Employer
Novus Surgical Consultants LLC
1970 Broad Street, East Petersburg, PA 17520 · EIN 85-3089440 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 122
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 $12,473
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 57 | Comp not disclosed Premium $196,444 |
| Dental | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, LLC | 63 | $3,101 10.0% of $31,009 |
| Dental | The Lincoln National Life Insurance Company | Gis Benefits Inc | 63 | $1,673 5.4% of $31,009 |
| Vision | Highmark, Inc. | Robert Kole | 122 | $321 4.0% of $8,046 |
| Vision | Highmark, Inc. | The Benecon Group | 122 | $160 2.0% of $8,046 |
| Life | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, LLC | 89 | $1,264 11.4% of $11,106 |
| Life | The Lincoln National Life Insurance Company | Gis Benefits Inc | 89 | $555 5.0% of $11,106 |
| AD&D | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, LLC | 11 | $269 15.0% of $1,795 |
| AD&D | The Lincoln National Life Insurance Company | Gis Benefits Inc | 11 | $109 6.1% of $1,795 |
| Other | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, LLC | 89 | $1,625 10.6% of $15,265 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 89 | $763 5.0% of $15,265 |
| Other | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, LLC | 89 | $1,975 15.0% of $13,169 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 89 | $658 5.0% of $13,169 |
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 $72,262
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $46,922 | $384.61 |
| Bsi Corporate Benefits, LLC | Broker | $36,370 | $298.11 |
| Hy Holdings Inc | Admin | $6,212 | $50.92 |
| Innovu | Other | $2,848 | $23.34 |
| Capital Bluecross | Admin | $-20,090 | $-164.67 |