Employer
Fortna Inc.
333 Buttonwood Street, W. Reading, PA 19611 · EIN 23-2289371 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $40,090
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 402 | Comp not disclosed Premium $932,491 |
| Dental | Sun Life Assurance Company Of Canada | Patriot (Power-Kunkle Group, Inc.) | 495 | $33,919 6.1% of $555,385 |
| Vision | Vision Benefits Of America | Patriot (Power-Kunkle Group, Inc.) | 327 | $1,917 5.0% of $38,342 |
| Expatriate Medical | Four Ever Life Insurance | Patriot (Power-Kunkle Group, Inc.) | — | $2,543 15.0% of $16,950 |
| Travel | Four Ever Life Insurance | Acson Insurance Services | 3 | $1,711 8.0% of $21,390 |
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 $228,875
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Power Kunkle Group Inc | Broker | $147,019 | $365.72 |
| The Benecon Group LLC | Broker | $53,478 | $133.03 |
| Connectcare 3 | Patient Advocate | $18,576 | $46.21 |
| Capital Blue Cross | Admin | $9,802 | $24.38 |