Employer
White Oak Mills, Inc.
419 W. High Street, Elizabethtown, PA 17022 · EIN 23-1596291 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
Covered lives: 59
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 $2,977
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Avalon Insurance Company | — | 38 | Comp not disclosed Premium $256,036 |
| Dental | Guardian | Ap Benefit Advisors, LLC | 42 | $1,068 9.8% of $10,903 |
| Dental | Guardian | Murray Ins Assoc Inc | 42 | $1,043 9.6% of $10,903 |
| Dental | Guardian | Mark Stephen Mettille | 42 | $545 5.0% of $10,903 |
| Dental | Guardian | Mazzmar LLC | 42 | $2 0.0% of $10,903 |
| Vision | Highmark Inc. | Kachelries, Robert G | 59 | $213 4.0% of $5,330 |
| Vision | Highmark Inc. | The Benecon Group | 59 | $106 2.0% of $5,330 |
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 $84,784
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $47,842 | $810.88 |
| Lehigh Valley Benefits Group | Broker | $16,416 | $278.24 |
| Homestead Smart Health Plans | Admin | $10,401 | $176.29 |
| Highmark Blue Shield (Central) | Admin | $10,125 | $171.61 |