Employer
Shank'S Extracts, LLC
350 Richardson Drive, Lancaster, PA 17603 · EIN 23-1688295 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $8,899
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Ameritas Life Insurance Corp | Engle, Hambright & Davies, Inc. | 288 | $2,705 5.2% of $51,846 |
| Vision | National Vision Administrators | Ehd | 155 | $339 5.0% of $6,781 |
| Life | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 204 | $1,234 10.0% of $12,340 |
| Other | United Of Omaha Life Insurance Company | Engle, Hambright & Davies, Inc. | 204 | $4,621 10.0% of $46,205 |
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 $92,735
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Engle-Hambright & Davies, Inc. | Broker | $41,725 | $278.17 |
| The Benecon Group, LLC | Broker | $24,518 | $163.45 |
| Capital Blue Cross | Admin | $17,980 | $119.87 |
| Connectcare 3 | Patient Advocate | $8,512 | $56.75 |