Loading employer…
Employer
290 Chambers Road, Toughkenamon, PA 19374 · EIN 23-2242656 · Dec 1, 2021 to Nov 30, 2022
Plan year 2021
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $81,529
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Benefitmall.Com/Centerstone | 200 | $13,065 1.4% of $963,313 |
| Dental | The Guardian Life Insurance Company Of America | Creative Benefits, Inc | 149 | $4,548 6.8% of $66,842 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | O'Neil Voluntary Benefit Services | 160 | $28,004 30.2% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Roth Voluntary Benefit Services Inc | 160 | $11,370 12.3% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Ruth Graham Conaghan | 160 | $7,280 7.9% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Creative Benefits, Inc | 160 | $6,939 7.5% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Fulvio A. Acosta | 160 | $3,327 3.6% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Brad Lee Mundy | 160 | $3,290 3.6% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Nicholas Cusmano | 160 | $2,876 3.1% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Shane Thomas Williams | 160 | $280 0.3% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Eduardo Tucto | 160 | $268 0.3% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Edward J. Williams | 160 | $237 0.3% of $92,576 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Rochelle Diane Kelly-Perry Thomas | 160 | $45 0.0% of $92,576 |
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.