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Employer
2 Danforth Drive, Easton, PA 18045 · EIN 22-2036612 · Oct 1, 2024 to Sep 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 $6,967
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 33 | Comp not disclosed Premium $132,661 |
| Dental + Vision | Highmark Inc | Tranguch,Nicholas Franklin | 60 | $1,673 7.4% of $22,641 |
| Dental + Vision | Highmark Inc | The Benecon Group, Inc. | 60 | $456 2.0% of $22,641 |
| Life | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 10 | $642 19.7% of $3,253 |
| Life | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 46 | $542 18.0% of $3,011 |
| Other | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 46 | $1,471 18.0% of $8,157 |
| Voluntary | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 18 | $1,462 18.1% of $8,093 |
| Voluntary | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 12 | $721 19.6% of $3,670 |
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 $45,467
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $25,897 | $431.62 |
| Bsi Corporate Benefits | Broker | $24,350 | $405.83 |
| Hy Holdings Inc | Carrier | $4,080 | $68.00 |
| Innovu | Other | $1,815 | $30.25 |
| Capital Bluecross | Carrier | $-10,675 | $-177.92 |