Employer
Moser Roofing Solutions
801 Rohrerstown Road, Lancaster, PA 17601 · EIN 46-5718021 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 39
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 $5,583
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 23 | Comp not disclosed Premium $105,561 |
| Dental + Vision | Principal Life Insurance Company | — | — | Schedule A not provided |
| Life | Equitable Financial Life Insurance Company Of America | Assured Partners | 36 | $1,708 15.0% of $11,385 |
| Life | Equitable Financial Life Insurance Company Of America | Boon-Chapman Benefit Administrators | 36 | $456 4.0% of $11,385 |
| Other | The Lincoln National Life Insurance Company | Ap Benefit Advisors LLC | 39 | $885 15.0% of $5,897 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 39 | $371 6.3% of $5,897 |
| Other | The Lincoln National Life Insurance Company | Boon Chapman Bnft Admnstrs | 39 | $295 5.0% of $5,897 |
| Other | The Lincoln National Life Insurance Company | Ap Benefit Advisors LLC | 39 | $1,066 15.0% of $7,106 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 39 | $447 6.3% of $7,106 |
| Other | The Lincoln National Life Insurance Company | Boon Chapman Bnft Admnstrs | 39 | $355 5.0% of $7,106 |
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 $33,815
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $22,039 | $565.10 |
| Assured Partners (Central Pa) | Broker | $8,448 | $216.62 |
| Revivehealth, Inc. | Other | $3,328 | $85.33 |