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Employer
550 East 5th Street, Bloomsburg, PA 17815 · EIN 24-0772363 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $5,223
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Highmark, Inc. | Mccann, James | 62 | $1,420 8.0% of $17,746 |
| Dental | Highmark, Inc. | Mcgriff Insurance Services Inc. | 62 | $355 2.0% of $17,746 |
| Vision | Vision Benefits Of America | Mcgriff Insurance Services Inc. | 40 | $193 5.0% of $3,851 |
| Life | Companion Life Insurance Company | Consolidated Benefits Inc. | 65 | $1,982 12.0% of $16,460 |
| Voluntary Benefits | Aflac | Steven G Schultz | 7 | $428 7.5% of $5,726 |
| Voluntary Benefits | Aflac | Mcgriff Insurance Services Inc. | 7 | $321 5.6% of $5,726 |
| Voluntary Benefits | Aflac | Jeffrey Chubb | 7 | $178 3.1% of $5,726 |
| Voluntary Benefits | Aflac | Susan J Chubb | 7 | $67 1.2% of $5,726 |
| Voluntary Benefits | Aflac | C A Lupp Inc. | 7 | $49 0.9% of $5,726 |
| Voluntary Benefits | Aflac | Joseph B Mcginty Jr. | 7 | $46 0.8% of $5,726 |
| Voluntary Benefits | Aflac | Justin P Abraham | 7 | $41 0.7% of $5,726 |
| Voluntary Benefits | Aflac | Matthew G Berger | 7 | $8 0.1% of $5,726 |
| Voluntary Benefits | Aflac | Angela Umosella | 7 | $3 0.1% of $5,726 |
| Voluntary Benefits | Aflac | Darren D. Riddle | 7 | $3 0.1% of $5,726 |
| Voluntary Benefits | Aflac | Ryan K. Goldberg | 7 | $3 0.1% of $5,726 |
| Voluntary Benefits | Aflac | Martin E. Bystrom | 7 | $3 0.1% of $5,726 |
| Voluntary Benefits | Aflac | Geary L Walizerf | 1 | $55 3.4% of $1,627 |
| Voluntary Benefits | Aflac | Fred A Reeder | 1 | $37 2.3% of $1,627 |
| Voluntary Benefits | Aflac | John M Washo | 1 | $28 1.7% of $1,627 |
| Voluntary Benefits | Aflac | Irene E Brooks | 1 | $3 0.2% of $1,627 |
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.