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Employer
500 East Middle Street, Hanover, PA 17331 · EIN 81-0733476 · Jan 1, 2024 to Dec 31, 2024
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 $27,720
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 164 | Comp not disclosed Premium $721,747 |
| Dental | United Concordia Insurance Company | Engle, Hambright & Davies, Inc. | 267 | $6,710 9.0% of $74,459 |
| Vision | Vision Benefits Of America | Engle, Hambright & Davies, Inc. | 147 | $432 3.5% of $12,425 |
| Life | Standard Insurance Company | — | — | Schedule A not provided |
| Life | Equitable Financial Life Insurance Company Of America | Engle, Hambright & Davies, Inc. | 211 | $14,829 12.9% of $114,984 |
| Life | Equitable Financial Life Insurance Company Of America | James R Nelligan & Associates | 211 | $5,749 5.0% of $114,984 |
| Other | Standard Insurance Company | — | — | Comp not disclosed |
| Other | Standard Insurance Company | — | — | Comp not disclosed |
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 $56,840
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Engle Hambright & Davies, Inc. | Broker | $33,316 | $124.78 |
| The Benecon Group | Broker | $31,605 | $118.37 |
| ConnectCare3 | Patient Advocate | $10,979 | $41.12 |
| Capital Bluecross | Admin | $-19,060 | $-71.39 |