Employer
Tri State Capital Bank
301 Grant Street, Pittsburgh, PA 15219 · EIN 20-5888359 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $148,185
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | Henderson Brothers Inc. | 768 | $123,555 2.5% of $5,006,064 |
| Dental | Metropolitan Life Insurance Company | Henderson Brothers Inc. | 786 | $8,381 3.9% of $215,945 |
| Vision | Vision Benefits Of America | Henderson Brothers Inc. | 384 | $780 1.6% of $49,036 |
| Life | Prudential Insurance Company Of America | Henderson Brothers Inc. | 391 | $15,403 3.2% of $486,718 |
| Life | Prudential Insurance Company Of America | Img | 391 | $66 0.0% of $486,718 |
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.
No Schedule C parties in this year.