Loading employer…
Employer
515 Willow Springs Lane, York, PA 17406 · EIN 23-2152245 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $24,097
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 77 | Comp not disclosed Premium $408,698 |
| Dental | Metropolitan Life Insurance Company | James R Nelligan & Associates | 170 | $3,574 6.0% of $59,884 |
| Dental | Metropolitan Life Insurance Company | Engle, Hambright & Davies, Inc. | 170 | $2,716 4.5% of $59,884 |
| Vision | Vision Benefits Of America | Engle, Hambright & Davies, Inc. | 74 | $364 3.5% of $10,387 |
| Vision | Vision Benefits Of America | Engle, Hambright & Davies, Inc. | 21 | $101 8.0% of $1,264 |
| Life | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 83 | $1,982 15.0% of $13,210 |
| Life | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 83 | $660 5.0% of $13,210 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 17 | $995 10.0% of $9,952 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 17 | $498 5.0% of $9,952 |
| Accident Voluntary | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 25 | $595 10.0% of $5,946 |
| Accident Voluntary | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 25 | $297 5.0% of $5,946 |
| Other | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 83 | $3,804 15.0% of $25,358 |
| Other | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 83 | $1,268 5.0% of $25,358 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 21 | $3,042 15.0% of $20,283 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 21 | $1,014 5.0% of $20,283 |
| Voluntary Life | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 29 | $2,390 15.0% of $15,933 |
| Voluntary Life | United Of Omaha Life Insurance Company | James R Nelligan & Associates | 29 | $797 5.0% of $15,933 |
| EAP | Wellspan Employee Assistance Program | — | — | Schedule A not provided |
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 $113,377
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $78,236 | $460.21 |
| Engle Hambright & Davies, Inc. | Broker | $35,141 | $206.71 |