Employer
Ross Technology Company
104 North Maple Avenue, Leola, PA 17540 · EIN 23-1643289 · Jan 1, 2021 to Dec 31, 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 $16,771
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | American Insurance Administration | 136 | $431 4.0% of $10,774 |
| Dental | United Concordia Insurance Company | — | 128 | Schedule A not provided |
| Dental | United Concordia Insurance Company | — | 128 | Schedule A not provided |
| Life | The Guardian Life Insurance Company Of America | — | 67 | Schedule A not provided |
| Life | The Guardian Life Insurance Company Of America | — | 67 | Schedule A not provided |
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.