Employer
Penn Tank Lines, Inc.
300 Lionville Station Road, Chester Springs, PA 19425 · EIN 23-2845134 · 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 $56,429
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Service Plan | Assured Partners (Central Pa) | 146 | $906 4.9% of $18,330 |
| Life | Hartford Life And Accident | Assured Partners (Central Pa) | 233 | $33,724 19.2% of $175,213 |
| Accident, Critical Illness, Hospital Indemnity | Relistar Life Insurance Company | Assured Partners (Central Pa) | 60 | $21,799 64.8% of $33,666 |
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 $175,132
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Administrators | Medical/Rx Administrator | $141,145 | $536.67 |
| United Concordia Companies, Inc. | Dental Administrator | $21,651 | $82.32 |
| Ap Benefit Advisors, LLC | Cobra/Benefit Admin | $12,336 | $46.90 |