Employer
James, Smith, Dietterick & Connelly, LLP
11 East Chocolate Avenue, Suite 300, Hershey, PA 17033 · EIN 25-1584038 · May 1, 2024 to Apr 30, 2025
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 $7,394
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $7,434 |
| Stop-loss | Avalon Insurance Company | — | 27 | Comp not disclosed Premium $82,916 |
| Dental | United Concordia Companies, Inc. | Pci Insurance Agency | 24 | $1,369 11.6% of $11,777 |
| Vision | Davis Vision | Pci Insurance Agency | 22 | $4 0.2% of $1,946 |
| Life | Unum Life Insurance Company Of America | Gunn Mowery, LLC | 39 | $6,021 9.9% of $61,124 |
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.
Visible subtotal $15,041
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gunn Mowery | Broker | $8,120 | $208.21 |
| The Benecon Group | Broker | $5,556 | $142.46 |
| ConnectCare3 | Patient Advocate | $1,233 | $31.62 |
| Capital Bluecross | Admin | $132 | $3.38 |