Employer
Mountain Ridge Metals, LLC
1517 State Route 209, Millersburg, PA 17061 · EIN 36-4919989 · Mar 1, 2022 to Feb 28, 2023
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 $41,915
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Unitedhealthcare Insurance Company | Keystone Insurance & Benefits Group | 107 | $23,625 3.4% of $685,722 |
| Dental + Vision | Metropolitan Life Insurance Company | Keystone Ins & Benefits Group LLC | 148 | $6,513 12.7% of $51,461 |
| Dental + Vision | Metropolitan Life Insurance Company | Keystone Insurers Group Inc | 148 | $2,619 5.1% of $51,461 |
| Life | United Of Omaha Life Insurance Company | Keystone Ins & Benefits Group LLC | 78 | $2,514 10.0% of $25,144 |
| Other | United Of Omaha Life Insurance Company | Keystone Ins & Benefits Group LLC | 7 | $269 10.0% of $2,686 |
| Other | United Of Omaha Life Insurance Company | Keystone Ins & Benefits Group LLC | 78 | $1,071 10.0% of $10,712 |
| Voluntary Life | United Of Omaha Life Insurance Company | Keystone Ins & Benefits Group LLC | 25 | $888 10.0% of $8,882 |
| Voluntary Short-Term Disability | United Of Omaha Life Insurance Company | Keystone Ins & Benefits Group LLC | 60 | $4,416 10.0% of $44,156 |
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.
No Schedule C parties in this year.