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Employer
4201 Chambers Hill Road, Harrisburg, PA 17111 · EIN 23-1660234 · Jun 1, 2024 to May 31, 2025
Plan year 2024
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Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $11,825
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Unum Life Insurance Company Of America | Gunn Mowery, LLC | 144 | $2,747 10.4% of $26,437 |
| Life | Unum Life Insurance Company Of America | Skiles, Timothy | 144 | $1,322 5.0% of $26,437 |
| Life | Unum Life Insurance Company Of America | Gunn Mowery, LLC | 59 | $3,259 15.0% of $21,727 |
| Other | Unum Life Insurance Company Of America | Gunn Mowery, LLC | 43 | $2,666 15.0% of $17,776 |
| Grp Accident | Unum Insurance Company | Gunn Mowery, LLC | 21 | $283 7.2% of $3,905 |
| Grp Accident | Unum Insurance Company | Benechoice Enrollment Solution | 21 | $189 4.8% of $3,905 |
| Grp Accident | Unum Insurance Company | Skiles, Timothy N | 21 | $145 3.7% of $3,905 |
| Hospital Ee Paid | Unum Insurance Company | Gunn Mowery, LLC | 15 | $271 9.0% of $3,017 |
| Hospital Ee Paid | Unum Insurance Company | Benechoice Enrollment Solution | 15 | $181 6.0% of $3,017 |
| Hospital Ee Paid | Unum Insurance Company | Skiles, Timothy N | 15 | $162 5.4% of $3,017 |
| Attained Age Critical Illness | Unum Insurance Company | Gunn Mowery, LLC | 17 | $360 9.0% of $3,998 |
| Attained Age Critical Illness | Unum Insurance Company | Benechoice Enrollment Solution | 17 | $240 6.0% of $3,998 |
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $48 |
| Stop-loss | Avalon Insurance Company | — | 84 | Comp not disclosed Premium $290,597 |
Schedule C
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 $48,317
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Gunn-Mowery, LLC | Broker | $29,204 | $298.00 |
| The Benecon Group, LLC | Broker | $14,686 | $149.86 |
| ConnectCare3 | Patient Advocate | $4,433 | $45.23 |
| Capital Bluecross | Admin | $-6 | $-0.06 |