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Employer
3145 Hamilton Blvd Bypass, Allentown, PA 18103 · EIN 23-2824084 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $5,345
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 21 | Comp not disclosed Premium $94,709 |
| Dental + Vision | Capital Advantage Assurance Company | Bsi Corporate Benefits, Inc. | 40 | $1,853 9.3% of $19,846 |
| Life | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, Inc. | 32 | $994 15.0% of $6,629 |
| AD&D | Sun Life Assurance Company Of Canada | Bsi Corporate Benefits, Inc. | 3 | $107 15.5% of $689 |
| Other | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, Inc. | 32 | $1,518 15.0% of $10,122 |
| Other | The Lincoln National Life Insurance Company | Bsi Corporate Benefits, Inc. | 32 | $873 15.0% of $5,821 |
| EAP | Healthiest You | — | — | Schedule A not provided |
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 $56,725
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $23,687 | $592.18 |
| Bsi Corporate Benefits, LLC | Broker | $22,916 | $572.90 |
| Capital Bluecross | Admin | $8,515 | $212.88 |
| Innovu | Other | $1,607 | $40.18 |