Employer
Lafayette Manor, Inc.
147 Lafayette Manor Rd, Uniontown, PA 15401 · EIN 25-1291588 · Jul 1, 2021 to Jun 30, 2022
Plan year 2021
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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 $14,265
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | Paul Sprowls Agency Inc. | 119 | $3,406 7.6% of $44,776 |
| Medical | Principal Life Insurance Company | Emerson Reid LLC | 119 | $2,309 5.2% of $44,776 |
| Medical | Upmc Health Options | Emerson Reid & Co. | 32 | $8,300 3.0% of $276,534 |
| Vision | Upmc Health Benefits | Emerson Reid & Co. | 93 | $250 4.1% of $6,146 |
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.