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Employer
1250 Camp Hill Bypass, Camp Hill, PA 17011 · EIN 25-1735093 · 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 $1,524
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 15 | Comp not disclosed Premium $120,247 |
| Dental | Sun Life Assurance Company Of Canada | Mpb Risk Services, LLC | 11 | $244 3.3% of $7,500 |
| Dental | Sun Life Assurance Company Of Canada | Commonwealth Financial Group | 11 | $133 1.8% of $7,500 |
| Vision | Highmark, Inc. | — | — | Schedule A not provided |
| Life | Principal Life Insurance Company | — | — | Schedule A not provided |
| Other | Standard Insurance Company | Mpb Risk Services, LLC | 14 | $971 12.7% of $7,646 |
| Other | Standard Insurance Company | Commonwealth Financial Group | 14 | $176 2.3% of $7,646 |
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.
Visible subtotal $11,928
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $5,550 | $370.00 |
| Mpb Risk Services, LLC | Broker | $5,328 | $355.20 |
| Commonwealth Financial Group | Broker | $1,044 | $69.60 |
| Capital Bluecross | Admin | $6 | $0.40 |