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Employer
260 Country Club Road, Easton, PA 18045 · EIN 25-1209150 · Aug 1, 2021 to Jul 31, 2022
Plan year 2021
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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 $9,527
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 73 | Comp not disclosed Premium $213,770 |
| Life | The Guardian Life Insurance Company Of America | Hampson Mowrer Kreitz | 18 | $2,552 16.5% of $15,468 |
| Life | The Guardian Life Insurance Company Of America | Independence Planning Group | 18 | $8 0.1% of $15,468 |
| Life | The Guardian Life Insurance Company Of America | Mazzmar LLC | 18 | $2 0.0% of $15,468 |
| Life | Colonial Life & Accident Insurance Company | Hampson Mowrer Kreitz Insurance | 30 | $2,408 4.5% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Mark J Weishaar | 30 | $1,554 2.9% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Lisa Oliano | 30 | $603 1.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Ronald Oliano | 30 | $504 0.9% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Andrew M Sibert | 30 | $333 0.6% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Tanya Wishard | 30 | $312 0.6% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Christopher Fisher | 30 | $293 0.6% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Jeff M Newman | 30 | $198 0.4% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Edward Francis Klinges | 30 | $174 0.3% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Gary D Davis | 30 | $115 0.2% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Merridith Stanton | 30 | $88 0.2% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Michael J Perri | 30 | $78 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Edward P Dougherty | 30 | $69 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Donald C Savoy Inc Ta Savoy Associa | 30 | $65 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Harry Lore | 30 | $54 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Blue Dky Benefit Solutions Inc. | 30 | $46 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Lisa A Perri | 30 | $45 0.1% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Integrity Insurance Inc | 30 | $19 0.0% of $53,140 |
| Life | Colonial Life & Accident Insurance Company | Soteria Partners LLC | 30 | $7 0.0% of $53,140 |
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 $41,299
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $15,977 | $190.20 |
| Highmark | Admin | $22,531 | $268.23 |
| Connectcare 3 | Patient Advocate | $2,791 | $33.23 |