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Employer
449 Eisenhower Boulevard, Suite 300, Harrisburg, PA 17111 · EIN 25-1645583 · Jan 1, 2020 to Sep 30, 2020
Plan year 2020
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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 $13,603
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Capital Advantage Assurance Company | — | 86 | Comp not disclosed Premium $681,936 |
| Dental | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 86 | $3,353 7.7% of $43,552 |
| Vision | Vision Benefits Of America | Assured Partners (Central Pa) | 93 | $276 3.5% of $7,888 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 112 | $1,760 17.0% of $10,358 |
| AD&D | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 34 | $185 16.8% of $1,099 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 112 | $2,892 17.0% of $17,038 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 112 | $4,188 17.0% of $24,672 |
| Vol Life, Vol Spouse Life, Vol Child Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 48 | $949 16.7% of $5,699 |
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 $9,000
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Ap Benefit Advisors, LLC | Broker | $9,000 | $70.31 |