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Employer
230 North College Street, Palmyra, PA 17078 · EIN 23-0939960 · 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 $11,786
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $2,186 |
| Stop-loss | Crum & Forster | — | 56 | Comp not disclosed Premium $270,104 |
| Dental | United Concordia Insurance Company | Webb Insurance, Inc. | 93 | $2,353 9.1% of $25,883 |
| Dental | United Concordia Insurance Company | Mcconkey Benefits & Financial Servi | 93 | $-34 -0.1% of $25,883 |
| Vision | Vision Benefits Of America | Webb Insurance, Inc. | 60 | $364 10.0% of $3,641 |
| Life | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 74 | $1,181 10.0% of $11,810 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 74 | $620 5.2% of $11,810 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 74 | $276 2.3% of $11,810 |
| Life | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 23 | $599 10.0% of $5,993 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 23 | $484 8.1% of $5,993 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 23 | $215 3.6% of $5,993 |
| Other | United Of Omaha Life Insurance Company | Webb Insurance, Inc. | 65 | $1,277 10.0% of $12,770 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 65 | $650 5.1% of $12,770 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 65 | $289 2.3% of $12,770 |
| Other | United Of Omaha Life Insurance Company | Bob Webb Insruance Inc | 65 | $2,060 10.0% of $20,605 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 65 | $1,005 4.9% of $20,605 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 65 | $447 2.2% of $20,605 |
| EAP | Mazzitti & Sullivan | — | — | 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 $61,079
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $52,309 | $562.46 |
| Webb Insurance, Inc. | Broker | $17,000 | $182.80 |
| E. K. Mcconkey & Co., Inc. | Broker | $-210 | $-2.26 |
| Revivehealth, Inc. | Other | $8,840 | $95.05 |
| Capital Bluecross | Admin | $-16,860 | $-181.29 |