Employer
Grosfillex, Inc.
230 Old West Penn Avenue, Robesonia, PA 19551 · EIN 23-1714549 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $19,264
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental + Vision | Principal Life Insurance Company | Assured Partners (Central Pa) | 141 | $11,729 9.2% of $128,015 |
| Dental + Vision | Principal Life Insurance Company | Gis Benefits Inc | 141 | $7,535 5.9% of $128,015 |
| Stop-loss | Avalon Insurance Company | — | 79 | Comp not disclosed Premium $454,285 |
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 $122,169
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $87,235 | $1,002.70 |
| Assured Partners (Central Pa) | Broker | $38,196 | $439.03 |
| Revivehealth, Inc. | Other | $22,302 | $256.34 |
| Highmark Blue Shield (Central) | Admin | $-25,564 | $-293.84 |