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Employer
414 S. 16th Street, Suite 100, Philadelphia, PA 19146 · EIN 46-1485037 · 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 $32,161
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | The Safegard Group | 205 | $14,593 10.7% of $135,961 |
| Medical | Principal Life Insurance Company | James R Nelligan & Associates | 205 | $7,922 5.8% of $135,961 |
| Supplemental | Colonial Life & Accident Insurance Company | Roth Voluntary Benefit Services Inc | 31 | $5,082 17.2% of $29,466 |
| Supplemental | Colonial Life & Accident Insurance Company | Patriot Growth Insurance Services L | 31 | $4,266 14.5% of $29,466 |
| Supplemental | Colonial Life & Accident Insurance Company | O'Neill Voluntary Benefit Services | 31 | $216 0.7% of $29,466 |
| Supplemental | Colonial Life & Accident Insurance Company | Emerson Rogers LLC | 31 | $60 0.2% of $29,466 |
| Supplemental | Colonial Life & Accident Insurance Company | Arthur Joseph Liggio | 31 | $11 0.0% of $29,466 |
| Supplemental | Colonial Life & Accident Insurance Company | Mco Partners LLC | 31 | $11 0.0% of $29,466 |
| Telemedicine | Teladoc | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | — | Comp not disclosed Premium $237 |
| Stop-loss | Sun Life Assurance Company | — | 107 | Comp not disclosed Premium $472,934 |
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 $120,667
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Patriot (The Safegard Group, Inc.) | Broker | $60,650 | $566.82 |
| The Benecon Group | Broker | $30,993 | $289.65 |
| Revivehealth, Inc. | Other | $15,782 | $147.50 |
| Independence Administrators (Ia) | Admin | $13,242 | $123.76 |