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Employer
6051 Wallace Road Extension, Wexford, PA 15090 · EIN 85-0943754 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $107,672
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Reliastar Life Insurance Company | — | 847 | Comp not disclosed Premium $723,996 |
| Vision | Fidelity Security Life Insurance Company | — | 555 | Comp not disclosed Premium $15,693 |
| Vision | Vision Benefits Of America | — | 486 | Comp not disclosed Premium $42,259 |
| Life | Reliance Standard Life Insurance Company | Seubert & Associates Inc. | 944 | $20,172 10.0% of $201,723 |
| Life | Reliance Standard Life Insurance Company | Professional Group Plans, Inc. | 944 | $10,086 5.0% of $201,723 |
| Life | Reliance Standard Life Insurance Company | Seubert & Associates Inc. | 400 | $13,236 10.0% of $132,364 |
| Life | Reliance Standard Life Insurance Company | Professional Group Plans, Inc. | 400 | $6,618 5.0% of $132,364 |
| Other | Reliance Standard Life Insurance Company | Seubert & Associates Inc. | 483 | $12,900 10.0% of $128,995 |
| Other | Reliance Standard Life Insurance Company | Professional Group Plans, Inc. | 483 | $6,450 5.0% of $128,995 |
| Accident | Reliance Standard Life Insurance Company | Seubert & Associates Inc | 277 | $8,416 20.0% of $42,082 |
| Accident | Reliance Standard Life Insurance Company | Professional Group Plans, Inc. | 277 | $2,104 5.0% of $42,082 |
| Critical Illness | Reliance Standard Life Insurance Company | Seubert & Associates | 279 | $9,154 20.0% of $45,769 |
| Critical Illness | Reliance Standard Life Insurance Company | Professional Group Plans | 279 | $2,288 5.0% of $45,769 |
| Other | Reliance Standard Life Insurance Company | Seubert & Associates, Inc. | 140 | $12,998 20.0% of $64,992 |
| Other | Reliance Standard Life Insurance Company | Professional Group Plans, Inc. | 140 | $3,250 5.0% of $64,992 |
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.