Employer
To-Jo Mushrooms, Inc.
974 Penn Green Road, Avondale, PA 19311 · EIN 23-2542450 · Dec 1, 2024 to Nov 30, 2025
Plan year 2024
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $7,565
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 203 | $2,617 5.1% of $50,872 |
| Dental | Metropolitan Life Insurance Company | Emerson Rogers LLC | 203 | $3,040 6.0% of $50,872 |
| Vision | Unitedhealthcare Insurance Company | — | 138 | Comp not disclosed Premium $7,067 |
| Life | American Heritage Life Insurance Company | Multiple Brokers (See Appendix) | 15 | $1,908 6.8% of $27,868 |
Schedule C
Additional compensation
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 $73,312
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Administrators | Medical Admin | $73,312 | $344.19 |