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Employer
1231 Mt Wilson Rd, Lebanon, PA 17042 · EIN 32-0362825 · 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 $16,285
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | American Heritage Life Insurance Company | Marsh & Mclennan Agency, LLC East | 131 | $4,004 13.2% of $30,247 |
| Medical | American Heritage Life Insurance Company | Hipps Crystal | 131 | $2,394 7.9% of $30,247 |
| Medical | American Heritage Life Insurance Company | Ingroup Associates, Inc. | 131 | $333 1.1% of $30,247 |
| Medical | American Heritage Life Insurance Company | Trocki George | 131 | $171 0.6% of $30,247 |
| Medical | American Heritage Life Insurance Company | Peterson Douglas C | 131 | $156 0.5% of $30,247 |
| Medical | American Heritage Life Insurance Company | Element Risk Management LLC | 131 | $149 0.5% of $30,247 |
| Medical | American Heritage Life Insurance Company | Talmas David A | 131 | $34 0.1% of $30,247 |
| Medical | American Heritage Life Insurance Company | Trocki Benefit Group Inc | 131 | $11 0.0% of $30,247 |
| Medical | American Heritage Life Insurance Company | Shanaman Amy Jo | 131 | $9 0.0% of $30,247 |
| Medical | American Heritage Life Insurance Company | Gelhard Donna | 131 | $8 0.0% of $30,247 |
| Life | Hartford Life And Accident | — | 192 | Schedule A not provided |
| Life | Hartford Life And Accident | — | 192 | Schedule A not provided |
| Life | Hartford Life And Accident | — | 192 | 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.
No Schedule C parties in this year.