Employer
Usw Local 1355-01 Health Fund Trust
100 West Ridge Avenue, Suite A, Sharpsville, PA 16150 · EIN 81-6651546 · Jan 1, 2021 to Dec 31, 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 $339
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Companion Life | Emerson Reid, LLC | 25 | $282 9.8% of $2,885 |
| Medical | Companion Life | Turnkey Benefit Insurance Services | 25 | $57 2.0% of $2,885 |
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.
Visible subtotal $166,960
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Emerson Reid, LLC | None | $74,475 | $559.96 |
| Self Insurance Service Co. Inc. | None | $72,336 | $543.88 |
| Grossman Yanak & Ford LLP | None | $20,149 | $151.50 |