Employer
Fairmount Homes
333 Wheat Ridge Drive, Ephrata, PA 17522 · EIN 23-1680874 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 207
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $12,896
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 122 | Comp not disclosed Premium $237,422 |
| Stop-loss | Crum & Forster | — | 135 | Comp not disclosed Premium $191,867 |
| Dental + Vision | Capital Advantage Assurance Company | Ap Benefit Advisors | 207 | $4,129 5.2% of $79,261 |
| AD&D | Sun Life Assurance Company Of Canada | Murray Insurance Associates Inc | 52 | $8,767 15.1% of $58,075 |
Schedule C
Additional compensation
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 $76,827
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $41,730 | $201.59 |
| Assured Partners (Central Pa) | Broker | $29,544 | $142.72 |
| Lr Webber | Admin | $10,503 | $50.74 |
| ConnectCare3 | Patient Advocate | $6,224 | $30.07 |
| Capital Advantage Assurance Company | Admin | $-11,174 | $-53.98 |