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Employer
274 Lakemont Park Blvd, Altoona, PA 16602 · EIN 58-1935744 · 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 $20,226
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Companies, Inc. | Henderson Brothers Inc. | 128 | $2,638 7.8% of $33,799 |
| Vision | Eyemed Vision Care | Henderson Brothers Inc. | 128 | $885 10.0% of $8,812 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 111 | $345 6.1% of $5,640 |
| AD&D | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 30 | $5,111 21.3% of $24,028 |
| Vol Std | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 39 | $3,548 20.8% of $17,076 |
| Critical Illness | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 28 | $5,132 25.2% of $20,384 |
| Vol Accident | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 50 | $1,162 20.9% of $5,568 |
| Vol Hospital Indem | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 25 | $1,405 21.0% of $6,704 |
| Stop-loss | HM Life Insurance Company | — | 73 | Comp not disclosed Premium $379,576 |
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 $44,967
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $20,573 | $278.01 |
| Highmark West | Admin | $24,394 | $329.65 |