Employer
Lititz Christian School
Po Box 415, Lititz, PA 17543 · EIN 90-0123234 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 53
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 $2,380
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 34 | Comp not disclosed Premium $179,074 |
| Dental + Vision | Principal Life Insurance Company | — | 53 | Schedule A not provided |
| Dental + Vision | Principal Life Insurance Company | — | 53 | Schedule A not provided |
| Dental + Vision | Principal Life Insurance Company | — | 53 | Schedule A not provided |
| Life | Unum Life Insurance Company Of America | — | 25 | Comp not disclosed Premium $1,749 |
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 $21,868
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Assured Partners (Central Pa) | Broker | $13,266 | $250.30 |
| The Benecon Group | Broker | $12,608 | $237.89 |
| Capital Bluecross | Admin | $-4,006 | $-75.58 |