Employer
Jgm Fabricators & Constructors LLC
1201 Valley Road, Coatesville, PA 19320 · EIN 47-5419401 · Jul 1, 2024 to Jun 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 $13,998
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 96 | Comp not disclosed Premium $380,934 |
| Dental | United Concordia Insurance Company | — | 167 | Schedule A not provided |
| Dental | United Concordia Insurance Company | — | 167 | Schedule A not provided |
| Dental | United Concordia Insurance Company | — | 167 | Schedule A not provided |
| Life | Standard Insurance Company | Onedigital Premier Svcs LLC | 121 | $2,188 11.3% of $19,444 |
| Other | Standard Insurance Company | Onedigital Premier Svcs LLC | 121 | $3,987 15.1% of $26,376 |
| Other | Standard Insurance Company | Onedigital Premier Svcs LLC | 121 | $2,223 10.9% of $20,404 |
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 $53,347
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $35,602 | $339.07 |
| Pcf Insurance Services Of The West | Broker | $23,660 | $225.33 |
| Highmark Blue Shield (Sepa) | Admin | $-5,915 | $-56.33 |