Employer

Riverview Bank

200 Front Street, Marysville, PA 17053 · EIN 23-0581420 · Jan 1, 2021 to Nov 30, 2021

Plan year 2021

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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 $14,967

Coverage	Carrier	Broker	Lives	Direct comp
Dental	Delta Dental Of Pennsylvania	Lr Webber	—	$13,817 10.5% of $131,031
Vision	Highmark Inc	Lr Webber	—	$1,150 6.0% of $19,046

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.