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Employer
77 Hot Metal Street, Pittsburgh, PA 15203 · EIN 13-2721761 · Jan 1, 2024 to Dec 31, 2024
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 $587,000
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Reliastar Life Insurance Company | Willis Towers Watson Northeast, Inc | 4641 | $46,620 2.0% of $2,335,951 |
| Stop-loss | Reliastar Life Insurance Company | Willis Towers Watson Northeast, Inc | 4641 | $23,457 1.0% of $2,335,951 |
| Stop-loss | Reliastar Life Insurance Company | Willis Towers Watson | 4641 | $140,157 6.0% of $2,335,951 |
| Stop-loss | Reliastar Life Insurance Company | Ringmaster Insurance Agency, LLC | 4641 | $1,000 0.0% of $2,335,951 |
| Medical | Cigna Health And Life Insurance Company And Affiliates | Willis Towers Watson Us LLC | 8177 | $14 1.1% of $1,225 |
| Medical | Hawaii Medical Service Association | — | 23 | Comp not disclosed Premium $203,795 |
| Medical | Kaiser Foundation Health Plan | Willis Towers Watson Northeast, Inc | 197 | $14,865 1.2% of $1,265,191 |
| Medical | Kaiser Foundation Health Plan, Inc. | Willis Towers Watson Northeast, Inc | 105 | $23,224 4.2% of $551,271 |
| Medical | Triple S Salud, Inc. | — | 32 | Schedule A not provided |
| Vision | Vision Service Plan | — | 4271 | Comp not disclosed Premium $840,277 |
| Vision | Vision Service Plan | — | 4173 | Comp not disclosed |
| Life | Continental American Insurance Company | Willis Towers Watson | 7561 | $133,841 5.3% of $2,514,445 |
| Life | Continental American Insurance Company | Willis Towers Watson | 7561 | $89,755 3.6% of $2,514,445 |
| Accident Voluntary Employee, Critical Illness Vol Employee & Vol Dependent | Reliastar Life Insurance Company | The Hdh Group, Inc. | 4560 | $54,924 10.0% of $549,245 |
| Accident Voluntary Employee, Critical Illness Vol Employee & Vol Dependent | Reliastar Life Insurance Company | Bene Re LLC | 4560 | $43,939 8.0% of $549,245 |
| Accident Voluntary Employee, Critical Illness Vol Employee & Vol Dependent | Reliastar Life Insurance Company | Benefitfocus Com Inc | 4560 | $15,204 2.8% of $549,245 |
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.