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Employer
1501 Ligonier Street, Latrobe, PA 15650 · EIN 25-1872667 · 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 $171,394
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 675 | Comp not disclosed Premium $862,131 |
| Stop-loss | HM Life Insurance Company | — | 155 | Comp not disclosed Premium $177,113 |
| Dental | Sun Life Assurance Company Of Canada | Hub International | 718 | $5,336 1.5% of $362,345 |
| Dental | Standard Insurance Company | Emerson Rogers LLC | 131 | $4,004 5.2% of $77,480 |
| Dental | Standard Insurance Company | Kmrd Partners | 131 | $2,108 2.7% of $77,480 |
| Vision | Highmark | — | 1823 | Comp not disclosed Premium $105,882 |
| Vision | Standard Insurance Company | Emerson Rogers LLC | 125 | $865 5.7% of $15,191 |
| Vision | Standard Insurance Company | Kmrd Partners | 125 | $349 2.3% of $15,191 |
| Life | Prudential Insurance Company Of America | Hub Heartland LLC | 830 | $118,546 11.4% of $1,043,674 |
| Life | Prudential Insurance Company Of America | Img | 830 | $178 0.0% of $1,043,674 |
| Life | Standard Insurance Company | Kmrd Partners | 140 | $5,154 3.9% of $131,022 |
| Life | Standard Insurance Company | Emerson Rogers LLC | 140 | $7,910 6.0% of $131,022 |
| Other | Standard Insurance Company | Emerson Rogers LLC | 140 | $7,388 6.0% of $122,244 |
| Other | Standard Insurance Company | Kmrd Partners | 140 | $5,011 4.1% of $122,244 |
| Other | Standard Insurance Company | Emerson Rogers LLC | 140 | $8,308 6.1% of $136,806 |
| Other | Standard Insurance Company | Kmrd Partners | 140 | $6,237 4.6% of $136,806 |
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.