Employer
Klick-Lewis Inc
720 E. Main Street, Palmyra, PA 17078 · EIN 23-1472192 · 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 $1,753
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance | — | 40 | Comp not disclosed Premium $284,589 |
| Dental | United Concordia Insurance Company | — | — | Schedule A not provided |
| Vision | Davis Vision | — | — | Schedule A not provided |
| Life | Principal Life Insurance Company | — | 68 | Schedule A not provided |
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 $32,325
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $16,830 | $227.43 |
| Patriot (The Safegard Group, Inc.) | Broker | $12,201 | $164.88 |
| Hub International Northeast Ltd | Broker | $48 | $0.65 |
| Capital Blue Cross | Admin | $3,246 | $43.86 |