Employer
Polymer Enterprises Inc
1600 Washington St, Indiana, PA 15701 · EIN 25-0650190 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $8,357
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | — | 417 | Comp not disclosed Premium $182,705 |
| Vision | Highmark Inc | Highmark, Inc. | 417 | Comp not disclosed Premium $42,581 |
| Accidental Death & Dismemberment | Sun Life Assurance Company Of Canada | C B Tracy & Associates DBA Tracyco | 494 | $8,357 5.6% of $148,083 |
| Accidental Death & Dismemberment | Hartford Life And Accident | Godwins Inc | 8 | Comp not disclosed Premium $769 |
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 $231,158
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark Inc | Administrative Services | $231,158 | $375.26 |