Employer
Liberty Excavators, Inc.
4402 Gettysburg Road, Camp Hill, PA 17011 · EIN 23-2023985 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $268,278
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Unitedhealthcare Insurance Company | Centerstone Insurance & Financial | 319 | $133,729 7.2% of $1,853,808 |
| Medical | Unitedhealthcare Insurance Company | Brown & Brown Of Pennsylvania | 319 | $102,699 5.5% of $1,853,808 |
| Medical | Capital Advantage Assurance Company | — | — | Schedule A not provided |
| Dental | Unitedhealthcare Insurance Company | Brown & Brown Of Pennsylvania | 161 | $6,974 9.2% of $75,443 |
| Dental | Unitedhealthcare Insurance Company | Centerstone And Financial Services | 161 | $2,712 3.6% of $75,443 |
| Dental | Unitedhealthcare Insurance Company | Emerson Rogers LLC | 161 | $774 1.0% of $75,443 |
| AD&D | Unitedhealthcare Insurance Company | Centerstone Insurance & Financial S | 196 | $6,810 5.5% of $122,884 |
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.