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Employer
50 Naus Way, Bloomsburg, PA 17815 · EIN 23-2597641 · 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 $47,536
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | Shields, Gregory P | 150 | $33,624 3.2% of $1,048,512 |
| Dental | Delta Dental Of Pennsylvania | Brown & Brown Of Pennsylvania | 150 | $2,588 10.0% of $25,879 |
| Vision | Eyemed Vision Care | Brown & Brown Of Pennsylvania | 150 | $678 9.1% of $7,479 |
| Life | Boston Mutual Life Insurance Company | Alpha Benefits Group, Inc | 27 | $901 15.0% of $6,005 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 60 | $2,471 11.7% of $21,064 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Ins Services Inc | 60 | $1,741 8.3% of $21,064 |
| Other | The Lincoln National Life Insurance Company | Strategic Non-Medical Sltns LLC | 60 | $1,053 5.0% of $21,064 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 58 | $2,091 11.7% of $17,919 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Ins Services Inc | 58 | $1,493 8.3% of $17,919 |
| Other | The Lincoln National Life Insurance Company | Strategic Non-Medical Sltns LLC | 58 | $896 5.0% of $17,919 |
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.