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Employer
Three Gateway Center, Pittsburg, PA 15222 · EIN 14-1514924 · 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 $47,858
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Mvp Health Care | Marshall & Sterling Employee Benefi | 73 | $29,265 4.0% of $730,732 |
| Medical | Capital District Physicians Health Plan Inc. | Marshall & Sterling Employee Benefi | 24 | $3,600 4.4% of $82,541 |
| Dental | Guardian | Marshall & Sterling Employee Benefi | 53 | $4,852 14.7% of $33,018 |
| Vision | Empire Healthchoice Assurance, Inc. | Marshall & Sterling Employee Benefi | 75 | $636 18.0% of $3,539 |
| Vision | Empire Healthchoice Assurance, Inc. | Fna Insurance Services | 75 | $255 7.2% of $3,539 |
| Life | Anthem Life & Disability Insurance Company | Marshall & Sterling Employee Benefi | 184 | $6,315 32.4% of $19,513 |
| Life | Anthem Life & Disability Insurance Company | Fna Insurance Services | 184 | $2,935 15.0% of $19,513 |
| Other | Anthem Life & Disability Insurance Company | — | 116 | Comp not disclosed Premium $26,730 |
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 $106,752
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Zenith American Solutions | None | $35,911 | $195.17 |
| Marshall & Sterling Employee Benefi | None | $25,911 | $140.82 |
| Merrill Lynch Pierce Fenner & Smith | None | $16,496 | $89.65 |
| Teal, Becker & Chiaramonte Cpas | None | $15,000 | $81.52 |
| Western Asset Multi Core Plus | None | $7,434 | $40.40 |
| Barnes, Iaccarino & Shepherd LLP | None | $6,000 | $32.61 |