Employer
Intervala, LLC
1001 Technology Drive, Mt Plesant, PA 15666 · EIN 81-0760901 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $19,216
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Blue Cross Blue Shield | — | 404 | Comp not disclosed Premium $2,737,590 |
| Dental | United Concordia Insurance Company | Usi Insurance Services (Ri) | 456 | $1,875 1.4% of $130,054 |
| Vision | Vision Benefits Of America | — | 246 | Comp not disclosed Premium $20,815 |
| Life | Provident Life And Accident Insurance Company | Hodge-Mace Benefits Group | 1 | $8 2.0% of $409 |
| Life | Provident Life And Accident Insurance Company | Usi Insurance Services (Ri) | 1 | $3 0.7% of $409 |
| Life | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 381 | $17,330 6.2% of $280,831 |
| Accident, Critical Illness, Hospital | Unum Life Insurance Company Of America | — | 3 | Comp not disclosed Premium $53 |
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.
No Schedule C parties in this year.