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Employer
285 Kappa Drive, Pittsburgh, PA 15238 · EIN 25-0947393 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $37,747
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 155 | Comp not disclosed Premium $490,517 |
| Dental | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 133 | $3,795 6.0% of $62,859 |
| Dental | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 133 | $941 1.5% of $62,859 |
| Dental | The Lincoln National Life Insurance Company | Seubert & Associates Inc | 133 | $2 0.0% of $62,859 |
| Vision | Eyemed Vision Care | Henderson Brothers Inc. | 228 | $1,620 9.9% of $16,417 |
| Life | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 206 | $1,412 10.9% of $13,002 |
| Life | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 206 | $195 1.5% of $13,002 |
| Life | The Lincoln National Life Insurance Company | Seubert & Associates Inc | 206 | $1 0.0% of $13,002 |
| AD&D | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 49 | $769 20.9% of $3,680 |
| AD&D | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 49 | $55 1.5% of $3,680 |
| Critical Illness | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 37 | $4,021 39.4% of $10,202 |
| Accident | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 47 | $3,498 46.9% of $7,465 |
| Hospital Indemnity | The Lincoln National Insurance Company | Henderson Brothers Inc. | 25 | $5,381 58.7% of $9,173 |
| Other | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 206 | $5,313 13.7% of $38,920 |
| Other | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 206 | $583 1.5% of $38,920 |
| Other | The Lincoln National Life Insurance Company | Seubert & Associates Inc | 206 | $2 0.0% of $38,920 |
| Other | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 206 | $2,204 9.0% of $24,394 |
| Other | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 206 | $366 1.5% of $24,394 |
| Other | The Lincoln National Life Insurance Company | Seubert & Associates Inc | 206 | $1 0.0% of $24,394 |
| Vol Child And Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Henderson Brothers Inc. | 63 | $7,021 18.6% of $37,776 |
| Vol Child And Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Watchtower Technologies Inc | 63 | $567 1.5% of $37,776 |
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 $204,833
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Henderson Brothers Inc. | Broker | $61,589 | $251.38 |
| The Benecon Group | Broker | $37,309 | $152.28 |
| Umr, Inc. | Admin | $91,703 | $374.30 |
| ConnectCare3 | Patient Advocate | $11,928 | $48.69 |
| Rxbenefits, Inc. | Admin | $2,304 | $9.40 |