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Employer
1925 Turner Street, Allentown, PA 18104 · EIN 23-1396838 · 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 $77,639
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 506 | Comp not disclosed Premium $365,222 |
| Stop-loss | Crum & Forster | — | 522 | Comp not disclosed Premium $348,651 |
| Vision | Vision Benefits Of America | Bsi Corporate Benefits, Inc. | 463 | $2,540 5.0% of $50,804 |
| Life | Unum Life Insurance Company Of America | Bsi Corporate Benefits, Inc. | 693 | $8,281 6.1% of $136,192 |
| Life | Unum Life Insurance Company Of America | Mcclellan, David J | 693 | $6,823 5.0% of $136,192 |
| AD&D | Unum Life Insurance Company Of America | Bsi Corporate Benefits, Inc. | 168 | $10,453 15.1% of $69,103 |
| AD&D | Unum Life Insurance Company Of America | Mcclellan, David J | 168 | $3,484 5.0% of $69,103 |
| Other | Unum Life Insurance Company Of America | Mcclellan, David J | 821 | $7,735 5.0% of $154,707 |
| Other | Unum Life Insurance Company Of America | Bsi Corporate Benefits, Inc. | 821 | $4,262 2.8% of $154,707 |
| Hospital Ee Paid | Unum Insurance Company | Mcclellan, David J | 67 | $5,034 20.7% of $24,355 |
| Hospital Ee Paid | Unum Insurance Company | Bsi Corporate Benefits, Inc. | 67 | $3,965 16.3% of $24,355 |
| Long-Term Care | Unum Life Insurance Company Of America | Bsi Corporate Benefits, Inc. | 861 | $6,291 10.1% of $62,242 |
| Group Accident | Unum Life Insurance Company | Mcclellan, David J | 115 | $3,306 20.4% of $16,190 |
| Group Accident | Unum Life Insurance Company | Bsi Corporate Benefits, Inc. | 115 | $2,633 16.3% of $16,190 |
| Attained Age Critical Illness | Unum Insurance Company | Mcclellan, David J | 86 | $7,213 21.0% of $34,406 |
| Attained Age Critical Illness | Unum Insurance Company | Bsi Corporate Benefits, Inc. | 86 | $5,619 16.3% of $34,406 |
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 $619,211
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $115,565 | $134.22 |
| Lr Webber | Broker | $111,879 | $129.94 |
| Capital Advantage Assurance Company | Admin | $252,191 | $292.90 |
| Hy Holdings Inc | Admin | $85,731 | $99.57 |
| Sun Life Assurance Company Of Canad | Admin | $34,060 | $39.56 |
| ConnectCare3 | Patient Advocate | $19,785 | $22.98 |