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Employer
5501 Old York Road, Philadelphia, PA 19141 · EIN 23-1396794 · Aug 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $501,471
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | Marsh & Mclennan Agency, LLC East | 5783 | $13,201 5.0% of $264,015 |
| Medical | Metropolitan Life Insurance Company | Marsh & Mclennan Agency, LLC East | 1 | $14,893 6894.9% of $216 |
| Medical | Metropolitan Life Insurance Company | Marsh & Mclennan Agency, LLC East | 7 | $23,860 5995.0% of $398 |
| Dental | Aetna Life Insurance Co. | — | 1193 | Comp not disclosed Premium $221,222 |
| Vision | Vision Benefits Of America | — | 5227 | Comp not disclosed Premium $335,215 |
| Life | Reliance Standard Life Insurance Company | Marsh & Mclennan Agency, LLC East | 6317 | $3,194 3.9% of $81,879 |
| Life | Minnesota Life Insurance Company | Nfp Executive Benefits LLC | 444 | $16,929 4.3% of $391,809 |
| Life | Reliance Standard Life Insurance Company | Marsh & Mclennan Agency, LLC East | 1066 | $23,162 3.9% of $593,888 |
| Life | Minnesota Life Insurance Company | Nfp Executive Benefits LLC | 452 | $3,083 1.4% of $222,684 |
| AD&D | Assurity Life Insurance Company | Ece Specialists LLC | 3895 | $164,321 7.8% of $2,097,516 |
| AD&D | Assurity Life Insurance Company | Lisa Raabe | 3895 | $148,949 7.1% of $2,097,516 |
| AD&D | Assurity Life Insurance Company | Alera Group Agency, LLC | 3895 | $16,609 0.8% of $2,097,516 |
| Pre-Paid Legal | Arag Insurance Company | Marsh & Mclennan Agency, LLC East | 926 | $4,936 10.0% of $49,356 |
| Employee Assistance Program | Carebridge Corporation | — | 7418 | Comp not disclosed Premium $24,528 |
| Other | Hartford Life & Accident | Saul R Locker | 753 | $37,784 12.2% of $308,581 |
| Other | Hartford Life & Accident | The Arjay Group Inc. | 753 | $30,550 9.9% of $308,581 |
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.