Employer
Osage Piping & Fabricating, Inc.
85 Industrial Road, Highspire, PA 17034 · EIN 23-2752647 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $2,411
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 26 | Comp not disclosed Premium $104,385 |
| Dental | Delta Dental Of Pennsylvania | Epic Insurance Brokers (Central Pa) | 51 | $1,199 10.0% of $11,988 |
| Vision | Capital Advantage Assurance Company | Edgewood Partners Insurance | 51 | $1,212 57.5% of $2,107 |
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 $5,899
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Epic Insurance Brokers (Central Pa) | Broker | $10,325 | $202.45 |
| The Benecon Group | Broker | $7,781 | $152.57 |
| ConnectCare3 | Patient Advocate | $1,658 | $32.51 |
| Capital Bluecross | Admin | $-13,865 | $-271.86 |