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Employer
471 Hepburn Street, Williamsport, PA 17701 · EIN 20-8979596 · 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 $60,778
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | Emerson Rogers LLC | 143 | $34,308 2.0% of $1,736,783 |
| Dental | The Guardian Life Insurance Company Of America | Usi Insurance Services (Ri) | 83 | $4,019 8.7% of $46,426 |
| Vision | Vision Benefits Of America | Usi Insurance Services (Ri) | 86 | $294 4.2% of $6,972 |
| Life | Colonial Life And Accident Insurance Company | Usi Insurance Services (Ri) | 23 | $1,873 6.8% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Benechoice Enrollment Solutions & T | 23 | $1,078 3.9% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Petrina Skiles | 23 | $890 3.2% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Eagle-Hambright Davies Inc | 23 | $519 1.9% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Elizabeth J Griffiths & Other Agent | 23 | $452 1.6% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Emerosn Rogers LLC | 23 | $216 0.8% of $27,700 |
| Life | Colonial Life And Accident Insurance Company | Mary J Yarnell | 23 | $191 0.7% of $27,700 |
| Life | United Of Omaha Life Insurance Company | Usi Insurance Services (Ri) | 109 | $16,938 23.3% of $72,721 |
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.