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Employer
25 Decibel Road, Suite 205, State College, PA 16801 · EIN 20-5967335 · 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 $9,794
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $659 |
| Stop-loss | Crum & Forster | — | 51 | Comp not disclosed Premium $181,241 |
| Dental + Vision | The Guardian Life Insurance Company Of America | Emerson Rogers LLC | 56 | $3,706 15.2% of $24,309 |
| Life | United Of Omaha Life Insurance Company | Emerson Rogers LLC | 34 | $1,742 24.2% of $7,197 |
| Other | United Of Omaha Life Insurance Company | Emerson Rogers LLC | 66 | $2,006 19.1% of $10,503 |
| Accident | United Of Omaha Life Insurance Company | Emerson Rogers LLC | 32 | $908 18.7% of $4,854 |
| Other | United Of Omaha Life Insurance Company | Emerson Rogers LLC | 28 | $1,432 18.7% of $7,677 |
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.
Visible subtotal $47,790
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $44,455 | $673.56 |
| Aperture Consulting-Richard Wilber | Broker | $19,920 | $301.82 |
| Capital Bluecross | Admin | $-16,585 | $-251.29 |