Employer
The Clinic For Special Children, Inc.
Po Box 500, Intercourse, PA 17534 · EIN 23-2555373 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
Covered lives: 74
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 $2,640
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 29 | Comp not disclosed Premium $30,674 |
| Dental | Delta Dental Of Pennsylvania | Engle-Hambright & Davies, Inc. | 74 | $348 10.0% of $3,479 |
| Vision | Highmark Inc. | Engle-Hambright & Davies, Inc. | 66 | $35 6.1% of $577 |
| Stop-loss | HM Life Insurance Company | — | 29 | Comp not disclosed Premium $214,967 |
| Dental | Delta Dental Of Pennsylvania | Engle-Hambright & Davies, Inc. | 69 | $2,035 10.0% of $20,346 |
| Vision | Highmark Inc. | Burkhardt, Andrew William | 36 | $222 6.0% of $3,708 |
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 $27,005
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Engle-Hambright & Davies, Inc. | Broker | $2,016 | $27.24 |
| The Benecon Group | Broker | $1,449 | $19.58 |
| Capital Bluecross | Admin | $348 | $4.70 |
| ConnectCare3 | Patient Advocate | $317 | $4.28 |
| Engle-Hambright & Davies, Inc. | Broker | $12,024 | $174.26 |
| The Benecon Group | Broker | $10,851 | $157.26 |