Employer
Groff'S Heating Air Conditioning & Plumbing, Inc.
3012 Willow Street Pike North, Willow Street, PA 17584 · EIN 23-2830723 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 121
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 $11,633
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Starmount Life Insurance Company | Ccab Insurance & Benefits, Inc | 75 | $4,032 10.0% of $40,315 |
| Dental | Starmount Life Insurance Company | Skiles, Timothy | 75 | $2,016 5.0% of $40,315 |
| Vision | Ngl | Ccab Insurance & Benefits, Inc | 112 | $680 10.0% of $6,797 |
| Life | Met Life | — | — | Schedule A not provided |
| Other | Unum Life Insurance Company Of America | Ccab Insurance & Benefits, Inc | 47 | $2,136 6.6% of $32,579 |
| Other | Unum Life Insurance Company Of America | Skiles, Timothy | 47 | $1,629 5.0% of $32,579 |
| Cancer, Critical Care, Accident, Life, Supplemental | Colonial Life & Accident Insurance Company | Ccab Insurance & Benefits, Inc | 27 | $470 3.3% of $14,112 |
| Cancer, Critical Care, Accident, Life, Supplemental | Colonial Life & Accident Insurance Company | Benechoice Enrollment Solutions & T | 27 | $412 2.9% of $14,112 |
| Cancer, Critical Care, Accident, Life, Supplemental | Colonial Life & Accident Insurance Company | Petrina Skiles | 27 | $195 1.4% of $14,112 |
| Cancer, Critical Care, Accident, Life, Supplemental | Colonial Life & Accident Insurance Company | Lance A Bradley | 27 | $63 0.4% of $14,112 |
| Stop-loss | HM Life Insurance Company | — | 80 | Comp not disclosed Premium $334,198 |
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 $70,222
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $70,237 | $739.34 |
| Ccab Insurance & Benefits, Inc. | Broker | $24,920 | $262.32 |
| Capital Bluecross | Admin | $-24,935 | $-262.47 |