Employer
Triple Crown Corporation
5351 Jaycee Avenue, Harrisburg, PA 17112 · EIN 23-2047738 · Apr 1, 2024 to Mar 31, 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 $24,459
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | The Guardian Life Insurance Company Of America | — | 150 | Schedule A not provided |
| Dental | The Guardian Life Insurance Company Of America | — | 150 | Schedule A not provided |
| Vision | Capital Advantage Assurance Company | Aia American Insurance Admins | 192 | $357 4.0% of $8,917 |
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.