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Employer
650 N. State Street, York, PA 17403 · EIN 23-2170263 · Oct 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $16,634
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | 137 | Comp not disclosed Premium $182,985 |
| Dental | United Concordia Insurance Company | Mcconkey Benefits & Financial Servi | 243 | $2,118 9.9% of $21,439 |
| Dental | United Concordia Insurance Company | Mather & Strohl Administrative Serv | 243 | $1,037 4.8% of $21,439 |
| Vision | Vision Benefits Of America | Mcconkey Benefits & Financial Servi | 112 | $958 5.0% of $19,151 |
| Life | Life Insurance Company Of North America | Mcconkey Benefits & Financial Servi | 139 | $6,848 22.1% of $31,014 |
| Life | Life Insurance Company Of North America | Benefitmall | 139 | $1,948 6.3% of $31,014 |
| AD&D | Life Insurance Company Of North America | Mcconkey Benefits & Financial Servi | 139 | $141 13.2% of $1,068 |
| AD&D | Life Insurance Company Of North America | Benefitmall | 139 | $53 5.0% of $1,068 |
| Other | Life Insurance Company Of North America | Mcconkey Benefits & Financial Servi | 139 | $2,014 23.7% of $8,509 |
| Other | Life Insurance Company Of North America | Benefit Mall | 139 | $530 6.2% of $8,509 |
| Other | Life Insurance Company Of North America | Mcconkey Benefits & Financial Servi | 139 | $658 10.0% of $6,579 |
| Other | Life Insurance Company Of North America | Benefitmall | 139 | $329 5.0% of $6,579 |
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 $24,850
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Mcconkey Benefits & Financial Serv. | Broker | $12,325 | $89.96 |
| The Benecon Group | Broker | $425 | $3.10 |
| Highmark | Admin | $9,550 | $69.71 |
| Benefitmall | Admin | $2,550 | $18.61 |