Loading employer…
Employer
1200 Grubb Road, Palmyra, PA 17078 · EIN 23-7404857 · 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 $15,746
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 144 | Comp not disclosed Premium $390,998 |
| Stop-loss | Crum & Forster | — | 155 | Comp not disclosed Premium $418,228 |
| Dental | United Concordia Insurance Company | Usi Insurance Services (Ri) | 199 | $2,725 4.2% of $64,688 |
| Vision | National Vision Administrators, LLC | Usi Insurance Services (Ri) | 191 | $277 3.0% of $9,224 |
| Life | Life Insurance Company Of North America- Life | Usi Insurance Services (Ri) | 179 | $2,637 15.9% of $16,538 |
| Other | Life Insurance Company Of North America- Ltd | Usi Insurance Services (Ri) | 14 | $1,462 15.4% of $9,466 |
| Accidental Death And Dismemberment | Life Insurance Company Of North America- Add | Usi Insurance Services (Ri) | 179 | $351 15.9% of $2,205 |
| Other | Life Insurance Company Of North America- Std | Usi Insurance Services (Ri) | 179 | $8,294 16.0% of $51,913 |
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 $95,244
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $78,482 | $394.38 |
| Lr Webber | Broker | $30,594 | $153.74 |
| ConnectCare3 | Patient Advocate | $7,116 | $35.76 |
| Highmark, Inc. | Admin | $-20,948 | $-105.27 |