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Employer
3 Grow Avenue, Montrose, PA 18801 · EIN 23-2720289 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $15,892
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Geisinger Health Plan | The Benefits Group Of Haudensc | — | Comp not disclosed |
| Medical | Geisinger Quality Options | The Benefits Group Of Haudensc | — | Comp not disclosed |
| Dental + Vision | Guardian Life Insurance Company Of America | The Benefits Group Of Haudensc | 118 | $5,360 5.8% of $92,337 |
| Dental + Vision | Guardian Life Insurance Company Of America | Marsh & Mclennan Agency, LLC East | 118 | $4,605 5.0% of $92,337 |
| Dental + Vision | Guardian Life Insurance Company Of America | Enrollease | 118 | $852 0.9% of $92,337 |
| Life | The Lincoln National Life Insurance Co | Brown & Brown Of Pennsylvania | 132 | $875 8.9% of $9,796 |
| Life | The Lincoln National Life Insurance Co | Marsh & Mclennan Agency, LLC East | 132 | $285 2.9% of $9,796 |
| Intensive Care, Cancer, Accident | Aflac | Michelle M Reeder | 27 | $1,376 6.4% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Rollin C Price | 27 | $458 2.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | R & B Insurance Services LLC | 27 | $423 2.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Jeffrey C Chubb | 27 | $144 0.7% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Joseph B Mcginty Jr | 27 | $143 0.7% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Delmas R Butler Jr | 27 | $90 0.4% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Geary L Walizer | 27 | $84 0.4% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Jack Albert Martin | 27 | $74 0.3% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Stephen D Bissell | 27 | $72 0.3% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Mollie A Price | 27 | $68 0.3% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Susan J Chubb | 27 | $65 0.3% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Mark L Hufhand | 27 | $63 0.3% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Irene E Brooks | 27 | $52 0.2% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Randall Sims | 27 | $41 0.2% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Fred A Reeder | 27 | $32 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | C A Lupp Inc | 27 | $24 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Victor Lysczek | 27 | $23 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Daniel R Judy | 27 | $17 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Joseph B Mcginty Jr | 27 | $16 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Sjc Business Services LLC | 27 | $14 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Matthew G Berger | 27 | $12 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Daniel Cero | 27 | $11 0.1% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Darren D Riddle | 27 | $3 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Ryan K Goldberg | 27 | $3 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Angela Massarelli | 27 | $2 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | David W Ranck | 27 | $2 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Mark D Barbier | 27 | $2 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Martin E Bystrom | 27 | $1 0.0% of $21,482 |
| Intensive Care, Cancer, Accident | Aflac | Dianne L Martin | 27 | $1 0.0% of $21,482 |
| Other | The Lincoln National Life Insurance Co | Brown & Brown Of Pennsylvania | — | Comp not disclosed |
| Acc | The Lincoln National Life Insurance Co | Brown & Brown Of Pennsylvania | 10 | $599 20.0% of $2,995 |
| Other | Madison National Life Insurance Company | Brown & Brown Of Pennsylvania | — | Comp not disclosed |
| Other | Madison National Life Insurance Company | North American Benefits Company | — | Comp not disclosed |
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.