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Employer
34 Angstadt Lane, Birdsboro, PA 19508 · EIN 23-1936912 · Dec 1, 2024 to Nov 30, 2025
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 $20,171
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $13,871 |
| Medical | Highmark Inc. | Mitchell, Patrick A | 47 | $14,220 2.8% of $509,925 |
| Dental | Delta Dental Of Pennsylvania | Engle, Hambright & Davies, Inc. | 35 | $1,358 10.0% of $13,584 |
| Vision | Ameritas Life Insurance Corp | Engle, Hambright & Davies, Inc. | 37 | $268 11.6% of $2,314 |
| Vision | Ameritas Life Insurance Corp | James R Nelligan & Associates | 37 | $127 5.5% of $2,314 |
| Life | The Guardian Life Insurance Company Of America | Engle, Hambright & Davies, Inc. | 40 | $2,855 10.7% of $26,572 |
| Life | The Guardian Life Insurance Company Of America | James R Nelligan & Associates | 40 | $1,329 5.0% of $26,572 |
| Life | The Guardian Life Insurance Company Of America | Mazzmar LLC | 40 | $14 0.1% of $26,572 |
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.
Visible subtotal $3,003
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $1,926 | $40.98 |
| Engle Hambright & Davies | Broker | $1,077 | $22.91 |