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Employer
6390 Hedgewood Drive, Allentown, PA 18106 · EIN 30-0937526 · Oct 1, 2023 to Sep 30, 2024
Plan year 2023
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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 $168,727
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Axis Insurance Company | Hub Interntional Midwest Ltd (Fl) | 191 | $51,930 11.0% of $471,406 |
| Medical | Cigna Health And Life Insurance Company | Hub International | 142 | $35,962 2.8% of $1,281,488 |
| Dental | United Of Omaha Life Insurance Company | Hub International | 281 | $23,782 14.2% of $167,855 |
| Vision | United Of Omaha Life Insurance Company | Hub International | 252 | $4,876 18.2% of $26,816 |
| Life | United Of Omaha Life Insurance Company | Hub International | 805 | $10,700 22.0% of $48,528 |
| Life | United Of Omaha Life Insurance Company | Ea Legacy LLC | 805 | $2,569 5.3% of $48,528 |
| Life | United Of Omaha Life Insurance Company | Hub International | 107 | $13,117 23.5% of $55,886 |
| Life | United Of Omaha Life Insurance Company | Ea Legacy LLC | 107 | $2,794 5.0% of $55,886 |
| Other | United Of Omaha Life Insurance Company | Hub International | 805 | $5,857 15.0% of $39,049 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Hub International | 250 | $8,974 22.5% of $39,897 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Hub International | 162 | $8,166 22.6% of $36,102 |
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.