Employer
Mitsubishi Chemical Advanced Materials Inc.
2120 Fairmont Avenue, Reading, PA 19605 · EIN 51-0406796 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $39,741
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 642 | Comp not disclosed Premium $1,314,879 |
| Vision | Vision Service Plan | Patriot (Power-Kunkle Group, Inc.) | 608 | $2,941 2.5% of $115,878 |
| Life | Prudential Insurance Company Of America | Patriot (Power-Kunkle Group, Inc.) | 941 | $36,800 3.5% of $1,046,330 |
| Rx | Avalon Insurance Company | — | 107 | Comp not disclosed Premium $211,237 |
| Senior Hospital And Senior Physician | Capital Advantage Assurance Company | — | 116 | Comp not disclosed Premium $278,702 |
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 $281,220
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $90,841 | $96.54 |
| Power-Kunkle Group, Inc. | Broker | $12,892 | $13.70 |
| Capital Bluecross | Admin | $111,334 | $118.31 |
| Delta Dental Of Pennsylvania | Admin | $38,759 | $41.19 |
| Connectcare 3 | Patient Advocate | $27,394 | $29.11 |