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Employer
100 Mifflin Drive, Wrightsville, PA 17368 · EIN 23-2576501 · Sep 1, 2024 to Aug 31, 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 $8,457
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 92 | Comp not disclosed Premium $450,433 |
| Medical | Equitable Financial Life Insurance Company Of America | — | 116 | Schedule A not provided |
| Medical | Equitable Financial Life Insurance Company Of America | — | 116 | Schedule A not provided |
| Medical | Bevcap Management LLC | — | 96 | Comp not disclosed Premium $86,582 |
| Dental | Humana Insurance Company | Mcconkey Benefits & Financial Servi | 94 | $533 8.0% of $6,668 |
| Vision | Highmark, Inc. | Mcconkey Benefits & Financial Servi | 140 | $396 6.0% of $6,549 |
| EAP | Wellspan | — | — | 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 $47,591
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| E. K. Mcconkey & Co., Inc. | Broker | $31,284 | $223.46 |
| The Benecon Group | Broker | $27,493 | $196.38 |
| Innovu | Broker | $4,140 | $29.57 |
| Brown & Brown Of Pennsylvania, Lp. | Broker | $858 | $6.13 |
| Capital Advantage Assurance Company | Admin | $-16,184 | $-115.60 |