Employer
H2, LLC
1336 Loop Road, Lancaster, PA 17601 · EIN 23-3077749 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 59
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 $8,233
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 51 | Comp not disclosed Premium $11,611 |
| Dental + Vision | Sun Life Assurance Company Of Canada | — | — | Schedule A not provided |
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $790 |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | 59 | Comp not disclosed Premium $173,249 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Ap Benefit Advisors LLC | 51 | $8,233 11.1% of $74,089 |
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 $26,306
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Assured Partners (Central Pa) | Broker | $1,428 | $26.94 |
| The Benecon Group, LLC | Broker | $987 | $18.62 |
| Capital Bluecross | Admin | $306 | $5.77 |
| ConnectCare3 | Patient Advocate | $278 | $5.25 |
| Assured Partners (Central Pa) | Broker | $18,928 | $320.81 |
| The Benecon Group, LLC | Broker | $17,274 | $292.78 |
| Capital Bluecross | Admin | $-12,895 | $-218.56 |