Employer
Ultra-Poly Corporation
102 Demi Road, Portland, PA 18351 · EIN 22-2036151 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $35,789
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | United Concordia Insurance Company | — | 248 | Schedule A not provided |
| Vision | Eyemed Vision Care On Behalf Of The Fidelity Security Life Ins Company | — | 229 | Comp not disclosed Premium $17,520 |
| Life | Prudential Insurance Company Of America | American Insurance Administrators | 191 | $19,355 11.6% of $167,393 |
| Life | Prudential Insurance Company Of America | American Insurance Administrators | 191 | $8,307 5.0% of $167,393 |
| Life | Prudential Insurance Company Of America | Img | 191 | $44 0.0% of $167,393 |
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.