Employer
St. Marys Carbon Company
259 Eberl Street, St Marys, PA 15857 · EIN 25-0929301 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $22,044
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | Emerson Rogers LLC | 62 | $20,705 12.0% of $172,544 |
| AD&D | Dearborn Life Insurance Company | St. Mary'S Insurance Agency, Inc. | 59 | $1,237 9.2% of $13,391 |
| AD&D | Dearborn Life Insurance Company | Aon Risk Service Central, Inc. | 59 | $102 0.8% of $13,391 |
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 $5,009
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark, Inc. | Insurance Carrier | $5,009 | $43.56 |
| St Marys Insurance Agency, Inc. | Insurance Broker | Comp not disclosed | — |