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Employer
1407 Scalp Avenue, Johnstown, PA 15904 · EIN 25-1007465 · 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 $26,616
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | — | 9 | Comp not disclosed Premium $61,575 |
| Medical | Upmc Health Options | — | 305 | Comp not disclosed Premium $1,542,860 |
| Dental | Upmc Health Benefits | Cbiz Benefits & Ins. Services | 171 | $4,731 10.0% of $47,439 |
| Dental | Upmc Health Benefits | Cbiz Benefits & Ins. Services | 8 | $226 12.2% of $1,856 |
| Dental | Upmc Health Benefits | Cbiz Benefits & Ins. Services | 119 | $2,248 10.3% of $21,852 |
| Dental | Upmc Health Benefits | Cbiz Benefits & Ins. Services | 1 | $54 10.8% of $501 |
| Vision | Vision Benefits Of America | Cbiz Benefits & Ins. Services | 171 | $1,076 3.8% of $28,336 |
| Life | American United Life Insurance Company | Cbiz Benefits & Ins. Services | 182 | $18,160 15.7% of $115,782 |
| Business Travel Accident | Hartford Life And Accident | Cbiz Benefits & Ins. Services | 182 | $121 16.1% of $750 |
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.