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Employer
10 North High Street, West Chester, PA 19380 · EIN 23-2719985 · 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 $72,639
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Mercer (Us), Inc. | 215 | $53,566 2.9% of $1,841,241 |
| Dental | Metropolitan Life Insurance Company | Mercer (Us), Inc. | 272 | $3,993 3.2% of $126,710 |
| Dental | Metropolitan Life Insurance Company | Mercer (Us), Inc. | 272 | $2,206 1.7% of $126,710 |
| Dental | Metropolitan Life Insurance Company | Mercer (Us), Inc. | 272 | $17 0.0% of $126,710 |
| Vision | Vision Service Plan | Mercer (Us), Inc. | 110 | $962 6.5% of $14,715 |
| Life | Life Insurance Company Of North America | — | 117 | Schedule A not provided |
| Business Travel Accident | Hartford Fire Insurance Company | Conner Strong & Buckelew Companies | 119 | $215 15.5% of $1,386 |
| Other | Life Insurance Company Of North America | — | 117 | Schedule A not provided |
| Other | Life Insurance Company Of North America | — | 117 | Schedule A not provided |
| Accidental Death And Dismemberment | Life Insurance Company Of North America | — | 117 | Schedule A not provided |
| Other | Independence Blue Cross | Mercer (Us), Inc. | 215 | $10,703 2.9% of $367,633 |
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.