Employer
Keystone Sanitary Landfill, Inc.
249 Dunham Dr, Dunmore, PA 18512 · EIN 23-2637846 · Jan 1, 2024 to Dec 31, 2024
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 $13,283
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 92 | Comp not disclosed Premium $672,473 |
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $3,640 |
| Dental | United Concordia Insurance Company | Universal Employee Benefits | 138 | $4,181 8.0% of $52,259 |
| Vision | Vision Benefits Of America | Universal Employee Benefits Solutio | 53 | $528 10.0% of $5,278 |
| Accident, Cancer, Group Hi/Gap | American Fidelity Assurance Company | Pennsylvania Auto Assoc Ins Agy Inc | 62 | $8,064 7.2% of $111,577 |
| Accident, Cancer, Group Hi/Gap | American Fidelity Assurance Company | American Fidelity Assurance Company | 62 | $510 0.5% of $111,577 |
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 $49,917
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $28,295 | $205.04 |
| Highmark Bcbs Nepa | Admin | $15,298 | $110.86 |
| ConnectCare3 | Patient Advocate | $6,324 | $45.83 |