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Employer
1742 Sixth Ave, York, PA 17403 · EIN 23-0890670 · 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 $3,058
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed |
| Stop-loss | Crum & Forster | — | 35 | Comp not disclosed Premium $113,546 |
| Medical | Principal Life Insurance Company | Univest Insurance, LLC | 54 | $490 9.9% of $4,962 |
| Medical | Principal Life Insurance Company | Emerson Rogers LLC | 54 | $244 4.9% of $4,962 |
| Dental | Delta Dental Of Pennsylvania | — | — | Schedule A not provided |
| Vision | Vision Service Plan | Emerson Rogers LLC | 25 | $153 6.1% of $2,518 |
| Vision | Vision Service Plan | Univest Insurance, LLC | 25 | $148 5.9% of $2,518 |
| Vision | Vision Service Plan | Insurance Coalition Inc | 25 | $107 4.2% of $2,518 |
| Life | Equitable Financial Life Insurance Company Of America | Insurance Coalition Inc | 34 | $839 8.7% of $9,604 |
| Life | Equitable Financial Life Insurance Company Of America | Univest Insurance, LLC | 34 | $743 7.7% of $9,604 |
| Life | The Lincoln National Life Insurance Company | Emerson Rogers LLC | 36 | $55 20.1% of $274 |
| Other | The Lincoln National Life Insurance Company | Emerson Rogers LLC | 36 | $279 20.0% of $1,394 |
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.
Visible subtotal $38,034
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $26,846 | $497.15 |
| Pci (Pa Chamber Insurance) | Broker | $11,220 | $207.78 |
| Innovu | Broker | $-32 | $-0.59 |