Employer
Eagle River Homes LLC
21 S. Groffdale Road, Leola, PA 17540 · EIN 20-5144960 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 152
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | 103 | Comp not disclosed Premium $315,689 |
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 $28,828
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $27,269 | $264.75 |
| Harding-Yost Insurance | Broker | $26,925 | $261.41 |
| Capital Blue Cross | Admin | $-25,366 | $-246.27 |