Employer
Steffy Concrete, Inc.
Po Box 337, Reamstown, PA 17567 · EIN 23-2985268 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 36
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 $870
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $1,440 |
| Stop-loss | Crum & Forster | — | 25 | Comp not disclosed Premium $125,073 |
| Dental + Vision | Capital Advantage Assurance Company | Douple Agency, Inc. | 36 | $870 9.5% of $9,197 |
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 $44,835
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $27,288 | $758.00 |
| Douple Insurance Agency, Inc. | Broker | $8,350 | $231.94 |
| Capital Bluecross | Admin | $9,197 | $255.47 |