Employer
Penn Line Service Inc.
300 Scottdale Avenue, Scottdale, PA 15683 · EIN 25-1000923 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $104,243
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Service Plan | — | 877 | Comp not disclosed Premium $112,319 |
| Life | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 1564 | $104,243 11.0% of $945,557 |
| Employee Assistance Program | Lytle Behavioral Health, LLC | — | 1707 | Schedule A not provided |
| Employee Assistance Program | Workpartners | — | 1800 | Comp not disclosed Premium $19,440 |
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.
No Schedule C parties in this year.