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Employer
1603 Burtner Road, Natrona Heights, PA 15065 · EIN 25-1264233 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $27,030
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental | Henderson Brothers Inc. | 196 | $4,312 10.0% of $43,124 |
| Vision | Fidelity Security Life Insurance Company | Assurex Global Corporation | 180 | $528 5.4% of $9,855 |
| Vision | Fidelity Security Life Insurance Company | Henderson Brothers Inc. | 180 | $528 5.4% of $9,855 |
| Life | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 47 | $2,916 15.0% of $19,440 |
| Life | Reliance Standard Life Insurance Company | Watchtower Technologies | 47 | $292 1.5% of $19,440 |
| Life | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 95 | $724 15.0% of $4,828 |
| Life | Reliance Standard Life Insurance Company | Watchtower Technologies | 95 | $72 1.5% of $4,828 |
| AD&D | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 45 | $244 15.0% of $1,624 |
| AD&D | Reliance Standard Life Insurance Company | Watchtower Technologies | 45 | $24 1.5% of $1,624 |
| Legal | Legalplans, Usa | Henderson Brothers Inc. | 10 | $371 15.0% of $2,472 |
| Other | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 94 | $2,061 15.0% of $13,738 |
| Other | Reliance Standard Life Insurance Company | Watchtower Technologies | 94 | $206 1.5% of $13,738 |
| Accident | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 34 | $3,771 60.0% of $6,285 |
| Accident | Reliance Standard Life Insurance Company | Watchtower Technologies | 34 | $126 2.0% of $6,285 |
| Critical Illness | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 31 | $8,232 60.0% of $13,720 |
| Critical Illness | Reliance Standard Life Insurance Company | Watchtower Technologies | 31 | $274 2.0% of $13,720 |
| Hospital Indemnity | Reliance Standard Life Insurance Company | Henderson Brothers Inc. | 17 | $2,273 60.0% of $3,788 |
| Hospital Indemnity | Reliance Standard Life Insurance Company | Watchtower Technologies, Inc. | 17 | $76 2.0% of $3,788 |
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.
No Schedule C parties in this year.