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Employer
100 Erie Insurance Place, Erie, PA 16530 · EIN 25-0466020 · 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 $449,840
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Metropolitan Life Insurance Company | Buck Global, LLC | 6652 | $61,968 1.5% of $4,123,240 |
| Other | Metropolitan Life Insurance Company | Buck Global, LLC | 6596 | $49,780 1.5% of $3,348,163 |
| Dental | Delta Dental Of Pennsylvania | Unmapped | 6295 | $293,428 6.5% of $4,487,287 |
| Long Term Care | Metropolitan Life Insurance Company | Loesel-Shaaf Insurance Agency Inc | 47 | $5,439 9.9% of $54,969 |
| Long Term Care | Genworth Life Insurance Company | Edward Althoff | 303 | $39,069 9.7% of $403,301 |
| Long Term Care | Genworth Life Insurance Company | Mowery Associates | 303 | Comp not disclosed Premium $403,301 |
| Other | Metropolitan Life Insurance Company | Buck Global, LLC | 203 | $156 1.1% of $13,760 |
| Other | Metropolitan Life Insurance Company | — | 202 | Comp not disclosed Premium $65,246 |
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 $228,400
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Davis Vision | Admin | $17,909 | $2.90 |
| Metropolitan Life Insurance Company | Admin | $210,491 | $31.91 |