Employer
Summit Physician Services
785 Fifth Avenue, Suite 3, Chambersburg, PA 17201 · EIN 25-1716306 · Jan 1, 2020 to Dec 31, 2020
Plan year 2020
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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 $220,920
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pennsylvania | — | 722 | Schedule A not provided |
| Vision | Capital Advantage Assurance Company | Marty Miracle | 818 | $1,464 1.9% of $75,994 |
| Life | Life Insurance Company Of North America | — | 853 | Schedule A not provided |
| Other | Metropolitan Life Insurance Company | Usi Southwest Inc | 411 | $14,706 10.7% of $137,727 |
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.
No Schedule C parties in this year.