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Employer
445 County Line Rd, Gilbertsville, PA 19525 · EIN 23-2517991 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $8,695
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Crum & Forster | — | 103 | Comp not disclosed Premium $698,306 |
| Dental | Delta Dental Of Pennsylvania | Patriot (Power-Kunkle Group, Inc.) | 242 | $8,282 10.0% of $82,818 |
| Vision | Vision Benefits Of America | Patriot (Power-Kunkle Group, Inc.) | 112 | $343 2.6% of $12,992 |
| Vision | Vision Benefits Of America | Patriot Growth Insurance Services | 112 | $70 0.5% of $12,992 |
| Life | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
| AD&D | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
| Other | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
| Other | United Of Omaha Life Insurance Company | — | — | Schedule A not provided |
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 $163,111
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $123,296 | $1,100.86 |
| Patriot (Power-Kunkle Group, Inc.) | Broker | $39,815 | $355.49 |