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Employer
3826 Route 31 East, Jones Mills, PA 15646 · EIN 25-1795040 · 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 $114,696
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 141 | $3,528 8.3% of $42,497 |
| Dental | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 141 | $2,125 5.0% of $42,497 |
| Dental | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 141 | $2,125 5.0% of $42,497 |
| Vision | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 119 | $2,732 20.7% of $13,167 |
| Vision | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 119 | $658 5.0% of $13,167 |
| Life | United Of Omaha Life Insurance Company | Seubert & Associates, Inc. | 99 | $6,943 15.9% of $43,610 |
| Life | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 99 | $6,542 15.0% of $43,610 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 99 | $2,181 5.0% of $43,610 |
| Other | United Of Omaha Life Insurance Company | Seubert & Associates, Inc. | 46 | $5,392 15.8% of $34,127 |
| Other | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 46 | $3,413 10.0% of $34,127 |
| Other | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 46 | $1,706 5.0% of $34,127 |
| Other | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 29 | $1,767 15.9% of $11,143 |
| Other | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 29 | $1,114 10.0% of $11,143 |
| Other | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 29 | $557 5.0% of $11,143 |
| Accident | United Of Omaha Life Insurance Company | Seubert & Associates, Inc. | 69 | $3,103 20.8% of $14,936 |
| Accident | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 69 | $2,240 15.0% of $14,936 |
| Accident | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 69 | $747 5.0% of $14,936 |
| Critical Illness | United Of Omaha Life Insurance Company | Seubert & Associates, Inc. | 44 | $1,776 21.0% of $8,474 |
| Critical Illness | United Of Omaha Life Insurance Company | Web Benefits Design Corporation | 44 | $1,271 15.0% of $8,474 |
| Critical Illness | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 44 | $424 5.0% of $8,474 |
| Medical | Highmark, Inc. | Seubert & Associates, Inc. | 210 | $50,139 4.3% of $1,157,139 |
| Other | Highmark, Inc. | Seubert & Associates, Inc. | 210 | $14,213 4.2% of $334,922 |
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.
No Schedule C parties in this year.