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Employer
15 Bradley Street, Warren, PA 16365 · EIN 25-1411751 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $121,761
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark, Inc. | — | 444 | Comp not disclosed Premium $1,834,535 |
| Vision | Vision Benefits Of America | — | 139 | Comp not disclosed Premium $14,175 |
| Vision | Vision Benefits Of America | — | 718 | Comp not disclosed Premium $81,305 |
| Life | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 1701 | $40,692 9.5% of $428,191 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 1701 | $21,410 5.0% of $428,191 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 424 | $13,940 5.0% of $278,804 |
| Life | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 424 | $31,728 11.4% of $278,804 |
| Other | United Of Omaha Life Insurance Company | Seubert & Associates Inc. | 729 | $9,658 13.0% of $74,349 |
| Other | United Of Omaha Life Insurance Company | Professional Group Plans, Inc. | 729 | $3,717 5.0% of $74,349 |
| Business Travel Accident | Life Insurance Company Of North America | Seubert & Associates Inc. | — | $405 9.9% of $4,107 |
| Business Travel Accident | Life Insurance Company Of North America | Hubbard Bert Karle Weber, Inc. | — | $211 5.1% of $4,107 |
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.
No Schedule C parties in this year.