Employer
Spooky Nook Sports, Inc.
2913 Spooky Nook Road, Manheim, PA 17545 · EIN 45-4847699 · Jul 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 188
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 $6,245
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | — | Comp not disclosed Premium $116,978 |
| Dental | Standard Insurance Company | Murray Insurance Associates | 112 | $1,349 3.7% of $36,875 |
| Vision | Standard Insurance Company | Murray Insurance Associates | 94 | $168 2.7% of $6,177 |
| Life | Standard Insurance Company | Murray Insurance Associates | 36 | $847 11.7% of $7,270 |
| Other | Standard Insurance Company | Murray Insurance Associates | 151 | $1,678 9.1% of $18,538 |
| Other | Standard Insurance Company | Murray Insurance Associates | 63 | $1,270 13.6% of $9,366 |
| Other | Standard Insurance Company | Murray Ins Assoc Inc | 41 | $655 11.8% of $5,555 |
| Other | Standard Insurance Company | Gis Benefits Inc | 41 | $278 5.0% of $5,555 |
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 $32,774
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $2,924 | — |
| Highmark Blue Shield (Central) | Admin | $-1,250 | — |
| Take Commmand | Admin | $31,100 | $165.43 |