Employer
Tom Bowman Trucking
281 Bowmans Mill Rd, Orangeville, PA 17859 · EIN 65-1164293 · Jan 1, 2024 to Dec 31, 2024
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 $13,612
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $33,239 |
| Medical | Highmark, Inc. | Mccann, James | 42 | $8,040 2.1% of $381,766 |
| Medical | Highmark, Inc. | Mcgriff Insurance Services Inc. | 42 | $4,020 1.1% of $381,766 |
| Dental | Delta Dental Of Pennsylvania | Seubert & Associates Inc | 37 | $1,305 10.0% of $13,046 |
| Vision | Vision Benefits Of America | Mcgriff Insurance Services Inc. | 33 | $247 7.2% of $3,425 |
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 $2,879
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $2,351 | $55.98 |
| Mcgriff Insurance Services Inc | Broker | $648 | $15.43 |
| Capital Bluecross | Admin | $-120 | $-2.86 |