Employer
Ridg U Rak, Inc.
P O Box 150, North East, PA 16428 · EIN 25-1413734 · Jan 1, 2023 to Dec 31, 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 $80,920
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Highmark, Inc. | — | 234 | Comp not disclosed Premium $41,549 |
| Stop-loss | HM Life Insurance Company | C H Reams & Associates, Inc | 232 | $53,814 10.0% of $538,147 |
| Medical | Highmark, Inc. | C H Reams & Associates, Inc | 232 | $27,106 0.9% of $2,956,321 |
| Dental | Delta Dental Of Pennsylvania | — | 234 | Comp not disclosed Premium $102,972 |
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 $-15,942
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark Inc | Insurance Carrier | $-15,942 | $-64.80 |