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Employer
3675 Amber Street, Philadelphia, PA 19134 · EIN 33-4675393 · 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 $29,194
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company | — | 80 | Comp not disclosed Premium $509,466 |
| Medical | Principal Life Insurance Company | Onedigital Premier Services | 141 | $5,979 10.1% of $59,074 |
| Medical | Principal Life Insurance Company | Hatcher Insurance Inc | 141 | $2,893 4.9% of $59,074 |
| Life | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 169 | $2,870 4.8% of $59,582 |
| Life | Unum Life Insurance Company Of America | Onedigital Premier Services LLC | 169 | $2,191 3.7% of $59,582 |
| Life | Unum Life Insurance Company Of America | Hatcher Insruance, LLC | 169 | $2,121 3.6% of $59,582 |
| AD&D | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 48 | $1,985 11.0% of $18,051 |
| AD&D | Unum Life Insurance Company Of America | Hatcher Insurance LLC | 48 | $1,237 6.9% of $18,051 |
| AD&D | Unum Life Insurance Company Of America | Centro Benefits Research LLC | 48 | $669 3.7% of $18,051 |
| Other | Unum Life Insurance Company Of America | Premier Worksite Solutions LLC | 22 | $1,480 8.3% of $17,831 |
| Other | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 22 | $987 5.5% of $17,831 |
| Other | Unum Life Insurance Company Of America | Onedigital Premier Services | 22 | $664 3.7% of $17,831 |
| Other | Unum Life Insurance Company Of America | Hatcher Insurance LLC | 22 | $609 3.4% of $17,831 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Premier Worksite Solutions LLC | 92 | $1,574 6.5% of $24,050 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Onedigital (Philadelphia) | 92 | $670 2.8% of $24,050 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Leon L. Levy & Associates | 92 | $290 1.2% of $24,050 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Skiles, Timothy Nash | 92 | $111 0.5% of $24,050 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Digital Insurance, Inc. | 92 | $53 0.2% of $24,050 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Marsh & Mclennan Agency, LLC East | 92 | $37 0.2% of $24,050 |
| Gciee, Grpaccvoen | Unum Life Insurance Company Of America | Premier Worksite Solutions LLC | 64 | $1,840 10.8% of $17,074 |
| Gciee, Grpaccvoen | Unum Life Insurance Company Of America | Kistler Tiffany Benefits Co | 64 | $721 4.2% of $17,074 |
| Gciee, Grpaccvoen | Unum Life Insurance Company Of America | Skiles, Timothy Nash | 64 | $103 0.6% of $17,074 |
| Gciee, Grpaccvoen | Unum Life Insurance Company Of America | Hatcher Insurance LLC | 64 | $66 0.4% of $17,074 |
| Gciee, Grpaccvoen | Unum Life Insurance Company Of America | Digital Insurance, Inc. | 64 | $44 0.3% of $17,074 |
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 $85,155
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $45,402 | $488.19 |
| The Benecon Group, LLC | Broker | $25,978 | $279.33 |
| Independence Administrators (Ia) | Admin | $13,775 | $148.12 |