Employer
Lancaster Archery Supply, Inc.
21 Graybill Road, Leola, PA 17540 · EIN 23-2556771 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
Covered lives: 112
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental + Vision | Highmark, Inc | — | — | Schedule A not provided |
| Life | Unum Life Insurance Company Of America | — | — | Schedule A not provided |
| AD&D | Unum Life Insurance Company Of America | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | 109 | Comp not disclosed Premium $402,487 |
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.
Visible subtotal $57,171
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Harding-Yost Insurance Associates | Broker | $32,269 | $296.05 |
| The Benecon Group | Broker | $26,094 | $239.39 |
| ConnectCare3 | Patient Advocate | $7,213 | $66.17 |
| Capital Bluecross | Admin | $-8,405 | $-77.11 |