Employer
G.R. Mitchell, Inc.
14 Beaver Valley Pike, Willow Street, PA 17584 · EIN 23-1710257 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 50
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 $12,135
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $278 |
| Stop-loss | Avalon Insurance Company | — | 50 | Comp not disclosed Premium $183,651 |
| Stop-loss | Revivehealth, Inc. | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Dental + Vision | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
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 $59,995
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $42,495 | $849.90 |
| Assured Partners (Central Pa) | Broker | $19,932 | $398.64 |
| Revivehealth, Inc. | Other | $12,663 | $253.26 |
| Capital Bluecross | Admin | $-15,095 | $-301.90 |