Employer
T. C. Motor Car Company
4500 Broadway, Allentown, PA 18014 · EIN 23-2616195 · Dec 1, 2023 to Nov 30, 2024
Plan year 2023
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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 | Optum Health (Unimerica Insurance Company) | — | 30 | Comp not disclosed Premium $194,815 |
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 $33,629
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Bsi Corporate Benefits | Broker | $21,388 | $712.93 |
| The Benecon Group | Broker | $12,602 | $420.07 |
| Hy Holdings Inc | Admin | $4,504 | $150.13 |
| Connectcare 3 | Patient Advocate | $1,927 | $64.23 |
| Innovu | Other | $1,517 | $50.57 |
| Capital Blue Cross | Admin | $-8,309 | $-276.97 |