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Employer
1901 North Fifth Street, Harrisburg, PA 17102 · EIN 23-1365148 · Jun 1, 2024 to May 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 $41,616
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 182 | Comp not disclosed Premium $274,471 |
| Stop-loss | Zurich North American Insurance Company | — | 184 | Comp not disclosed Premium $149,945 |
| Medical | Aflac | Joann G Ciavarella | 85 | $9,265 10.4% of $88,933 |
| Medical | Aflac | William L Murray Jr | 85 | $2,855 3.2% of $88,933 |
| Medical | Aflac | Anthony S Almodovar | 85 | $2,017 2.3% of $88,933 |
| Medical | Aflac | Dianne L Martin | 85 | $412 0.5% of $88,933 |
| Medical | Aflac | Charles L Jennings | 85 | $200 0.2% of $88,933 |
| Medical | Aflac | John K Fisher | 85 | $103 0.1% of $88,933 |
| Medical | Aflac | Matthew G Berger | 85 | $87 0.1% of $88,933 |
| Medical | Aflac | Clarence L Roe | 85 | $60 0.1% of $88,933 |
| Medical | Aflac | Robert A Anderson | 85 | $53 0.1% of $88,933 |
| Medical | Aflac | Chris H Robinson | 85 | $22 0.0% of $88,933 |
| Medical | Aflac | Daniel R Judy | 85 | $19 0.0% of $88,933 |
| Medical | Aflac | Gaile F Delbaugh | 85 | $18 0.0% of $88,933 |
| Medical | Aflac | Ryan K Goldberg | 85 | $18 0.0% of $88,933 |
| Medical | Aflac | Darren D Riddle | 85 | $17 0.0% of $88,933 |
| Medical | Aflac | Irene E Brooks | 85 | $16 0.0% of $88,933 |
| Medical | Aflac | Angela Massarelli | 85 | $10 0.0% of $88,933 |
| Medical | Aflac | Christopher A Lupp | 85 | $6 0.0% of $88,933 |
| Medical | Aflac | Martin E Bystrom | 85 | $3 0.0% of $88,933 |
| Dental | Capital Advantage Assurance Company | Brown & Brown Of Pennsylvania | 176 | $7,640 8.5% of $89,882 |
| Vision | Capital Advantage Assurance Company | Brown & Brown Of Pennsylvania | 176 | $1,348 8.5% of $15,853 |
| Life | American Heritage Life Insurance | Howard B Labow | 9 | $192 4.3% of $4,414 |
| Life | American Heritage Life Insurance | Maia Labow | 9 | $62 1.4% of $4,414 |
| Life | American Heritage Life Insurance | Edward Taylor | 9 | $3 0.1% of $4,414 |
| Life | American Heritage Life Insurance | James Dominic Fernandez | 9 | $2 0.0% of $4,414 |
| Life | American Heritage Life Insurance | Thomas W Boston | 9 | $1 0.0% of $4,414 |
| Life | Metropolitan Life Insurance Company | Krise Broeg & Boushell LLC | 201 | $2,522 6.7% of $37,896 |
| Other | Provident Life And Accident Insurance Company | Krise Broeg & Boushell, LLC | 50 | $2,608 10.3% of $25,307 |
| Other | Northwestern Mutual | Matthew Robert Krise | 49 | $1,544 4.8% of $32,500 |
| Other | Northwestern Mutual | Japheth Michael Broeg | 49 | $1,497 4.6% of $32,500 |
| Other | Northwestern Mutual | Christopher Jay Boushell | 49 | $1,497 4.6% of $32,500 |
| Other | Northwestern Mutual | Guinan Fncl Grp LLC | 49 | $540 1.7% of $32,500 |
| Other | Northwestern Mutual | Brad Andrew Nelson | 49 | $330 1.0% of $32,500 |
| Other | Northwestern Mutual | Matthew Robert Krise | 201 | $1,897 1.3% of $145,669 |
| Other | Northwestern Mutual | Christopher Jay Boushell | 201 | $1,842 1.3% of $145,669 |
| Other | Northwestern Mutual | Japheth Michael Broeg | 201 | $1,841 1.3% of $145,669 |
| Other | Northwestern Mutual | Guinan Fncl Grp LLC | 201 | $664 0.5% of $145,669 |
| Other | Northwestern Mutual | Brad Andrew Nelson | 201 | $405 0.3% of $145,669 |
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.