Employer
Mountz Jewelers, L. P.
3780 Trindle Road, Camp Hill, PA 17011 · EIN 25-1858491 · Sep 1, 2024 to Aug 31, 2025
Plan year 2024
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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 $10,708
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | — | Comp not disclosed Premium $33,557 |
| Medical | Capital Advantage Assurance Company | Gunn Mowery, LLC | 35 | $9,735 4.7% of $209,155 |
| Dental | Delta Dental Of Pennsylvania | Gunn Mowery, LLC | 34 | $848 10.0% of $8,481 |
| Vision | Highmark, Inc | Theodore Mowery | 369 | $125 6.0% of $2,089 |
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 $8,791
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group LLC | Broker | $4,658 | $12.62 |
| Gunn-Mowery | Broker | $3,836 | $10.40 |
| Capital Blue Cross | Admin | $174 | $0.47 |
| ConnectCare3 | Patient Advocate | $123 | $0.33 |