Employer
Tom Masano, Inc.
815 Lancaster Avenue, Shillington, PA 19607 · EIN 23-1746978 · 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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | American Fidelity Assurance Company | — | — | Schedule A not provided |
| Accident, Cancer | American Fidelity Assurance Company | — | — | Schedule A not provided |
| Accident | American Fidelity Assurance Company | — | — | Schedule A not provided |
| Accident, Cancer | American Fidelity Assurance Company | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | 165 | Comp not disclosed Premium $526,218 |
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 $-40,401
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Patriot (Power-Kunkle Group, Inc.) | Broker | $47,714 | $289.18 |
| The Benecon Group, LLC | Broker | $30,594 | $185.42 |
| ConnectCare3 | Patient Advocate | $11,291 | $68.43 |
| Capital Bluecross | Admin | $-130,000 | $-787.88 |