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Employer
15250 Nbn Way, Bldg C, Blue Ridge Summit, PA 17214 · EIN 52-1164576 · Aug 1, 2024 to Jul 31, 2025
Plan year 2024
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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 $61,361
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Cigna Health And Life Insurance Company | Cbiz Benefits & Ins. Services | 122 | $43,618 2.0% of $2,181,005 |
| Dental + Vision | Cigna Health And Life Insurance Company | Cbiz Benefits & Ins. Services | 119 | $5,314 4.7% of $112,080 |
| Life | Metropolitan Life Insurance Company | Cbiz Benefits & Ins. Services | 339 | $6,301 10.6% of $59,519 |
| Life | Massachusetts Mutual Life Insurance Company | Dajoma | 10 | $1,287 11.8% of $10,932 |
| Life | Massachusetts Mutual Life Insurance Company | George S Kinigopoulos | 10 | $236 2.2% of $10,932 |
| Dbl Disability | First Unum Life Insurance Company | Cbiz Benefits & Ins. Services | 8 | $590 17.0% of $3,470 |
| Critical Illness, Accident, Hospital | Continental American Insurance Company | Cbiz Benefits & Ins. Services | 17 | $2,146 22.4% of $9,579 |
| Critical Illness, Accident, Hospital | Continental American Insurance Company | Matthew W Evans | 17 | $1,575 16.4% of $9,579 |
| Critical Illness, Accident, Hospital | Continental American Insurance Company | Drew Skibitsky | 17 | $294 3.1% of $9,579 |
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.
No Schedule C parties in this year.