Employer
Function Inc.
5570 Snydertown Road, Paxinos, PA 17860 · EIN 47-4804405 · Nov 1, 2021 to Oct 31, 2022
Plan year 2021
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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 $19,561
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | — | 317 | Comp not disclosed Premium $3,124,069 |
| Dental + Vision | Principal Life Insurance Company | — | 354 | Comp not disclosed Premium $115,293 |
| Other | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 279 | $5,259 10.7% of $49,031 |
| Other | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 279 | $2,452 5.0% of $49,031 |
| Other | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 279 | $8,168 11.1% of $73,649 |
| Other | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 279 | $3,682 5.0% of $73,649 |
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.
No Schedule C parties in this year.