Employer
Tyrone Hospital
187 Hospital Drive, Tyrone, PA 16686 · EIN 23-1440116 · Jan 1, 2021 to Apr 1, 2021
Plan year 2021
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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 $180
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Vision Benefits Of America | Emerson Reid & Company | — | $180 5.0% of $3,599 |
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.