Employer
Lifeservices Management Corp
1625 Lowell Ave, Erie, PA 16505 · EIN 23-2875554 · 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 $277
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Swiss Re Corporate Solutions | — | 119 | Comp not disclosed Premium $317,464 |
| Vision | National Vision Administrators, L.L.C. | Loesel-Schaaf Insurance | 20 | $277 5.0% of $5,538 |
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.
Visible subtotal $26,570
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Meritain Health | Claims Administrator | $21,307 | $160.20 |
| The Hdh Group DBA Hub International | Claims Administrator | $5,263 | $39.57 |