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Employer
Po Box 38, Kreamer, PA 17833 · EIN 23-1580600 · 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 $14,260
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental + Vision | Sun Life Assurance Company Of Canada | Marsh & Mclennan Agency, LLC East | 68 | $5,453 8.4% of $65,230 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Marsh & Mclennan Agency C/O Trion | 68 | $2,501 3.8% of $65,230 |
| Life | Standard Insurance Company | Marsh & Mclennan Agency, LLC East | 75 | $1,317 12.3% of $10,749 |
| Other | Standard Insurance Company | Marsh & Mclennan Agency, LLC East | 75 | $2,981 15.7% of $18,980 |
| Other | Standard Insurance Company | Marsh & Mclennan Agency, LLC East | 75 | $2,008 9.8% of $20,391 |
| Stop-loss | HM Life Insurance Company | — | 58 | Comp not disclosed Premium $644,584 |
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 $127,196
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $108,369 | $1,231.47 |
| Marsh & Mclennan Agency, LLC East | Broker | $25,172 | $286.05 |
| Revivehealth, Inc. | Admin | $11,635 | $132.22 |
| Highmark Blue Shield (Central) | Admin | $-17,980 | $-204.32 |