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Employer
400 Campus Drive, Collegeville, PA 19426 · EIN 22-3485049 · Oct 1, 2024 to Sep 30, 2025
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 $103,901
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Flexible Benefits Plan | 127 | $48,883 6.7% of $724,621 |
| Medical | Independence Blue Cross | Emerson Rogers LLC | 127 | $29,299 4.0% of $724,621 |
| Dental + Vision | Metropolitan Life Insurance Company | Boon Chapman Benefit Adminiatrators | 64 | $1,749 4.8% of $36,778 |
| Dental + Vision | Metropolitan Life Insurance Company | Gis Benefits Inc. | 64 | $704 1.9% of $36,778 |
| Dental + Vision | Metropolitan Life Insurance Company | Pentra LLC | 64 | $249 0.7% of $36,778 |
| Life | The Guardian Life Insurance Company Of America | The Foley Insurance Agency, Inc. | 102 | $12,356 18.0% of $68,565 |
| Life | The Guardian Life Insurance Company Of America | Pentra Inc. | 102 | $6,948 10.1% of $68,565 |
| Life | The Guardian Life Insurance Company Of America | Amerihealth Administrators, Inc. | 102 | $1,371 2.0% of $68,565 |
| Life | The Guardian Life Insurance Company Of America | Mazzmar LLC | 102 | $249 0.4% of $68,565 |
| Life | The Guardian Life Insurance Company Of America | American Insurance Administrators | 102 | $392 0.6% of $68,565 |
| Other | Independence Blue Cross | Flexible Benefits Plans, LLC | 46 | $1,068 1.1% of $98,506 |
| Other | Independence Blue Cross | Emerson Rogers LLC | 46 | $633 0.6% of $98,506 |
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 $2,170
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Interflex Payments, LLC | Contract Administrator | $2,170 | $17.09 |