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Employer
180 South Main Street, Manchester, PA 17345 · EIN 03-0416307 · Dec 1, 2024 to Nov 30, 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 $21,222
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | Mather & Strohl Administrative | 119 | $5,633 14.6% of $38,540 |
| Dental | United Concordia Insurance Company | Mcconkey Benefits & Financial Servi | 119 | $716 1.9% of $38,540 |
| Vision | Vision Benefits Of America | Mcconkey Benefits & Financial Servi | 74 | $767 10.0% of $7,668 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 102 | $913 16.8% of $5,446 |
| Life | United Of Omaha Life Insurance Company | Benefitmall | 102 | $164 3.0% of $5,446 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 102 | $134 2.5% of $5,446 |
| Life | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 40 | $3,114 21.0% of $14,832 |
| Life | United Of Omaha Life Insurance Company | Benefitmall | 40 | $445 3.0% of $14,832 |
| Life | United Of Omaha Life Insurance Company | Gi George Parent Lp | 40 | $324 2.2% of $14,832 |
| Other | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 102 | $3,281 16.7% of $19,595 |
| Other | United Of Omaha Life Insurance Company | Benefitmall | 102 | $588 3.0% of $19,595 |
| Other | United Of Omaha Life Insurance Company | Gi George Parent Lp | 102 | $481 2.5% of $19,595 |
| Voluntary | United Of Omaha Life Insurance Company | Mcconkey Benefits & Financial Servi | 29 | $3,735 21.3% of $17,548 |
| Voluntary | United Of Omaha Life Insurance Company | Benefitmall | 29 | $526 3.0% of $17,548 |
| Voluntary | United Of Omaha Life Insurance Company | Gi George Parent Lp | 29 | $401 2.3% of $17,548 |
| Stop-loss | Avalon Insurance Company | — | 82 | Comp not disclosed Premium $175,690 |
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 $12,576
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Mcconkey Benefits & Financial Serv | Broker | $28,304 | $345.17 |
| The Benecon Group, LLC | Broker | $976 | $11.90 |
| Benefitmall | Admin | $6,016 | $73.37 |
| Capital Bluecross | Admin | $-22,720 | $-277.07 |