Employer
H.L. Wiker, Inc.
709 Hartman Station Road, Lancaster, PA 17605 · EIN 35-2437792 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
Covered lives: 65
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 $5,267
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 45 | Comp not disclosed Premium $165,432 |
| Dental | Standard Insurance Company | Murray Insurance Associates | 47 | $1,367 4.4% of $31,075 |
| Vision | Standard Insurance Company | Murray Insurance Associates | 47 | $56 3.9% of $1,420 |
| Life | Standard Insurance Company | Murray Insurance Associates | 54 | $1,850 8.2% of $22,502 |
| Other | Standard Insurance Company | Murray Insurance Associates | 20 | $1,380 15.0% of $9,200 |
| Other | Standard Insurance Company | Murray Insurance Associates | 34 | $614 12.0% of $5,138 |
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 $43,136
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Assured Partners (Central Pa) | Broker | $19,602 | $301.57 |
| The Benecon Group, LLC | Broker | $16,881 | $259.71 |
| Highmark Blue Shield | Admin | $3,564 | $54.83 |
| Connectcare3, LLC | Patient Advocate | $3,089 | $47.52 |