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Employer
1900 Market Street, Suite 200, Philadelphia, PA 19103 · EIN 51-0368279 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
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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 $52,856
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Four Ever Life Ins Co. | — | — | Comp not disclosed Premium $1,407 |
| Vision | Vision Service Plan | — | 199 | Comp not disclosed Premium $55,599 |
| Life | Prudential Insurance Company Of America | Aon Consulting, Inc. | 209 | $2,759 1.9% of $141,675 |
| Life | Prudential Insurance Company Of America | Img | 209 | $45 0.0% of $141,675 |
| Other | Provident Life And Accident Insurance Company | Aon Consulting, Inc. | 14 | $1,576 60.0% of $2,627 |
| Other | Provident Life And Casualty Insurance Company | Aon Consulting, Inc. | 30 | $3,483 17.1% of $20,392 |
| Other | Provident Life And Casualty Insurance Company | Tompkins Insurance | 30 | $220 1.1% of $20,392 |
| Other | Provident Life And Casualty Insurance Company | Tompkins Insurance | 30 | $23 0.1% of $20,392 |
| Other | Provident Life And Accident Insurance Company | Aon Consulting, Inc. | 4 | $209 60.1% of $348 |
| Other | Provident Life And Accident Insurance Company | Aon Consulting, Inc. | 234 | $21,322 14.9% of $142,634 |
| Other | Provident Life And Accident Insurance Company | Tompkins Insurance | 234 | $1,214 0.9% of $142,634 |
| Other | Provident Life And Accident Insurance Company | Tompkins Insurance | 234 | $1,066 0.7% of $142,634 |
| Accidental Death And Dismemberment | Federal Insurance Company | — | 209 | Comp not disclosed Premium $50,493 |
| Accident, Critical Illness | Transamerica Life Insurance Company | Custom Benefit Programs Inc | 2 | $20,462 33.5% of $61,132 |
| Legal | Metlife Legal Plans | — | 40 | Comp not disclosed Premium $19,968 |
| Other | Provident Life And Accident Insurance Company | Aon Consulting, Inc. | 2 | $477 19.5% of $2,441 |
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.