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Employer
1952 Waddle Road, State College, PA 16804 · EIN 25-1150293 · 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 $77,511
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company Of Canada | Usi Insurance Services (Ri) | 983 | $67,500 4.3% of $1,578,695 |
| Dental | Sun Life Assurance Company Of Canada | Usi Insurance Services (Ri) | 812 | $8,728 2.3% of $378,428 |
| Vision | Eyemed Vision Care | — | 1944 | Comp not disclosed Premium $129,220 |
| Life | Standard Insurance Company | — | 1856 | Comp not disclosed Premium $227,194 |
| Long Term Care | Unum Life Insurance Company Of America | Strategic Non-Medical Solution | 236 | $1,283 1.5% of $85,595 |
| Other | Standard Insurance Company | — | 194 | Comp not disclosed Premium $83,220 |
| Other | Standard Insurance Company | — | 826 | Comp not disclosed Premium $275,755 |
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 $1,051,903
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Aetna Life Insurance Company | Contract Administrator | $794,829 | $408.86 |
| Usi Insurance Services LLC | Consulting Services | $114,490 | $58.89 |
| Sterling Wellness Solutions, LLC | Wellness Administrator | $80,999 | $41.67 |
| Inspira Financial | Administration | $32,567 | $16.75 |
| Optavise LLC | Consulting Services | $29,018 | $14.93 |