Employer
Spinal Evolution, Inc.
109 N. Fairwood Ave., Sinking Spring, PA 19608 · EIN 32-0687186 · Jul 1, 2024 to Jun 30, 2025
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 $9,805
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 30 | Comp not disclosed Premium $166,547 |
| Medical | Principal Life Insurance Company | Patriot Growth Insurance Services | 114 | $5,870 11.0% of $53,531 |
| Medical | Principal Life Insurance Company | James R Nelligan & Associates | 114 | $3,935 7.4% of $53,531 |
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 $26,589
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Patriot (Power-Kunkle Group, Inc.) | Broker | $13,364 | $117.23 |
| The Benecon Group | Broker | $11,101 | $97.38 |
| Capital Bluecross | Admin | $2,124 | $18.63 |