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Employer
286 Piper Road, St Marys, PA 15857 · EIN 81-1525483 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $156,318
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Cigna Health And Life Insurance Company And Affiliates | Willis Towers Watson | 470 | $112,979 1.8% of $6,140,084 |
| Medical | Cigna Health And Life Insurance Company And Affiliates | Hub International | 470 | $9,813 0.2% of $6,140,084 |
| Medical | Cigna Health And Life Insurance Company And Affiliates | Willis Tower Watsonus LLC | 470 | $191 0.0% of $6,140,084 |
| Dental | Northeast Delta Dental | Willis Towers Watson | 224 | $2,917 11.0% of $26,449 |
| Dental | Northeast Delta Dental | Willis Towers Watson | 4 | $1,460 4.7% of $31,308 |
| Vision | Eyemed Vision Care On Behalf Of Fidelity Security Life Insurance Co. | Willis Towers Watson Northeast, Inc | 650 | $1,503 10.8% of $13,975 |
| Life | Reliance Standard Life Insurance Company | Willis Towers Watson Northeast, Inc | 723 | $14,705 5.5% of $266,804 |
| Life | Reliance Standard Life Insurance Company | Willis Towers Watson | 723 | $4,491 1.7% of $266,804 |
| Accident, Critical Illness, Hospital | Reliastar Life Insurance Company | Willis Towers Watson Northeast, Inc | 257 | $4,298 9.4% of $45,882 |
| Accident, Critical Illness, Hospital | Reliastar Life Insurance Company | Bene Re LLC | 257 | $3,671 8.0% of $45,882 |
| Accident, Critical Illness, Hospital | Reliastar Life Insurance Company | Hub International | 257 | $290 0.6% of $45,882 |
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.
No Schedule C parties in this year.