,224 1.7% of $610,905 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Heritage Insurance Associates | 52 | $6,906 11.2% of $61,923 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Nfp Corporate Service | 52 | $204 0.3% of $61,923 |
Schedule C
Additional compensation
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 $5,371
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $3,882 | $47.93 |
| Iag, Inc | Broker | $864 | $10.67 |
| Capital Blue Cross | Admin | $432 | $5.33 |
| Connectcare 3 | Patient Advocate | $193 | $2.38 |