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Employer
400 North Second Street, Pottsville, PA 17901 · EIN 23-1919305 · 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 $7,623
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 38 | Comp not disclosed Premium $213,706 |
| Dental | Delta Dental - Sba Pa | Michael Macneal | 44 | $2,559 9.8% of $25,993 |
| Vision | Highmark Inc | Michael Macneal | 84 | $102 2.2% of $4,596 |
| Vision | Highmark Inc | The Benecon Group, Inc. | 84 | $91 2.0% of $4,596 |
| Vision | Highmark Inc | Albert Marino | 84 | $79 1.7% of $4,596 |
| Life | Reliance Standard Life Insurance Company | Pcf Insurance Services Of The West | 54 | $821 7.1% of $11,623 |
| Life | Reliance Standard Life Insurance Company | The Bric Agency | 54 | $458 3.9% of $11,623 |
| Life | Reliance Standard Life Insurance Company | Emerson Rogers LLC | 54 | $281 2.4% of $11,623 |
| Life | Reliance Standard Life Insurance Company | Onedigital Premier Services LLC | 54 | $208 1.8% of $11,623 |
| AD&D | Reliance Standard Life Insurance Company | Pcf Insurance Services Of The West | 30 | $76 9.7% of $785 |
| AD&D | Reliance Standard Life Insurance Company | The Bric Agency | 30 | $42 5.4% of $785 |
| AD&D | Reliance Standard Life Insurance Company | Emerson Rogers LLC | 30 | $19 2.4% of $785 |
| AD&D | Reliance Standard Life Insurance Company | Onedigital Premier Services LLC | 30 | $14 1.8% of $785 |
| Other | Reliance Standard Life Insurance Company | Pcf Insurance Services Of The West | 54 | $834 7.2% of $11,521 |
| Other | Reliance Standard Life Insurance Company | The Bric Agency | 54 | $434 3.8% of $11,521 |
| Other | Reliance Standard Life Insurance Company | Emerson Rogers LLC | 54 | $279 2.4% of $11,521 |
| Other | Reliance Standard Life Insurance Company | Onedigital Premier Services LLC | 54 | $197 1.7% of $11,521 |
| Other | Reliance Standard Life Insurance Company | Pcf Insurance Services Of The West | 54 | $584 9.9% of $5,901 |
| Other | Reliance Standard Life Insurance Company | The Bric Agency | 54 | $301 5.1% of $5,901 |
| Other | Reliance Standard Life Insurance Company | Emerson Rogers LLC | 54 | $144 2.4% of $5,901 |
| Other | Reliance Standard Life Insurance Company | Onedigital Premier Services LLC | 54 | $100 1.7% of $5,901 |
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 $63,056
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $42,550 | $506.55 |
| Pcf Insurance Services Of The West | Broker | $14,280 | $170.00 |
| The Bric Agency | Broker | $4,800 | $57.14 |
| Highmark Blue Shield (Central) | Admin | $1,426 | $16.98 |