Employer
Roofers Local Union #210
7454 Edinboro Road, Erie, PA 16509 · EIN 25-6390935 · May 1, 2024 to Apr 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 $21,654
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Highmark Blue Shield | Seubert & Associates | 111 | $21,654 31.8% of $67,996 |
| Life | Dearborn National Life Insurance Company | — | 129 | Comp not disclosed |
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 $105,971
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark | None | $96,971 | $751.71 |
| Heberlein & Falk,P.C. | None | $9,000 | $69.77 |