Employer
Prism Spectrum Holdings, LLC
102 Technology Lane, Export, PA 15632 · EIN 81-1000401 · Oct 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $29,086
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Aetna Life Insurance Company | Usi Insurance Services (Ri) | 526 | $26,301 2.7% of $958,296 |
| Dental | Metropolitan Life Insurance Company | Usi Insurance Services (Ri) | 606 | $2,785 10.8% of $25,868 |
| Life | Hartford Life And Accident | — | 248 | 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.
No Schedule C parties in this year.