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Employer
4400 Gettysburg Road, Camp Hill, PA 17011 · EIN 26-4366175 · Jul 1, 2024 to Jun 30, 2025
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 $54,128
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 76 | $6,307 11.6% of $54,595 |
| Dental | The Lincoln National Life Insurance Company | Strategic Non-Medical Sltns LLC | 76 | $2,730 5.0% of $54,595 |
| Dental | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 79 | $3,117 11.6% of $26,882 |
| Dental | The Lincoln National Life Insurance Company | Strategic Non-Medical Sltns LLC | 79 | $1,344 5.0% of $26,882 |
| Life | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 183 | $1,524 18.2% of $8,377 |
| Life | The Lincoln National Life Insurance Company | Strategic Non-Medical Solutions LLC | 183 | $419 5.0% of $8,377 |
| AD&D | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 96 | $1,159 18.2% of $6,365 |
| AD&D | The Lincoln National Life Insurance Company | Strategic Non-Medical Sltns LLC | 96 | $318 5.0% of $6,365 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 183 | $11,133 18.1% of $61,455 |
| Other | The Lincoln National Life Insurance Company | Strategic Non-Medical Solutions LLC | 183 | $3,073 5.0% of $61,455 |
| Other | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 183 | $8,543 18.1% of $47,125 |
| Other | The Lincoln National Life Insurance Company | Strategic Non-Medical Solutions LLC | 183 | $2,356 5.0% of $47,125 |
| Voluntary Life, Voluntary Child Life, Voluntary Spouse Life | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 96 | $7,929 18.1% of $43,859 |
| Voluntary Life, Voluntary Child Life, Voluntary Spouse Life | The Lincoln National Life Insurance Company | Strategic Non-Medical Solutions LLC | 96 | $2,193 5.0% of $43,859 |
| Voluntary Vision | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 138 | $1,983 11.6% of $17,116 |
| Stop-loss | Berkley Life And Health Insurance Co. | — | 138 | Comp not disclosed Premium $627,153 |
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 $139,373
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pa | Broker | $86,338 | $564.30 |
| The Benecon Group, LLC | Broker | $3,332 | $21.78 |
| Highmark Inc | Admin | $49,703 | $324.86 |