Employer
Rolling Rock Club
167 Clubhouse Lane, Laughlintown, PA 15655 · EIN 25-0763060 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $14,939
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Upmc Health Options | — | 137 | Comp not disclosed Premium $1,440,045 |
| Dental + Vision | Upmc Health Benefits | — | 187 | Comp not disclosed Premium $36,819 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 149 | $3,196 16.4% of $19,466 |
| Life | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 38 | $3,058 21.3% of $14,360 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 99 | $4,694 19.0% of $24,694 |
| Other | United Of Omaha Life Insurance Company | Henderson Brothers Inc. | 99 | $3,991 16.0% of $24,999 |
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.
No Schedule C parties in this year.