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Employer
1805 Berks Road, Worcester, PA 19490 · EIN 23-2966902 · 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 $47,821
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Unum Life Insurance Company Of America | — | 2590 | Comp not disclosed Premium $1,822,250 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 228 | $4,596 10.3% of $44,567 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 228 | $186 0.4% of $44,567 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 228 | $4 0.0% of $44,567 |
| Accident | Unum Insurance Company | Assured Partners (Central Pa) | 280 | $12,723 19.9% of $63,970 |
| Critical Illness | Unum Insurance Company | Assured Partners (Central Pa) | 275 | $19,435 19.8% of $98,190 |
| Hospital Indemnity | Unum Insurance Company | Assured Partners (Central Pa) | 256 | $10,866 19.9% of $54,519 |
| Vol. Group Accident | Unum Life Insurance Company Of America | Assured Partners (Central Pa) | 1 | $11 5.2% of $213 |
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 $2,681,316
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Blue Cross | Medical/Rx Admin Fees | $1,481,746 | $572.10 |
| Wellworks | Contract Admin | $363,408 | $140.31 |
| Express Scripts, Inc. | Rx Benefits | $254,160 | $98.13 |
| Talkspace Networks LLC | Telehealth Admin | $137,570 | $53.12 |
| Unum | Std Aso | $118,058 | $45.58 |
| Delta Dental Of Pennsylvania | Dental Admin | $106,405 | $41.08 |
| Revivehealth | Telemedicine Services | $89,097 | $34.40 |
| Carebridge Corporation | Eap Admin | $46,638 | $18.01 |
| Wex Inc. | Cobra/Fsa Fees | $35,660 | $13.77 |
| Health Advocate Solutions, Inc. | None | $35,062 | $13.54 |
| Vision Benefits Of America | Vision Admin Fees | $13,512 | $5.22 |