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Employer
One Quality Way, Aliquippa, PA 15001 · EIN 25-1677730 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $19,878
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | Coury Health Services, LLC | 131 | $3,822 9.1% of $41,908 |
| Vision | Eyemed | American Insurance Administrators | 87 | $610 9.9% of $6,154 |
| Life | United Of Omaha Life Insurance Company | National Benefit Center | 108 | $822 3.0% of $27,676 |
| Life | United Of Omaha Life Insurance Company | American Insurance Administrators | 108 | $1,384 5.0% of $27,676 |
| Life | United Of Omaha Life Insurance Company | Coury Health Services, LLC | 108 | $4,411 15.9% of $27,676 |
| AD&D | United Of Omaha Life Insurance Company | National Benefit Center | 22 | $249 3.1% of $8,105 |
| AD&D | United Of Omaha Life Insurance Company | American Insurance Administrators | 22 | $405 5.0% of $8,105 |
| AD&D | United Of Omaha Life Insurance Company | Coury Health Services, LLC | 22 | $1,309 16.2% of $8,105 |
| Other | United Of Omaha Life Insurance Company | National Benefit Center | 67 | $220 3.0% of $7,411 |
| Other | United Of Omaha Life Insurance Company | American Insurance Administrators | 67 | $371 5.0% of $7,411 |
| Other | United Of Omaha Life Insurance Company | Coury Health Services, LLC | 67 | $1,181 15.9% of $7,411 |
| Other | United Of Omaha Life Insurance Company | National Benefit Center | 42 | $456 2.8% of $16,378 |
| Other | United Of Omaha Life Insurance Company | American Insurance Administrators | 42 | $819 5.0% of $16,378 |
| Other | United Of Omaha Life Insurance Company | Coury Health Services, LLC | 42 | $2,551 15.6% of $16,378 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Coury Health Services, LLC | 1 | $72 3.4% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Khs Benefits LLC | 1 | $54 2.5% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Amy Beth Lieberman | 1 | $64 3.0% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Noelle Marie Kucera | 1 | $20 0.9% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Coury Health Services, LLC | 1 | $19 0.9% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Smith Benefits Consulting Group | 1 | $19 0.9% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Jacqueline Cotton | 1 | $8 0.4% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Elizabeth Ann Riffe | 1 | $6 0.3% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Smith Benefits Consulting Group | 1 | $4 0.2% of $2,143 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Coury Health Services, LLC | 9 | $355 3.3% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Khs Benefits LLC | 9 | $249 2.3% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Elizabeth Ann Riffe | 9 | $115 1.1% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Ethan Robert Riffe | 9 | $80 0.7% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Jacqueline Cotton | 9 | $66 0.6% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Smith Benefits Consulting Group | 9 | $40 0.4% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Amy Beth Lieberman | 9 | $47 0.4% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Coury Health Services, LLC | 9 | $26 0.2% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Vanessa Marie Trombetta | 9 | $14 0.1% of $10,895 |
| Accident, Hospital Indemnity, Critical Illness | Aflac | Smith Benefits Consulting Group | 9 | $10 0.1% of $10,895 |
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.