Loading employer…
Employer
1600 E. Cumberland St., Lebanon, PA 17042 · EIN 23-1296267 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $64,301
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Qbe Insurance | Capital Blue Cross | 178 | $28,901 6.3% of $460,745 |
| Medical | Capital Advantage Assurance Company | — | — | Schedule A not provided |
| Dental | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 151 | $4,367 7.2% of $60,353 |
| Dental | The Lincoln National Life Insurance Company | James R Nelligan & Associates | 151 | $3,850 6.4% of $60,353 |
| Dental | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 151 | $1,669 2.8% of $60,353 |
| Vision | Amerias Life Insurance Corp. | Engle, Hambright & Davies, Inc. | 312 | $1,418 5.7% of $24,877 |
| Vision | Amerias Life Insurance Corp. | James R Nelligan & Associates | 312 | $1,244 5.0% of $24,877 |
| Vision | Amerias Life Insurance Corp. | Marsh & Mclennan Agency, LLC East | 312 | $1,239 5.0% of $24,877 |
| Life | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 211 | $1,850 10.8% of $17,143 |
| Life | The Lincoln National Life Insurance Company | James R Nelligan & Associates | 211 | $1,333 7.8% of $17,143 |
| Life | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 211 | $781 4.6% of $17,143 |
| Ci | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 22 | $3,400 49.1% of $6,919 |
| Ci | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 22 | $1,434 20.7% of $6,919 |
| Ci | The Lincoln National Life Insurance Company | James R Nelligan & Associates | 22 | $551 8.0% of $6,919 |
| Hi | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 20 | $1,612 45.1% of $3,571 |
| Hi | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 20 | $709 19.9% of $3,571 |
| Hi | The Lincoln National Life Insurance Company | James R Nelligan & Associates | 20 | $288 8.1% of $3,571 |
| Acc. | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 32 | $1,716 45.4% of $3,778 |
| Acc. | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 32 | $740 19.6% of $3,778 |
| Acc. | The Lincoln National Life Insurance Company | James R Nelligan & Associates | 32 | $299 7.9% of $3,778 |
| Vol Child Life, Vol Spouse Life, Vol Life | The Lincoln National Life Insurance Company | Engle, Hambright & Davies, Inc. | 49 | $3,341 11.1% of $30,151 |
| Vol Child Life, Vol Spouse Life, Vol Life | The Lincoln National Life Insurance Company | Amwins Ancillary LLC | 49 | $2,279 7.6% of $30,151 |
| Vol Child Life, Vol Spouse Life, Vol Life | The Lincoln National Life Insurance Company | Marsh & Mclennan Agency, LLC East | 49 | $1,280 4.2% of $30,151 |
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 $2,133
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Rxbenefits, Inc. | Admin | $2,133 | $6.84 |