Employer
Friendship House
1509 Maple Street, Scranton, PA 18505 · EIN 24-0795422 · Jul 1, 2024 to Jun 30, 2025
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 $25,525
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Guardian Life Insurance Company | Kistler Tiffany Benefits Co | 203 | $16,674 12.4% of $134,903 |
| Dental | Guardian Life Insurance Company | One Digital Premier Services, LLC | 203 | $6,745 5.0% of $134,903 |
| Vision | National Vision Administrators, LLC | Kistler Tiffany Benefits Co | 224 | $2,106 10.0% of $21,063 |
| Stop-loss | HM Life Insurance Company | — | 150 | Comp not disclosed Premium $505,853 |
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 $82,660
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Cummings Insurance Agency | Broker | $45,325 | $302.17 |
| The Benecon Group | Broker | $29,385 | $195.90 |
| ConnectCare3 | Patient Advocate | $10,188 | $67.92 |
| Highmark Bcbs Nepa | Admin | $-2,238 | $-14.92 |