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Employer
6287 Lincoln Highway, Wrightsville, PA 17368 · EIN 23-2526025 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $17,113
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | The Guardian Life Insurance Company Of America | Usi Insurance Services (Ri) | 107 | $4,219 8.1% of $51,959 |
| Vision | National Vision Administrators, LLC | Usi Insurance Services (Ri) | 180 | $491 4.8% of $10,230 |
| Vision | National Vision Administrators, LLC | Watchtower Technologies Inc. DBA Th | 180 | $42 0.4% of $10,230 |
| Life | The Lincoln National Life Insurance Company | Usi Insurance Services (Ri) | 154 | $834 12.7% of $6,579 |
| Other | The Lincoln National Life Insurance Company | Usi Insurance Services (Ri) | 153 | $1,881 10.0% of $18,781 |
| Supplemental | Colonial Life & Accident Insurance Company | Alpha Benefits Group, Inc | 62 | $5,569 8.5% of $65,485 |
| Supplemental | Colonial Life & Accident Insurance Company | Petrina Skiles | 62 | $3,296 5.0% of $65,485 |
| Supplemental | Colonial Life & Accident Insurance Company | Benechoice Enrollment Solutions | 62 | $445 0.7% of $65,485 |
| Supplemental | Colonial Life & Accident Insurance Company | Usi Insurance Services (Ri) | 62 | $203 0.3% of $65,485 |
| Supplemental | Colonial Life & Accident Insurance Company | John E Lanzetta | 62 | $133 0.2% of $65,485 |
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 $32,227
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Capital Advantage Assurance Company | Admin | $32,227 | $179.04 |