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Employer
89 South Commerce Way, Bethlehem, PA 18017 · EIN 46-0535658 · Oct 1, 2024 to Sep 30, 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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health Unimerica Insurance Company | — | 104 | Comp not disclosed Premium $136,006 |
| Stop-loss | Crum & Forster | — | 114 | Comp not disclosed Premium $428,898 |
| Dental + Vision | Capital Advantage Assurance Company | — | — | Schedule A not provided |
| Life | Unum Life Insurance Company Of America | — | — | Schedule A not provided |
| AD&D | Unum Life Insurance Company Of America | — | — | Schedule A not provided |
| Attained Age Critical Illness | Unum Insurance Company | — | — | Schedule A not provided |
| Grp Accident | Unum Insurance Company | — | — | Schedule A not provided |
| Hospital Ee Paid | Unum Insurance Company | — | — | Schedule A not provided |
| Legal | Metlife Legal Plans | — | — | Schedule A not provided |
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 $283,942
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $81,911 | $665.94 |
| Tompkins Insurance | Broker | $74,420 | $605.04 |
| Capital Bluecross | Admin | $127,611 | $1,037.49 |