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Employer
711 Corey Street, Scranton, PA 18505 · EIN 23-7424474 · Jul 1, 2024 to Jun 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.
Visible subtotal $119,588
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Symetra Life Insurace Company | Creative Benefits, Inc | 307 | $118,511 17.6% of $672,939 |
| Medical | Highmark, Inc | — | 307 | Comp not disclosed Premium $843,340 |
| Dental | Guardian Life Insurance Company Of America | One Digital Premier Services LLC | 442 | $750 2.9% of $25,625 |
| Vision | National Vision Administrators, LLC | — | 457 | Comp not disclosed |
| Life | Hartford Life And Accident | Creative Benefits, Inc | 475 | $327 0.2% of $139,476 |
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 $612,237
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark Inc | None | $399,043 | $734.89 |
| Cynthia Rutkowski | Employee | $67,514 | $124.34 |
| Lynn Andreoli | Employee | $60,669 | $111.73 |
| Peoples Security Bank | None | $42,318 | $77.93 |
| Creative Benefits, Inc | None | $28,943 | $53.30 |
| Alan Ross And Company Pc | None | $13,750 | $25.32 |
| Carolyn Mclaughlin-Smith | None | Comp not disclosed | — |
| Prime Therapeutics | None | Comp not disclosed | — |