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Employer
115 Equity Drive, Greensburg, PA 15601 · EIN 26-1361520 · 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 $74,434
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | Lr Webber | 51 | $6,435 1.6% of $393,790 |
| Medical | Upmc Health Options | Lr Webber | 1 | $138 1.6% of $8,528 |
| Medical | Upmc Health Options | Lr Webber | 38 | $4,061 1.6% of $252,324 |
| Medical | Upmc Health Options | Lr Webber | 100 | $12,000 1.7% of $712,513 |
| Medical | Upmc Health Options | Lr Webber | 113 | $13,219 1.6% of $847,634 |
| Medical | Upmc Health Options | Lr Webber | — | $88 1.7% of $5,154 |
| Medical | Upmc Health Options | Lr Webber | 1 | $218 1.8% of $12,225 |
| Dental | Guardian | Lr Webber | 231 | $10,741 8.6% of $124,457 |
| Vision | Vision Benefits Of America | Leavitt Northeast Insurance Inc. | 207 | $881 4.0% of $22,017 |
| Life | United Of Omaha Life Insurance Company | Lr Webber | 271 | $2,102 15.0% of $14,016 |
| Life | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 271 | $68 0.5% of $14,016 |
| Life | United Of Omaha Life Insurance Company | Lr Webber | 84 | $3,514 15.0% of $23,423 |
| Life | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 84 | $125 0.5% of $23,423 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 270 | $1,098 5.0% of $21,959 |
| Other | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 270 | $104 0.5% of $21,959 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 75 | $3,019 15.0% of $20,128 |
| Other | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 75 | $90 0.4% of $20,128 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 229 | $9,940 15.0% of $66,265 |
| Other | United Of Omaha Life Insurance Company | Fmlasource Inc | 229 | $6,276 9.5% of $66,265 |
| Other | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 229 | $317 0.5% of $66,265 |
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.