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Employer
7564 Browns Mill Road, Chambersburg, PA 17202 · EIN 23-2205138 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $32,450
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 240 | Comp not disclosed Premium $887,686 |
| Vision | Capital Advantage Assurance Company | — | — | Schedule A not provided |
| Life | The Lincoln National Life Insurance Company | Strickler Agency, Inc. | 330 | $2,696 11.0% of $24,510 |
| Life | The Lincoln National Life Insurance Company | Gis Benefits Inc | 330 | $1,226 5.0% of $24,510 |
| AD&D | The Lincoln National Life Insurance Company | Strickler Agency, Inc. | 128 | $4,044 15.0% of $26,958 |
| AD&D | The Lincoln National Life Insurance Company | Gis Benefits Inc | 128 | $1,348 5.0% of $26,958 |
| Other | The Lincoln National Life Insurance Company | Strickler Agency, Inc. | 330 | $5,262 13.5% of $38,978 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 330 | $1,949 5.0% of $38,978 |
| Other | The Lincoln National Life Insurance Company | Strickler Agency, Inc. | 136 | $10,120 15.0% of $67,468 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 136 | $3,373 5.0% of $67,468 |
| Telehealth | Allyhealth | Strickler Agency, Inc. | 407 | $2,432 10.9% of $22,387 |
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 $330,438
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Strickler Agency, Inc. (Chambersbur | Broker | $67,968 | $167.00 |
| The Benecon Group, LLC | Broker | $45,001 | $110.57 |
| Capital Blue Cross | Admin | $177,858 | $437.00 |
| United Concordia Dental | Admin | $23,978 | $58.91 |
| ConnectCare3 | Patient Advocate | $15,633 | $38.41 |