Employer
Moravian Manors, Inc.
300 West Lemon Street, Lititz, PA 17543 · EIN 14-0810461 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 695
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 $59,640
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health Unimerica Insurance Company | — | 148 | Comp not disclosed Premium $165,577 |
| Stop-loss | Crum & Forster | — | 151 | Comp not disclosed Premium $157,608 |
| Dental + Vision | Capital Advantage Assurance Company | Ap Benefit Advisors LLC | 262 | $54,398 70.4% of $77,320 |
| Life | Aul Oneamerica | Ap Benefit Advisors LLC | 14 | $3,821 13.9% of $27,432 |
| Life | Transamerica Life Insurance Company | Ap Benefit Advisors LLC | 1 | $1,421 10.0% of $14,214 |
| EAP | Wellspan Employee Assistance Program | — | 695 | Comp not disclosed Premium $6,197 |
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 $103,384
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Bencon Group LLC | Broker | $56,217 | $80.89 |
| Lr Webber | Broker | $12,528 | $18.03 |
| Assured Partners (Central Pa) | Broker | $4,958 | $7.13 |
| Capital Advantage Assurance Company | Admin | $22,257 | $32.02 |
| Connectcare 3 | Patient Advocate | $7,424 | $10.68 |