Employer
Valley Tire Company
1002 Arentzen Blvd, Charleroi, PA 15022 · EIN 25-1370485 · Oct 1, 2024 to Sep 30, 2025
Plan year 2024
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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 $16,810
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company Of Canada | — | 135 | Comp not disclosed Premium $325,562 |
| Life | United Of Omaha Life Insurance Company | Professional Group Plans Inc | 173 | $3,471 5.0% of $69,433 |
| Life | United Of Omaha Life Insurance Company | Lillis Mckibben Bongiovanni & Co (L | 173 | $13,339 19.2% of $69,433 |
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 $69,406
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Meritain Health | None | $30,927 | $178.77 |
| Frissora & Associates | None | $28,441 | $164.40 |
| Amca | None | $10,038 | $58.02 |