Loading employer…
Employer
4714 Gettysburg Road, Mechanicsburg, PA 17055 · EIN 75-2014828 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $273,711
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Reliastar Life Insurance Company | — | 728 | Schedule A not provided |
| Medical | Upmc Health Options | — | 13 | Comp not disclosed Premium $110,481 |
| Medical | Upmc Health Options | — | 26 | Comp not disclosed Premium $159,159 |
| Medical | Metropolitan Life Insurance Company | — | 229 | Schedule A not provided |
| Medical | Metropolitan Life Insurance Company | — | 395 | Schedule A not provided |
| Medical | Metropolitan Life Insurance Company | — | 389 | Schedule A not provided |
| Dental | Delta Dental Insurance Company | — | 725 | Comp not disclosed Premium $688,249 |
| Vision | Vision Service Plan | — | 683 | Comp not disclosed Premium $119,921 |
| Life | Metropolitan Life Insurance Company | — | 996 | Schedule A not provided |
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.
Visible subtotal $436,643
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Providence Risk & Insurance Svcs | None | $7,117 | $20.39 |
| Highmark | Claims Administrator | $429,526 | $431.25 |