Employer
Martin'S Flooring
608 Dwight Road, Denver, PA 17517 · EIN 23-2385853 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 37
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 $6,297
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 37 | Comp not disclosed Premium $168,504 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Engle-Hambright & Davies, Inc. | 15 | $4,465 11.9% of $37,440 |
| Dental + Vision | Sun Life Assurance Company Of Canada | James R Nelligan & Associates Lc | 15 | $1,832 4.9% of $37,440 |
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 $34,501
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $17,480 | $472.43 |
| Engle-Hambright & Davies, Inc. | Broker | $15,047 | $406.68 |
| Capital Bluecross | Admin | $1,974 | $53.35 |