Employer
Trans-Med Ambulance Inc.
14 Marion St, Luzerne, PA 18709 · EIN 56-2499349 · Oct 1, 2024 to Sep 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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 49 | Comp not disclosed Premium $140,596 |
| Dental | The Guardian Life Insurance Company | — | — | Schedule A not provided |
| Vision | Vision Benefits Of America | — | — | Schedule A not provided |
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 $19,009
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $24,654 | $503.14 |
| Highmark Bcbs Nepa | Admin | $-5,645 | $-115.20 |