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Employer
P.O. Box 888, Reading, PA 19607 · EIN 23-3013181 · Jan 1, 2024 to Dec 31, 2024
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 $37,622
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $1,913 |
| Stop-loss | HM Life Insurance Company | — | 173 | Comp not disclosed Premium $772,654 |
| Dental | The Guardian Life Insurance Company Of America | James R Nelligan & Associates | 194 | $22,086 9.8% of $225,784 |
| Dental | The Guardian Life Insurance Company Of America | Patriot (Power-Kunkle Group, Inc.) | 194 | $13,970 6.2% of $225,784 |
| Vision | Vision Service Plan | Patriot Growth Insurance Services L | 170 | $942 4.2% of $22,361 |
| Vision | Vision Service Plan | Patriot (Power-Kunkle Group, Inc.) | 170 | $624 2.8% of $22,361 |
| Telemedicine | American Well | — | — | 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 $81,895
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Patriot (Power-Kunkle Group, Inc.) | Broker | $63,180 | $325.67 |
| The Benecon Group, LLC | Broker | $29,744 | $153.32 |
| ConnectCare3 | Patient Advocate | $10,333 | $53.26 |
| Highmark Blue Shield (Central) | Admin | $-21,362 | $-110.11 |