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Employer
1350 West 26 Street, Erie, PA 16508 · EIN 25-1577930 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $125,793
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company Of Canada | Frissora & Associates, LLC | 214 | $8,912 2.5% of $356,468 |
| Vision | Highmark Inc. | The Hdh Group, Inc. | 298 | $331 1.8% of $18,803 |
| Vision | Highmark Inc. | Seubert & Associates Inc. | 298 | $235 1.2% of $18,803 |
| Life | Equitable Financial Life Insurance Company Of America | James Ward | 253 | $5,662 5.0% of $113,514 |
| Life | Equitable Financial Life Insurance Company Of America | The Hdh Group, Inc. | 253 | $5,635 5.0% of $113,514 |
| Life | Equitable Financial Life Insurance Company Of America | Professional Group Plans, Inc. | 253 | $5,208 4.6% of $113,514 |
| Life | Equitable Financial Life Insurance Company Of America | Seubert & Associates Inc. | 253 | $4,328 3.8% of $113,514 |
| Life | Trustmark Insurance Company | James Ward | 124 | $40,917 64.9% of $63,014 |
| Life | Trustmark Insurance Company | The Hdh Group, Inc. | 124 | $22,032 35.0% of $63,014 |
| Accident | Trustmark Insurance Company | James Ward | 114 | $6,599 19.5% of $33,831 |
| Accident | Trustmark Insurance Company | The Hdh Group, Inc. | 114 | $2,218 6.6% of $33,831 |
| Accident | Trustmark Insurance Company | Seubert & Associates Inc. | 114 | $1,334 3.9% of $33,831 |
| Critical Illness | Trustmark Insurance Company | James Ward | 80 | $8,462 19.5% of $43,402 |
| Critical Illness | Trustmark Insurance Company | The Hdh Group, Inc. | 80 | $2,833 6.5% of $43,402 |
| Critical Illness | Trustmark Insurance Company | Seubert & Associates Inc. | 80 | $1,725 4.0% of $43,402 |
| Hospital Indemnity | Trustmark Insurance Company | James Ward | 60 | $6,086 17.9% of $34,043 |
| Hospital Indemnity | Trustmark Insurance Company | The Hdh Group, Inc. | 60 | $2,040 6.0% of $34,043 |
| Hospital Indemnity | Trustmark Insurance Company | Seubert & Associates Inc. | 60 | $1,236 3.6% of $34,043 |
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.
No Schedule C parties in this year.