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Employer
P.O. Box 300, Nottingham, PA 19362 · EIN 23-1598830 · Sep 1, 2024 to Aug 31, 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 $130,282
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pennsylvania | — | 1121 | Comp not disclosed Premium $570,079 |
| Vision | Vision Service Plan | — | 1017 | Comp not disclosed Premium $180,039 |
| Life | Hartford Life And Accident | Assured Partners (Central Pa) | 1437 | $130,282 14.4% of $904,748 |
| Employee Assistance Program (Eap) | Magellan Healthcare | — | 1651 | Comp not disclosed Premium $23,774 |
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 $926,575
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Luminare Health Benefits | Health | $531,034 | $321.64 |
| Aetna | Health | $213,465 | $129.29 |
| Delta Dental Of Pennsylvania | Dental Admin Fees | $74,600 | $45.18 |
| Vision Service Plan | Vision Admin Fees | $28,806 | $17.45 |
| Teledoc | Health | $21,290 | $12.90 |
| Healthcare Bluebook | Health | $21,117 | $12.79 |
| Change Healthcare | Health | $18,749 | $11.36 |
| Multiplan | Health | $14,382 | $8.71 |
| Prime Therapeutics Management LLC | Rx Management | $3,132 | $1.90 |