Employer
Life Northwestern Pennsylvania, LLC
100 State Street, Erie, PA 16507 · EIN 25-0990591 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $52,249
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Unitedhealthcare Insurance Company | Vicary Insurance Agency LLC | 428 | $31,041 1.9% of $1,624,028 |
| Medical | Unitedhealthcare Insurance Company | Digital Insurance, Inc. | 428 | $1,527 0.1% of $1,624,028 |
| Life | Symetra Life Insurance Company | — | 182 | Schedule A not provided |
| Life | Symetra Life Insurance Company | — | 182 | Schedule A not provided |
| Life | Symetra Life Insurance Company | — | 182 | Schedule A not provided |
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.