Employer
Lehigh Valley Restaurant Group, Inc.
6802-A Hamilton Boulevard, Allentown, PA 18106 · EIN 23-2668914 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
View
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 $11,133
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Aetna Life Insurance Company | — | 276 | Comp not disclosed Premium $95,248 |
| Vision | Eyemed Vision Care On Behalf Of Fidelity Security Life Insurance Co. | Hays Companies, Inc. | 240 | $1,594 11.0% of $14,513 |
| Life | Reliance Standard Life Insurance Company | Hays Companies, Inc. | 133 | $9,539 15.0% of $63,593 |
| Employee Assistance Program | Carebridge Corporation | — | 5010 | Comp not disclosed Premium $22,166 |
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.