Employer
Good'S Store Inc.
165 Earland Drive, New Holland, PA 17557 · EIN 23-1931648 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 110
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $3,504
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental + Vision | Sun Life Assurance Company Of Canada | Ap Benefit Advisors, LLC | 32 | $2,448 12.4% of $19,747 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Gis Benefits, Inc. | 32 | $1,056 5.3% of $19,747 |
| Transplant | Hcc Life Insurance Company | — | 110 | Comp not disclosed Premium $14,210 |
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.
No Schedule C parties in this year.