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Employer
4193 State Route 6n East, Edinboro, PA 16412 · EIN 25-1618452 · 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 $33,315
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Michael S Vereb | 166 | $25,290 2.9% of $862,149 |
| Life | Guardian Life Insurance Company Of America | Gilbert L Troutman | 116 | $3,978 9.6% of $41,516 |
| Life | Guardian Life Insurance Company Of America | The Hdh Group, Inc. | 116 | $812 2.0% of $41,516 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | The Hdh Group, Inc. | 11 | $1,396 11.5% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Barbara Baxter Dejohn | 11 | $798 6.6% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Daniel J Slater | 11 | $388 3.2% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Timothy J Slater | 11 | $340 2.8% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Kati Naim | 11 | $224 1.8% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Howard J Horowitz | 11 | $81 0.7% of $12,154 |
| Critical Illness, Hospital, Cancer | Colonial Life And Accident Insurance Company | Brandon Marcello Cento | 11 | $8 0.1% of $12,154 |
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.
No Schedule C parties in this year.