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Employer
7 Springview Road, Carlisle, PA 17015 · EIN 25-1869453 · 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 $26,680
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 102 | Comp not disclosed Premium $286,065 |
| Dental | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 96 | $5,172 11.9% of $43,515 |
| Dental | The Lincoln National Life Insurance Company | Gis Benefits Inc | 96 | $2,407 5.5% of $43,515 |
| Dental | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 96 | $2,183 5.0% of $43,515 |
| Vision | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 95 | $840 7.0% of $12,025 |
| Vision | The Lincoln National Life Insurance Company | Gis Benefits Inc | 95 | $666 5.5% of $12,025 |
| Vision | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 95 | $603 5.0% of $12,025 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 126 | $1,394 20.7% of $6,732 |
| Life | The Lincoln National Life Insurance Company | Gis Benefits Inc | 126 | $455 6.8% of $6,732 |
| Life | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 126 | $338 5.0% of $6,732 |
| Other | The Lincoln National Life Insurance Company | Ap Benefits Advisors LLC | 124 | $1,509 19.1% of $7,916 |
| Other | The Lincoln National Life Insurance Company | Gis Beneftis Inc | 124 | $492 6.2% of $7,916 |
| Other | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 124 | $397 5.0% of $7,916 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 124 | $2,360 19.1% of $12,345 |
| Other | The Lincoln National Life Insurance Company | Gis Benefits Inc | 124 | $769 6.2% of $12,345 |
| Other | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 124 | $619 5.0% of $12,345 |
| Voluntary Child Life, Voluntary Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 58 | $883 19.1% of $4,625 |
| Voluntary Child Life, Voluntary Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Gis Benefits Inc | 58 | $291 6.3% of $4,625 |
| Voluntary Child Life, Voluntary Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 58 | $232 5.0% of $4,625 |
| Critical Illness | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 32 | $895 18.6% of $4,810 |
| Critical Illness | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 32 | $241 5.0% of $4,810 |
| Critical Illness | The Lincoln National Life Insurance Company | Gis Benefits Inc | 32 | $68 1.4% of $4,810 |
| Hospital Indemnity | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 45 | $1,506 18.6% of $8,083 |
| Hospital Indemnity | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 45 | $403 5.0% of $8,083 |
| Hospital Indemnity | The Lincoln National Life Insurance Company | Gis Benefits Inc | 45 | $111 1.4% of $8,083 |
| Accident | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 49 | $1,371 18.6% of $7,377 |
| Accident | The Lincoln National Life Insurance Company | Boon Chapman Benefit Administrators | 49 | $370 5.0% of $7,377 |
| Accident | The Lincoln National Life Insurance Company | Gis Benefits Inc | 49 | $105 1.4% of $7,377 |
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.
Visible subtotal $84,923
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $68,411 | $670.70 |
| Assured Partners (Central Pa) | Broker | $42,876 | $420.35 |
| Capital Bluecross | Admin | $-26,364 | $-258.47 |