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Employer
900 State Street, Erie, PA 16501 · EIN 87-2540072 · Jan 1, 2023 to Dec 31, 2023
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 $61,843
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc | Loesel-Schaaf Insurance | 202 | $38,203 1.9% of $1,963,463 |
| Medical | Highmark Inc | Emerson Rogers LLC | 202 | $3,749 0.2% of $1,963,463 |
| Dental | Delta Dental Insurance Company | Loesel-Schaaf Insurance | 391 | $6,593 5.7% of $115,773 |
| Dental | Delta Dental Insurance Company | Sequoia Benefits And Ins Svcs LLC | 391 | $1,511 1.3% of $115,773 |
| Vision | Vision Benefits Of America | Loesel-Schaaf Insurance | 73 | $350 4.0% of $8,758 |
| Vision | Vision Benefits Of America | Loesel-Schaaf Insurance | 78 | $478 4.0% of $11,960 |
| Life | The Lincoln National Life Insurance Company | Loesel-Schaaf Insurance | 188 | $2,569 6.2% of $41,302 |
| Life | The Lincoln National Life Insurance Company | Sequoia Benefits And Ins Svcs LLC | 188 | $167 0.4% of $41,302 |
| Other | The Lincoln National Life Insurance Company | Loesel-Schaaf Insurance | 188 | $4,531 7.0% of $64,998 |
| Other | The Lincoln National Life Insurance Company | Sequoia Benefits And Ins Svcs LLC | 188 | $119 0.2% of $64,998 |
| Other | The Lincoln National Life Insurance Company | Loesel-Schaaf Insurance | 189 | $3,297 3.5% of $94,238 |
| Other | The Lincoln National Life Insurance Company | Sequoia Benefits And Ins Svcs LLC | 189 | $276 0.3% of $94,238 |
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.