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Employer
P.O. Box 296, Currie Road, Portersville, PA 16051 · EIN 25-1437635 · 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 $160,609
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | Davevic Benefit Consultants | 119 | $9,407 2.2% of $433,118 |
| Medical | Upmc Health Options | Acrisure Mid-Atlantic Partners | 119 | $6,624 1.5% of $433,118 |
| Medical | Highmark Inc. | Acrisure Mid-Atlantic Partners | 152 | $33,507 1.8% of $1,884,868 |
| Medical | Highmark Inc. | Djme Ventures Inc. | 152 | $13,442 0.7% of $1,884,868 |
| Medical | Upmc Health Options | Davevic Benefit Consultants | 31 | $3,473 2.2% of $158,660 |
| Medical | Upmc Health Options | Acrisure Mid-Atlantic Partners | 31 | $2,438 1.5% of $158,660 |
| Medical | Upmc Health Options | Davevic Benefit Consultants | 42 | $4,163 1.4% of $300,318 |
| Medical | Upmc Health Options | Acrisure Mid-Atlantic Partners | 42 | $1,955 0.7% of $300,318 |
| Medical | Upmc Health Options | Davevic Benefit Consultants | 145 | $16,650 1.3% of $1,295,243 |
| Medical | Upmc Health Options | Acrisure Mid-Atlantic Partners | 145 | $9,000 0.7% of $1,295,243 |
| Medical | Upmc Health Options | Davevic Benefit Consultants | 20 | $2,254 1.9% of $116,520 |
| Medical | Upmc Health Options | Acrisure Mid-Atlantic Partners | 20 | $1,702 1.5% of $116,520 |
| Dental + Vision | Guardian Life Insurance Company | Davevic Benefit Consultants | 465 | $48,816 12.8% of $382,026 |
| Dental + Vision | Guardian Life Insurance Company | Acrisure Mid-Atlantic Partners | 465 | $7,178 1.9% of $382,026 |
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.