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Employer
401 Old Wyomissing Road, Reading, PA 19611 · EIN 23-2421258 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $4,847
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 32 | Comp not disclosed Premium $119,648 |
| Dental | The Guardian Life Insurance Company | Emerson Reid LLC | 39 | $3,574 17.9% of $19,920 |
| Vision | Eyemed Vision Care | Univest Insurance, LLC | 35 | $404 15.1% of $2,682 |
| Vision | Eyemed Vision Care | Emerson Reid & Co | 35 | $123 4.6% of $2,682 |
| Vision | Eyemed Vision Care | Emerson Rogers LLC | 35 | $79 2.9% of $2,682 |
| Life | Equitable Financial Life Insurance Company Of America | Univest Insurance, LLC | 57 | $500 15.0% of $3,333 |
| Life | Equitable Financial Life Insurance Company Of America | Emerson Reid LLC | 57 | $167 5.0% of $3,333 |
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.
Visible subtotal $29,540
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Univest Insurance | Broker | $16,170 | $283.68 |
| The Benecon Group, LLC | Broker | $8,408 | $147.51 |
| Capital Bluecross | Admin | $2,670 | $46.84 |
| ConnectCare3 | Patient Advocate | $2,292 | $40.21 |