Employer
Premier Medical Associates
120 5th Ave Ste Fap-043b, Pittsburgh, PA 15222 · EIN 25-1742869 · Jan 1, 2023 to Apr 30, 2023
Plan year 2023
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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 $18,821
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | Alliant Insurance Services, Inc. | 647 | $1,788 2.6% of $68,578 |
| Vision | Highmark, Inc. | Alliant Insurance Services, Inc. | 612 | $483 4.0% of $12,150 |
| Life | Hartford Life And Accident | Alliant Insurance Services, Inc. | 348 | $16,550 11.1% of $149,427 |
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 $-22,159
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark, Inc. | Insurance Company | $-22,159 | $-34.25 |