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Employer
1926 Peach Street, Erie, PA 16502 · EIN 25-1430922 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $17,639
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | — | 162 | Comp not disclosed Premium $1,417,807 |
| Dental | Highmark, Inc. | Stalwart Insurance LLC | 167 | $5,737 7.4% of $77,162 |
| Dental | Highmark, Inc. | Lr Webber | 167 | $2,527 3.3% of $77,162 |
| Vision | Vision Benefits Of America | — | 167 | Comp not disclosed Premium $9,784 |
| Life | Reliance Standard Life Insurance Company | Stalwart Insurance LLC | 188 | $2,389 7.9% of $30,161 |
| Life | Reliance Standard Life Insurance Company | L. R. Webber Associates | 188 | $1,348 4.5% of $30,161 |
| Life | Reliance Standard Life Insurance Company | Stalwart Insurance LLC | 5 | $131 207.9% of $63 |
| Other | Highmark, Inc. | — | 162 | Comp not disclosed Premium $705,356 |
| Other | Reliance Standard Life Insurance Company | Stalwart Insurance LLC | 178 | $3,655 12.4% of $29,558 |
| Other | Reliance Standard Life Insurance Company | L. R. Webber Associates | 178 | $1,852 6.3% of $29,558 |
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.