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Employer
223 George Junior Road, Grove City, PA 16127 · EIN 25-0753320 · Jan 1, 2024 to Dec 31, 2024
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 $46,868
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | Gilberts Insurance Agency, Inc | 452 | $5,067 4.0% of $126,008 |
| Medical | Principal Life Insurance Company | Alera Group, Inc DBA Arms | 452 | $3,224 2.6% of $126,008 |
| Medical | Principal Life Insurance Company | Alera General Agency Insurance Serv | 452 | $3,076 2.4% of $126,008 |
| Vision | Vision Benefits Of America | Gilberts Insurance Agency, Inc | 244 | $1,436 10.0% of $14,293 |
| Vision | Vision Benefits Of America | Alera Group Inc. C/O Arms Insurance | 244 | $708 5.0% of $14,293 |
| Life | Reliance Standard | The Hdh Group, Inc. | 383 | $7,287 13.0% of $56,053 |
| Life | Reliance Standard | The Hdh Group, Inc. | 99 | $4,669 25.0% of $18,677 |
| Life | Colonial Life And Accident Insurance Company | Arick Martin | 6 | $336 7.3% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Timothy J. Slater | 6 | $224 4.9% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Reschini Agency., Inc. | 6 | $155 3.4% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Kati Nairn | 6 | $26 0.6% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | David E. Hauck | 6 | $24 0.5% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Timothy Birdsong | 6 | $21 0.5% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Clarice D Lews LLC | 6 | $11 0.2% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Jonathan Andrew Graeser | 6 | $4 0.1% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Lucas Michael | 6 | $4 0.1% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | William E. Good | 6 | $2 0.0% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Sara Marie Bryer | 6 | $1 0.0% of $4,595 |
| Life | Colonial Life And Accident Insurance Company | Timothy J. Slater | 21 | $218 1.7% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | David E. Hauck | 21 | $122 0.9% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Reschini Agency., Inc. | 21 | $86 0.7% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Arick Martin | 21 | $70 0.5% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Lucas Michael | 21 | $47 0.4% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Jonathan Andrew Graeser | 21 | $47 0.4% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Barbara Baxter Dejohn | 21 | $21 0.2% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Kati Nairn | 21 | $20 0.2% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Lance A Bradley | 21 | $11 0.1% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Tammy A Morgart | 21 | $4 0.0% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Sara Marie Bryer | 21 | $3 0.0% of $12,962 |
| Life | Colonial Life And Accident Insurance Company | Arick Martin | 1 | $178 9.8% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | Timothy J. Slater | 1 | $147 8.1% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | Reschini Agency., Inc. | 1 | $141 7.7% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | Barbara Baxter Dejohn | 1 | $17 0.9% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | Timothy Birdsong | 1 | $11 0.6% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | Kati Nairn | 1 | $10 0.5% of $1,824 |
| Life | Colonial Life And Accident Insurance Company | David E. Hauck | 1 | $4 0.2% of $1,824 |
| Life | Reliance Standard | The Hdh Group, Inc. | 17 | $9,082 25.0% of $36,327 |
| Life | Colonial Life And Accident Insurance Company | Arick Martin | 3 | $168 4.7% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Timothy A Slater | 3 | $145 4.0% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Reschini Agency., Inc. | 3 | $92 2.6% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | The Hdh Group, Inc. | 3 | $36 1.0% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | David E. Hauck | 3 | $21 0.6% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Kati Nairn | 3 | $16 0.4% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Timothy Birdsong | 3 | $9 0.3% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Lucas Michael | 3 | $7 0.2% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Jonathan Andrew Graeser | 3 | $7 0.2% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Sara Marie Bryer | 3 | $3 0.1% of $3,589 |
| Life | Colonial Life And Accident Insurance Company | Tammy A Morgart | 3 | $3 0.1% of $3,589 |
| Other | Reliance Standard | The Hdh Group, Inc. | 383 | $3,721 13.0% of $28,628 |
| Other | Reliance Standard | The Hdh Group, Inc. | 375 | $4,602 13.0% of $35,404 |
| Other | Reliance Standard | The Hdh Group, Inc. | 375 | $1,524 13.0% of $11,727 |
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 $975,967
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gilbert Inc. Agency | Broker | $50,992 | $104.07 |
| Roundstone Man. | Stop Loss | $676,406 | $1,380.42 |
| C.A.S. | Tpa | $95,175 | $194.23 |
| Aimm | Medical Management | $82,862 | $169.11 |
| S&S Healthcare | Ppo Network | $61,130 | $124.76 |
| American Health Holding Inc. | Telemedicine | $9,402 | $19.19 |