Employer
Indiana Printing And Publishing Company, Inc.
775 Indiana Springs Road, Indiana, PA 15701 · EIN 25-0567290 · Jul 1, 2021 to Jun 30, 2022
Plan year 2021
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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 $1,418
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 26 | Comp not disclosed Premium $73,991 |
| Dental | United Concordia Insurance Company | Evergreen Insurance, LLC | 39 | $913 9.2% of $9,916 |
| Vision | Highmark Inc. | Evergreen Insurance LLC | 17 | $59 2.8% of $2,139 |
| Life | Unum Life Insurance Company Of America | Frank C. Kinter, Jr. | 53 | $446 6.9% of $6,463 |
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 $23,125
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $8,122 | $150.41 |
| Evergreen Insurance, LLC | Broker | $6,754 | $125.07 |
| Highmark | Admin | $6,788 | $125.70 |
| Connectcare 3 | Patient Advocate | $1,461 | $27.06 |