Employer
Susquehanna Valley Emergency Medica Services
126 Keller Ave, Lancaster, PA 17601 · EIN 23-6447141 · Jul 1, 2021 to Jun 30, 2022
Plan year 2021
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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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $23,799 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Ap Benefits Advisors | — | Comp not disclosed |
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 $5,404
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $3,344 | $128.62 |
| Ap Benefit Advisors | Broker | $1,443 | $55.50 |
| Highmark | Admin | $487 | $18.73 |
| Connectcare 3 | Patient Advocate | $130 | $5.00 |