Employer
Scotland Road Market, Inc.
410 Stouffer Avenue, Chambersburg, PA 17201 · EIN 25-1197011 · Sep 1, 2024 to Aug 31, 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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 37 | Comp not disclosed Premium $207,410 |
| Dental | United Concordia Life And Health Insurance Company | — | — | Schedule A not provided |
| Vision | National Vision Administrators | — | — | Schedule A not provided |
| Life | Madison National Life Insurance Company | — | — | Schedule A not provided |
| Life | Madison National Life Insurance Company | — | — | 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.
Visible subtotal $44,515
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Pci Insurance Agency | Broker | $12,338 | $138.63 |
| The Benecon Group, LLC | Admin | $31,433 | $353.18 |
| Capital Bluecross | Admin | $744 | $8.36 |