Employer
Lafata Contract Services LLC
1008 W 8th St., Suite A, King Of Prussia, PA 19406 · EIN 23-3065905 · Dec 1, 2020 to Nov 30, 2021
Plan year 2020
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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 $70,951
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Kistler Tiffany Benefits Co | 233 | $56,203 4.0% of $1,414,819 |
| Dental | Guardian | Birch Benefits, LLC | 110 | $3,231 3.9% of $82,070 |
| Life | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 121 | $7,872 10.0% of $78,723 |
| Life | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 121 | $3,645 4.6% of $78,723 |
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.
No Schedule C parties in this year.