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Employer
Po Box 10037, Erie, PA 16514 · EIN 25-1158956 · Jul 1, 2024 to Jun 30, 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 $24,108
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Reliastar Life Insurance Company | Frissora & Associates, LLC | 702 | $24,108 3.0% of $803,601 |
| Medical | Highmark Inc. - Freedom Blue | — | 115 | Comp not disclosed Premium $247,814 |
| Vision | Vision Benefits Of America | — | 271 | Comp not disclosed Premium $33,272 |
| Vision | Vision Benefits Of America | — | 260 | Comp not disclosed Premium $10,539 |
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 $273,122
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Meritain Health | None | $75,779 | $107.95 |
| Patricia Burson Dorman | Employee | $75,338 | $107.32 |
| Bridgeway Benefit Technologies | None | $38,472 | $54.80 |
| Flores & Associates | None | $22,220 | $31.65 |
| Diclaudio & Kramer, LLC | None | $16,280 | $23.19 |
| Mariner Institutional LLC | None | $14,000 | $19.94 |
| Meyer Unkovic And Scott | None | $9,745 | $13.88 |
| Usi Consulting Group | None | $9,240 | $13.16 |
| Logan, Mettley & Newcomer | None | $6,798 | $9.68 |
| Frissora & Associates | None | $5,250 | $7.48 |