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Employer
305 Micro Drive, Jonestown, PA 17038 · EIN 25-1875456 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $44,990
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | — | — | Comp not disclosed Premium $2,123,949 |
| Dental | Delta Dental Of Pennsylvania | — | — | Comp not disclosed Premium $99,631 |
| Vision | Ngl | — | — | Comp not disclosed Premium $13,738 |
| Life | Provident Life And Accident Insurance Company | National Benefits Group Of America | — | $54 1.9% of $2,770 |
| Life | Provident Life And Accident Insurance Company | Willis Towers Watson Northeast, Inc | — | $42 1.5% of $2,770 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | — | $12,844 25.0% of $51,376 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson | — | $1,624 3.2% of $51,376 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | — | $3,970 15.0% of $26,468 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson | — | $1,624 6.1% of $26,468 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson | — | $1,624 50.7% of $3,206 |
| Life | The Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | — | $801 25.0% of $3,206 |
| Critical Illness | Unum Life Insurance Company Of America | Willis Towers Watson Northeast, Inc | — | $787 5.4% of $14,620 |
| Critical Illness | Unum Life Insurance Company Of America | National Benefits Group Of America | — | $595 4.1% of $14,620 |
| Critical Illness | Unum Life Insurance Company Of America | Willis Towers Watson Northeast, Inc | — | $429 2.9% of $14,620 |
| Other | The Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | — | $10,610 15.0% of $70,734 |
| Other | The Lincoln National Life Insurance Company | Willis Towers Watson | — | $1,624 2.3% of $70,734 |
| Other | The Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | — | $6,738 15.0% of $44,919 |
| Other | The Lincoln National Life Insurance Company | Willis Towers Watson | — | $1,624 3.6% of $44,919 |
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.
No Schedule C parties in this year.