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Employer
7 Stauffer Industrial Park, Taylor, PA 18517 · EIN 23-2623564 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $5,593
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 68 | Comp not disclosed Premium $279,306 |
| Dental | Delta Dental Of Pennsylvania | Cummings Insurance Agency | 118 | $2,199 10.0% of $21,992 |
| Vision | Vison Benefits Of America | Cummings Insurance Agency | 68 | $251 6.0% of $4,156 |
| Life | Metropolitan Life Insurance Company | Cummings Insurance Agency | 84 | $3,083 14.7% of $20,987 |
| Supplemental | Colonial Life & Accident Insurance Company | Integrity Insurance Inc | 2 | $34 1.5% of $2,274 |
| Supplemental | Colonial Life & Accident Insurance Company | Cathy Good | 2 | $17 0.7% of $2,274 |
| Supplemental | Colonial Life & Accident Insurance Company | William E Good | 2 | $9 0.4% of $2,274 |
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 $67,501
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $58,862 | $498.83 |
| Cummings Insurance Agency | Broker | $19,317 | $163.70 |
| Highmark Blue Shield (Central) | Admin | $24 | $0.20 |
| Highmark Bcbs Nepa | Admin | $-10,702 | $-90.69 |