Employer
Fresh Roasted Coffee, LLC
1136 Walnut Street Ext., Sunbury, PA 17801 · EIN 26-4789561 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $1,345
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 47 | Comp not disclosed Premium $110,527 |
| Dental + Vision | Capital Advantage Assurance Company | Mcconkey Benefits & Financial Servi | 57 | $1,345 9.3% of $14,487 |
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 $40,777
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $11,995 | $210.44 |
| E. K. Mcconkey & Co., Inc. | Broker | $11,650 | $204.39 |
| Capital Bluecross | Admin | $14,513 | $254.61 |
| ConnectCare3 | Patient Advocate | $2,619 | $45.95 |