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Employer
245 Front Street, Northumberland, PA 17857 · EIN 24-0677265 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $16,661
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental + Vision | Highmark, Inc. | Lr Webber | 75 | $3,932 10.3% of $38,028 |
| Life | United Of Omaha Life Insurance Company | Lr Webber | 117 | $3,756 15.0% of $25,040 |
| Life | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 117 | $189 0.8% of $25,040 |
| Life | United Of Omaha Life Insurance Company | Lr Webber | 38 | $1,564 15.0% of $10,425 |
| Life | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 38 | $81 0.8% of $10,425 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 82 | $5,720 20.0% of $28,598 |
| Other | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 82 | $225 0.8% of $28,598 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Lr Webber | 22 | $547 15.0% of $3,646 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 22 | $24 0.7% of $3,646 |
| Other | United Of Omaha Life Insurance Company | Lr Webber | 32 | $591 15.0% of $3,940 |
| Other | United Of Omaha Life Insurance Company | Leavitt Group Insur Advisors Inc | 32 | $32 0.8% of $3,940 |
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.