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Employer
250 Airport Road, Indiana, PA 15701 · EIN 98-0226117 · 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 $62,130
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | American Insurance Administrators | 195 | $42,231 2.4% of $1,779,603 |
| Life | United Of Omaha Life Insurance Company | American Insurance Administrators | 128 | $818 2.9% of $28,098 |
| Life | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $1,719 6.1% of $28,098 |
| Life | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $2,810 10.0% of $28,098 |
| Life | United Of Omaha Life Insurance Company | Alera General Insurance Serv | 128 | $832 3.0% of $28,098 |
| Life | United Of Omaha Life Insurance Company | American Insurance Administrators | 45 | $411 3.0% of $13,603 |
| Life | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 45 | $914 6.7% of $13,603 |
| Life | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 45 | $1,360 10.0% of $13,603 |
| Life | United Of Omaha Life Insurance Company | Alera General Insurance Serv | 45 | $400 2.9% of $13,603 |
| Other | United Of Omaha Life Insurance Company | American Insurance Administrators | 128 | $602 2.9% of $20,567 |
| Other | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $1,275 6.2% of $20,567 |
| Other | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $2,807 13.6% of $20,567 |
| Other | United Of Omaha Life Insurance Company | Alera General Insurance Serv | 128 | $609 3.0% of $20,567 |
| Other | United Of Omaha Life Insurance Company | American Insurance Administrators | 128 | $705 2.9% of $24,227 |
| Other | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $1,494 6.2% of $24,227 |
| Other | United Of Omaha Life Insurance Company | Alera Group Inc DBA Coury Health Sv | 128 | $2,423 10.0% of $24,227 |
| Other | United Of Omaha Life Insurance Company | Alera General Insurance Serv | 128 | $720 3.0% of $24,227 |
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.