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Employer
1045 Spring Street, Wyomissing, PA 19610 · EIN 23-2332520 · 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 $132,438
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Service Plan | Assured Partners (Central Pa) | 440 | $2,188 2.8% of $78,379 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 829 | $65,518 23.0% of $285,158 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 829 | $30,067 23.1% of $130,312 |
| Voluntary Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 141 | $15,554 23.1% of $67,309 |
| Whole Life | Provident Life And Accident Insurance Company | Assured Partners (Central Pa) | 66 | $13,036 37.6% of $34,626 |
| Whole Life | Provident Life And Accident Insurance Company | Usi Insurance Services (Ri) | 66 | $145 0.4% of $34,626 |
| Accident | Unum Insurance Company | Assured Partners (Central Pa) | 48 | $1,734 19.2% of $9,031 |
| Critical Illness | Unum Insurance Company | Assured Partners (Central Pa) | 29 | $2,795 20.6% of $13,586 |
| Hospital Indemnity | Unum Insurance Company | Assured Partners (Central Pa) | 28 | $1,401 17.8% of $7,890 |
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 $-242,611
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| United Concordia Companies, Inc. | Den Admin | $67,597 | $78.97 |
| Ap Benefit Advisors, LLC | Ben/Cobra/Fsa Admin | $20,150 | $23.54 |
| Capital Advantage Assurance Co | Medical/Rx Admin | $-330,358 | $-385.93 |