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Employer
1000 Noble Energy Drive, Suite 300, Canonsburg, PA 15317 · EIN 47-5103354 · 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 $12,548
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | 94 | Comp not disclosed Premium $96,494 |
| Vision | Vision Service Plan | Henderson Brothers Inc. | 96 | $666 4.1% of $16,056 |
| Vision | Vision Service Plan | The Hdh Group, Inc. | 96 | $293 1.8% of $16,056 |
| Life | Standard Insurance Company | Hub International | 114 | $1,052 4.9% of $21,633 |
| Life | Standard Insurance Company | Henderson Brothers Inc. | 114 | $873 4.0% of $21,633 |
| Life | Standard Insurance Company | The Hdh Group, Inc. | 114 | $590 2.7% of $21,633 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | The Hdh Group, Inc. | 36 | $2,242 8.2% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Barbara Baxter Dejohn | 36 | $1,860 6.8% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Henderson Brothers Inc. | 36 | $844 3.1% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Timothy J. Slater | 36 | $637 2.3% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Daniel J. Slater | 36 | $460 1.7% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Kati Nairn | 36 | $349 1.3% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Howard J. Horowitz | 36 | $75 0.3% of $27,465 |
| Voluntary Worksite | Colonial Life & Accident Insurance Company | Brandon Marcello Cento | 36 | $5 0.0% of $27,465 |
| Other | Standard Insurance Company | Hub International | 114 | $1,460 4.9% of $29,544 |
| Other | Standard Insurance Company | Hub International | 114 | $1,142 4.9% of $23,509 |
| Telemedicine | First Stop Health, LLC | — | 110 | Comp not disclosed Premium $5,914 |
| Legal | Legal Shield | — | — | Schedule A not provided |
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 $60,561
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $27,830 | $204.63 |
| Meritain Health, An Aetna Company | Admin | $21,502 | $158.10 |
| United Concordia Companies, Inc. | Admin | $10,224 | $75.18 |
| Innovu | Other | $1,005 | $7.39 |