Employer
Lancaster Health Center
304 North Water Street, Lancster, PA 17603 · EIN 23-2160896 · Jan 1, 2021 to Dec 31, 2021
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 $10,476
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | Murray Insurance Associates, Inc. | 219 | $8,712 3.3% of $264,436 |
| Dental | Standard Life Insurance Company | Murray Insurance Associates | 118 | $625 5.7% of $11,008 |
| Vision | Standard Insurance Company | Murray Insurance Associates | 106 | $69 4.0% of $1,723 |
| Life | Standard Insurance Company | Murray Insurance Associates | 186 | $277 14.9% of $1,862 |
| AD&D | Standard Insurance Company | Murray Insurance Associates | 33 | $175 16.5% of $1,063 |
| Other | Standard Insurance Company | Murray Insurance Associates | 49 | $311 15.0% of $2,076 |
| Other | Standard Insurance Company | Murray Insurance Associates | 41 | $307 14.2% of $2,165 |
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.