Employer
Mid Penn Bank
349 Union Street, Millersburg, PA 17061 · EIN 23-0880270 · Oct 1, 2024 to Sep 30, 2025
Plan year 2024
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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 $7,475
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health Unimerica Insurance Company | — | 530 | Comp not disclosed Premium $1,134,460 |
| Dental + Vision | Starmount Life Insurance Company | — | 578 | Comp not disclosed Premium $329,827 |
| Life | Unum Life Insurance Company Of America | Mpb Risk Services, LLC | 660 | $222 0.1% of $400,483 |
| Life | Unum Life Insurance Company Of America | Mpb Risk Services, LLC | 113 | $7,253 13.9% of $52,348 |
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 $118,872
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Lr Webber | Broker | $93,540 | $141.73 |
| Mpb Risk Services, LLC | Broker | $45,268 | $68.59 |
| The Benecon Group LLC | Broker | $45,093 | $68.32 |
| Young, Oakes, Brown & Co | Broker | $425 | $0.64 |
| Pbasc | Admin | $16,924 | $25.64 |
| Capital Advantage Assurance Company | Admin | $-82,378 | $-124.82 |