Employer
Select Cs Physical Therapy, P.C.
4714 Gettysburg Road, Mechanicsburg, PA 17055 · EIN 86-3160041 · Jan 1, 2024 to Dec 31, 2024
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.
Visible subtotal $17,060
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Reliastar Life Insurance Company | — | 89 | Schedule A not provided |
| Medical | Metropolitan Life Insurance Company | — | 39 | Schedule A not provided |
| Medical | Metropolitan Life Insurance Company | — | 37 | Schedule A not provided |
| Medical | Metropolitan Life Insurance Company | — | 23 | Schedule A not provided |
| Dental | Delta Dental Insurance Company | — | 97 | Comp not disclosed Premium $43,719 |
| Vision | Vision Service Plan | — | 78 | Comp not disclosed Premium $9,378 |
| Life | Metropolitan Life Insurance Company | — | 140 | Comp not disclosed Premium $45,007 |
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 $27,083
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark | Claims Administrator | $27,083 | $185.50 |