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Employer
471 Jpl Wick Drive, Harrisburg, PA 17111 · EIN 25-1599215 · 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 $18,939
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | 87 | Comp not disclosed Premium $205,056 |
| Stop-loss | Avalon Insurance Company | — | 87 | Comp not disclosed Premium $246,821 |
| Dental | United Concordia Insurance Company | The Benecon Group, Inc. | 177 | $6,621 7.9% of $83,924 |
| Vision | Vision Benefits Of America | Gunn Mowery, LLC | 76 | $528 5.0% of $10,552 |
| Life | Sun Life Assurance Company Of Canada | Gunn Mowery, LLC | 102 | $9,070 8.5% of $107,016 |
| Life | Sun Life Assurance Company Of Canada | Benefitsdna LLC | 102 | $2,702 2.5% of $107,016 |
| Other | Sun Life Assurance Company Of Canada | Gunn Mowery, LLC | 1 | $12 6.7% of $178 |
| Other | Sun Life Assurance Company Of Canada | Benefitsdna LLC | 1 | $6 3.4% of $178 |
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 $96,721
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gunn-Mowery LLC | Broker | $13,804 | $138.04 |
| The Benecon Group | Broker | $6,941 | $69.41 |
| Highmark Blue Shield (Central) | Admin | $2,830 | $28.30 |
| ConnectCare3 | Patient Advocate | $2,095 | $20.95 |
| The Benecon Group | Broker | $35,400 | $200.00 |
| Gunn-Mowery LLC | Broker | $21,960 | $124.07 |
| Highmark Blue Shield (Central) | Admin | $10,950 | $61.86 |
| ConnectCare3 | Patient Advocate | $2,741 | $15.49 |