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Employer
1100 Bent Creek Boulevard, Mechanicsburg, PA 17050 · EIN 27-1139282 · Nov 1, 2021 to Oct 31, 2022
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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optumhealth | — | 2797 | Comp not disclosed Premium $5,430,020 |
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.
Visible subtotal $1,348,295
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $330,132 | $116.74 |
| L.R. Webber Associates, Inc. | Broker | $242,239 | $85.66 |
| Murray Securus | Broker | $40,840 | $14.44 |
| Susquehanna Insurance | Broker | $1,671 | $0.59 |
| Digital Insurance, LLC | Broker | Comp not disclosed | — |
| Independence Administrators | Admin | $327,732 | $115.89 |
| ConnectCare3 | Patient Advocate | $87,152 | $30.82 |
| Trustmark Benefits | Admin | $87,116 | $30.80 |
| Stoudt Advisors | Other | $77,925 | $27.55 |
| Highmark West | Admin | $54,150 | $19.15 |
| Capital Bluecross | Admin | $44,675 | $15.80 |
| Baker Tilly Virchow Krause, LLP | Auditor | $38,525 | $13.62 |
| Eliance Administrators | Admin | $33,434 | $11.82 |
| Aetna | Admin | $24,448 | $8.64 |
| Highmark | Admin | $-41,744 | $-14.76 |