Employer
Pine Hill Manufacturing, LLC
5140 Martin Drive, Gap, PA 17527 · EIN 23-3035227 · Aug 1, 2024 to Jul 31, 2025
Plan year 2024
Covered lives: 54
Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $511 |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | 44 | Comp not disclosed Premium $253,806 |
| Dental + Vision | Principal Life Insurance Company | — | — | Schedule A not provided |
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 $21,959
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $13,534 | $250.63 |
| Kelly Benefits Strategies | Broker | $9,160 | $169.63 |
| Ccab Insurance & Benefits, Inc. | Broker | $7,375 | $136.57 |
| ConnectCare3 | Patient Advocate | $3,064 | $56.74 |
| Capital Bluecross | Admin | $-11,174 | $-206.93 |