Employer

Winber Hospital Inc Chan Soon- Shiong Medical Center At Windber

600 Somerset Ave, Windber, PA 15963 · EIN 25-1244202 · Jul 1, 2024 to Jun 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 $20,516

Coverage	Carrier	Broker	Lives	Direct comp
Vision	Heartland	—	444	Comp not disclosed Premium $38,248
Life	Colonial Life & Accidentinsurance Company	Petrina Skiles	108	$10,049 7.5% of $134,494
Life	Colonial Life & Accidentinsurance Company	Benechoice Enrollment Solutions	108	$5,817 4.3% of $134,494
Life	Colonial Life & Accidentinsurance Company	Patrick Michael Rogers	108	$1,594 1.2% of $134,494
Life	Colonial Life & Accidentinsurance Company	James Bartlett LLC	108	$1,092 0.8% of $134,494
Life	Colonial Life & Accidentinsurance Company	Mary Yarnell	108	$883 0.7% of $134,494
Life	Colonial Life & Accidentinsurance Company	Elizabeth Jane Griffiths	108	$342 0.3% of $134,494
Life	Colonial Life & Accidentinsurance Company	Timothy Slater	108	$216 0.2% of $134,494
Life	Colonial Life & Accidentinsurance Company	Ashly Elcock	108	$213 0.2% of $134,494
Life	Colonial Life & Accidentinsurance Company	Ardena L Mcvicker	108	$172 0.1% of $134,494
Life	Colonial Life & Accidentinsurance Company	Lance A Bradley	108	$67 0.0% of $134,494
Life	Colonial Life & Accidentinsurance Company	Cathy Good	108	$59 0.0% of $134,494
Life	Colonial Life & Accidentinsurance Company	Lawrence Eugene Prichard	108	$12 0.0% of $134,494
Life	Kansas City Life Insurance Company	—	408	Comp not disclosed Premium $68,300
Other	Life Insurance Company Of North America	—	9	Comp not disclosed Premium $3,780

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.

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