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Employer
319 Washington Street, Johnstown, PA 15901 · EIN 25-0955578 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $45,999
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | Mesirow Insurance Services, Inc | — | $1 10.0% of $10 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services Inc | 11 | $309 8.6% of $3,573 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 11 | $26 0.7% of $3,573 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services Inc | 1 | $2 5.1% of $39 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 1 | $1 2.6% of $39 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services | 15 | $3,584 3.1% of $115,923 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 15 | $352 0.3% of $115,923 |
| Medical | Upmc Health Options | Mesirow Insurance Services Inc | 19 | $195 8.6% of $2,259 |
| Medical | Upmc Health Options | Sagewell Partners (Alliant Insuranc | 19 | $18 0.8% of $2,259 |
| Medical | Upmc Health Options | Mesirow Insurance Services Inc | 75 | $2,206 8.8% of $25,124 |
| Medical | Upmc Health Options | Sagewell Partners (Alliant Insuranc | 75 | $189 0.8% of $25,124 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services Inc | 7 | $73 7.7% of $952 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 7 | $9 0.9% of $952 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services Inc | 11 | $208 7.7% of $2,691 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 11 | $20 0.7% of $2,691 |
| Medical | Upmc Health Benefits | Mesirow Insurance Services Inc | 2 | $31 6.2% of $498 |
| Medical | Upmc Health Benefits | Sagewell Partners (Alliant Insuranc | 2 | $8 1.6% of $498 |
| Medical | Upmc Health Options | Mesirow Insurance Services Inc | 81 | $19,264 3.0% of $646,908 |
| Medical | Upmc Health Options | Sagewell Partners (Alliant Insuranc | 81 | $1,696 0.3% of $646,908 |
| Medical | Upmc Health Options | Mesirow Insurance Services Inc | 38 | $7,648 3.1% of $243,941 |
| Medical | Upmc Health Options | Sagewell Partners (Alliant Insuranc | 38 | $736 0.3% of $243,941 |
| Medical | Upmc Health Options | Mesirow Insurance Services Inc | 2 | $160 1.9% of $8,502 |
| Medical | Upmc Health Options | Sagewell Partners (Alliant Insuranc | 2 | $32 0.4% of $8,502 |
| Life | Principal Life Insurance Company | Alliant Insurance Services, Inc. | 133 | $7,712 20.7% of $37,242 |
| Accident, Critical Illness, Hospital Indemnity | Prudential Insurance Comapany Of America | Alliant Insurance Services, Inc. | 46 | $1,519 20.4% of $7,463 |
Schedule C
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.