Employer
Keystone Sporting Arms, LLC
155 Sodom Rd., Milton, PA 17847 · EIN 20-5795273 · 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 $2,800
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Fair American Insurance And Reinsurance Company | — | — | Comp not disclosed Premium $31,402 |
| Medical | Principal Life Insurance Company | The Sholley Agency Inc | 39 | $1,890 12.4% of $15,186 |
| Medical | Principal Life Insurance Company | U R L Inc | 39 | $910 6.0% of $15,186 |
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 $831
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $831 | $21.31 |