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Employer
105 Limekiln Road, Bechtelsville, PA 19505 · EIN 23-1630914 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $2,907
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 14 | Comp not disclosed Premium $124,424 |
| Dental | United Concordia Life And Health Insurance Company | — | 8 | Schedule A not provided |
| Vision | Davis Vision | — | 15 | Schedule A not provided |
| Life | Dearborn Life Insurance Company | — | 16 | Schedule A not provided |
| Voluntary Ltd | The Guardian Life Insurance Company | — | 3 | Schedule A not provided |
| Other | Madison National Life Insurance Company | — | 15 | Schedule A not provided |
| Other | Madison National Life Insurance Company | — | 15 | Schedule A not provided |
| Other | Madison National Life Insurance Company | — | 15 | Schedule A not provided |
| Supplemental Life | The Guardian Life Insurance Company | — | 1 | Schedule A not provided |
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 $26,201
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $20,772 | $830.88 |
| Pci (Pa Chamber Insurance) | Broker | $5,429 | $217.16 |