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Employer
2785 S Queen Street, Dallastown, PA 17313 · EIN 23-2888838 · Dec 1, 2024 to Nov 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 $9,818
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 75 | Comp not disclosed Premium $240,280 |
| Dental | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 64 | $2,585 8.2% of $31,614 |
| Dental | United Of Omaha Life Insurance Company | Gi George Parent Lp | 64 | $594 1.9% of $31,614 |
| Vision | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 61 | $428 8.3% of $5,129 |
| Vision | United Of Omaha Life Insurance Company | Gi George Parent Lp | 61 | $97 1.9% of $5,129 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 42 | $1,193 10.4% of $11,500 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 42 | $230 2.0% of $11,500 |
| Voluntary | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 40 | $1,823 10.4% of $17,589 |
| Voluntary | United Of Omaha Life Insurance Company | Gi George Parent Lp | 40 | $343 2.0% of $17,589 |
| Voluntary | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 33 | $2,271 15.3% of $14,820 |
| Voluntary | United Of Omaha Life Insurance Company | Gi George Parent Lp | 33 | $254 1.7% of $14,820 |
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.
Visible subtotal $58,971
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $54,769 | $730.25 |
| E. K. Mcconkey & Co., Inc. | Broker | $20,825 | $277.67 |
| Capital Bluecross | Admin | $-16,623 | $-221.64 |