Employer
Lancaster Country Club
1466 New Holland Pike, Lancaster, PA 17601 · EIN 23-0784690 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 83
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 $8,472
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $1,327 |
| Stop-loss | Avalon Insurance Company | — | 54 | Comp not disclosed Premium $267,200 |
| Dental | Metropolitan Life Insurance Company | — | — | Schedule A not provided |
| Life | The Guardian Life Insurance Company | Murray Ins Assoc Inc | 83 | $8,472 11.1% of $76,642 |
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 $70,961
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $50,534 | $608.84 |
| Assured Partners (Central Pa) | Broker | $20,427 | $246.11 |