Employer
Groff Tractor Holdings LLC
6779 Carlisle Pike, Mechanicsburg, PA 17050 · EIN 47-3900486 · Jun 1, 2021 to May 31, 2022
Plan year 2021
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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 $20,824
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | — | 382 | Schedule A not provided |
| Vision | Capital Advantage Assurance Company | Marty Miracle | 340 | $468 4.0% of $11,703 |
| Life | Boston Mutual Life Insurance Company | Usi Insurance Services (Ri) | 273 | $13,436 11.6% of $115,551 |
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.