Employer
General Doors Corporation
P.O. Box 205, Bristol, PA 19007 · EIN 51-0077094 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | — | Comp not disclosed Premium $1,314 |
| Stop-loss | Sun Life Assurance Company | — | 57 | Comp not disclosed Premium $331,030 |
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 $69,993
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Hub Intl. Ne Blue Bell (Isi Benefit | Broker | $28,518 | $475.30 |
| The Benecon Group | Broker | $13,641 | $227.35 |
| Hub Int. (Pa) | Broker | $5,831 | $97.18 |
| Patriot (The Safegard Group, Inc.) | Broker | $-143 | $-2.38 |
| Independence Administrators | Admin | $18,293 | $304.88 |
| Connectcare 3 | Patient Advocate | $3,853 | $64.22 |