Employer
Ebersole, Inc.
1900 Cumberland Street, Lebanon, PA 17042 · EIN 23-1325909 · Jan 1, 2020 to Dec 31, 2020
Plan year 2020
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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 |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 79 | Comp not disclosed Premium $30,500,127 |
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 $97,325
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Ingroup Associates | Broker | $23,356 | $256.66 |
| The Benecon Group | Broker | $18,249 | $200.54 |
| Highmark | Admin | $50,741 | $557.59 |
| Connectcare 3 | Patient Advocate | $4,979 | $54.71 |