Employer
Henry Molded Products, Inc.
71 N. 16th Street, Lebanon, PA 17042 · EIN 23-1632737 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $4,543
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 69 | Comp not disclosed Premium $278,484 |
| Medical | Equitable Financial Life Insurance Company Of America | Brown & Brown Of Pennsylvania | 96 | $3,203 7.9% of $40,309 |
| Medical | Equitable Financial Life Insurance Company Of America | Brown & Brown Insurance Services | 96 | $1,029 2.6% of $40,309 |
| Vision | National Vision Administrators, LLC | Brown & Brown Of Pennsylvania | 106 | $156 2.5% of $6,222 |
| Vision | National Vision Administrators, LLC | Brown & Brown Insurance Services, I | 106 | $155 2.5% of $6,222 |
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 $39,263
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pa | Broker | $30,555 | $288.25 |
| The Benecon Group, LLC | Broker | $17,411 | $164.25 |
| Connectcare 3 | Other | $4,724 | $44.57 |
| Innovu | Other | $3,492 | $32.94 |
| Capital Advantage Assurance Company | Admin | $-16,919 | $-159.61 |