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Employer
2400 Market Street 8th Floor, Philadelphia, PA 19103 · EIN 95-2051630 · 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 $1,869,454
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Guardian Life Insurance Company Of America | Salus Group | 32 | $183 15.0% of $1,219 |
| Life | Metropolitan Life Insurance Company | Marsh Usa, Inc. | 76993 | $199,950 3.0% of $6,698,950 |
| Life | Metropolitan Life Insurance Company | Special Risk Insurance Services Inc | 76993 | $28,272 0.4% of $6,698,950 |
| Life | Colonial Life & Accident Insurance Company | Ms Benefits LLC | 5 | $316 24.2% of $1,305 |
| Life | Colonial Life & Accident Insurance Company | Amy E Cohen | 5 | $15 1.1% of $1,305 |
| Life | Colonial Life & Accident Insurance Company | John Robert Dimartino | 5 | $14 1.1% of $1,305 |
| Life | Colonial Life & Accident Insurance Company | Robert W Sabol | 5 | $9 0.7% of $1,305 |
| Life | Colonial Life & Accident Insurance Company | David J Mcclellan | 5 | $6 0.5% of $1,305 |
| Life | Colonial Life & Accident Insurance Company | Adam Maggio | 5 | $1 0.1% of $1,305 |
| Life | The Paul Revere Life Insurance Company | Ms Benefits LLC | 2 | $376 14.5% of $2,590 |
| Life | The Paul Revere Life Insurance Company | David J Mcclellan | 2 | $12 0.5% of $2,590 |
| Bta Travel Accident | Metropolitan Life Insurance Company | — | 16510 | Comp not disclosed Premium $88,814 |
| Medical | Triple S Salud, Inc. | Cgf Insurance LLC | 19 | $7,903 4.8% of $163,036 |
| Medical | Aetna | Salus Group | 99 | $57,491 4.2% of $1,383,226 |
| Medical | Blue Care Network | Salus Group | 90 | $48,168 5.2% of $934,243 |
| Medical | Kaiser Permanente Mid Atlantic | Salus Group | 131 | $3,960 0.3% of $1,347,338 |
| Medical | Kaiser Permanente Of Colorado | — | 37 | Comp not disclosed Premium $309,371 |
| Medical | Independence Blue Cross | — | 507 | Comp not disclosed Premium $3,966,295 |
| Medical | Blue Cross Blue Shield Of Ri | — | 29 | Comp not disclosed Premium $588,150 |
| Medical | Cigna Health And Life Insurance Company | — | 2625 | Comp not disclosed Premium $19,260 |
| Medical | Kaiser Foundation Health Plan Of Colorado | Mercer (Us), Inc. | 193 | $28,003 2.0% of $1,400,137 |
| Medical | Kaiser Foundation Health Plan Of Georgia | Mercer (Us), Inc. | 243 | $32,012 2.0% of $1,601,221 |
| Medical | Kaiser Foundation Health Plan Of Hawaii | Mercer (Us), Inc. | 34 | $4,224 2.0% of $211,183 |
| Medical | Kaiser Foundation Health Plan Of The Mid-Atlantic | Mercer (Us), Inc. | 498 | $75,714 2.0% of $3,785,154 |
| Medical | Kaiser Foundation Health Plan Inc. | Mercer (Us), Inc. | 503 | $63,427 1.8% of $3,547,523 |
| Medical | Kaiser Foundation Health Plan Of The Northwest | Mercer (Us), Inc. | 271 | $34,578 2.0% of $1,730,363 |
| Medical | Kaiser Foundation Health Plan Inc. | Mercer (Us), Inc. | 771 | $85,701 1.8% of $4,867,426 |
| Medical | Kaiser Foundation Health Plan Of Washington | Mercer (Us), Inc. | 122 | $15,798 2.0% of $792,616 |
| Medical | Upmc Health Options | Mercer (Us), Inc. | 78 | $10,770 1.8% of $603,149 |
| Medical | Upmc Health Options | Mercer (Us), Inc. | 352 | $54,280 1.9% of $2,930,507 |
| Medical | Upmc Health Options | Mercer (Us), Inc. | 94 | $16,615 1.9% of $896,252 |
| Medical | Geisinger Quality Options, Inc. | Mercer (Us), Inc. | 124 | $23,396 2.0% of $1,169,820 |
| Medical | Independence Administrators | — | 9525 | Comp not disclosed Premium $92,451,127 |
| Medical | Upmc Health Options | Mercer (Us), Inc. | — | $41 2.0% of $2,072 |
| Medical | Upmc Health Options | Mercer (Us), Inc. | — | $33 2.0% of $1,647 |
| Medical | Blue Cross Blue Shield Of Michigan | Joseph J Haney | 1032 | $119,470 1.7% of $7,096,474 |
| Medical | Blue Cross Blue Shield Of Michigan | Assuredpartners Of Mi LLC | 1032 | $12,711 0.2% of $7,096,474 |
| Dental | Anthem Health Plans | — | 119 | Comp not disclosed Premium $75,090 |
| Dental | Delta Dental Of Pennsylvania | — | 39833 | Comp not disclosed Premium $14,348,488 |
| Dental + Vision | Guardian Life Insurance Company Of America | Salus Group | 17 | $765 7.0% of $10,926 |
| Vision | Vision Service Plan | — | 22579 | Comp not disclosed Premium $2,804,708 |
| Life | Aflac | Ms Benefits LLC | 188 | $4,182 3.4% of $122,213 |
| Life | Aflac | Ms Benefits LLC | 188 | $3,876 3.2% of $122,213 |
| Life | Aflac | Rosalinda Paparatto | 188 | $191 0.2% of $122,213 |
| Life | Aflac | Hensley A Akiboh | 188 | $177 0.1% of $122,213 |
| Life | Aflac | Kyle A Schoales | 188 | $157 0.1% of $122,213 |
| Life | Aflac | James E Warwick | 188 | $139 0.1% of $122,213 |
| Life | Aflac | Elaine Mcclelland | 188 | $105 0.1% of $122,213 |
| Life | Aflac | Brian W Patten | 188 | $92 0.1% of $122,213 |
| Life | Aflac | John Ray Ballinger | 188 | $87 0.1% of $122,213 |
| Life | Aflac | Ms Benefits LLC | 188 | $80 0.1% of $122,213 |
| Life | Aflac | John T Capozzi | 188 | $72 0.1% of $122,213 |
| Life | Aflac | James F Hill | 188 | $70 0.1% of $122,213 |
| Life | Aflac | Chris David Paolone | 188 | $68 0.1% of $122,213 |
| Life | Aflac | Michael Hensh | 188 | $67 0.1% of $122,213 |
| Life | Aflac | Rose M Sudano | 188 | $62 0.1% of $122,213 |
| Life | Aflac | Robert D Burton | 188 | $61 0.0% of $122,213 |
| Life | Aflac | Michael R Fisher | 188 | $57 0.0% of $122,213 |
| Life | Aflac | Ian Sollenberger | 188 | $52 0.0% of $122,213 |
| Life | Aflac | Brian Henry Cieslak | 188 | $50 0.0% of $122,213 |
| Life | Aflac | Mary Dressendofer | 188 | $50 0.0% of $122,213 |
| Life | Aflac | Barbara A Hawes | 188 | $47 0.0% of $122,213 |
| Life | Aflac | Glenn E Smith | 188 | $46 0.0% of $122,213 |
| Life | Aflac | Gsl Marking Inc | 188 | $37 0.0% of $122,213 |
| Life | Aflac | Jill Marie Gerson | 188 | $36 0.0% of $122,213 |
| Life | Aflac | Michael J Kelly | 188 | $35 0.0% of $122,213 |
| Life | Aflac | Matthew S Mcclay | 188 | $34 0.0% of $122,213 |
| Life | Aflac | Hub International | 188 | $34 0.0% of $122,213 |
| Life | Aflac | Pablo Cohen Velasquez | 188 | $33 0.0% of $122,213 |
| Life | Aflac | Jkapp Consulting LLC | 188 | $30 0.0% of $122,213 |
| Life | Aflac | Joseph Clarke | 188 | $30 0.0% of $122,213 |
| Life | Aflac | Mitchell B Rucko | 188 | $29 0.0% of $122,213 |
| Life | Aflac | John Christensen | 188 | $28 0.0% of $122,213 |
| Life | Aflac | John C Kautter | 188 | $27 0.0% of $122,213 |
| Life | Aflac | Jose David Fragoso-Coyotl | 188 | $25 0.0% of $122,213 |
| Life | Aflac | Brian Henry Cieslak | 188 | $24 0.0% of $122,213 |
| Life | Aflac | Benedikt N Mason | 188 | $24 0.0% of $122,213 |
| Life | Aflac | Lauren Merkt | 188 | $23 0.0% of $122,213 |
| Life | Aflac | Divya Jain | 188 | $22 0.0% of $122,213 |
| Life | Aflac | Brian W Patten | 188 | $21 0.0% of $122,213 |
| Life | Aflac | Jackson D Rhodes | 188 | $21 0.0% of $122,213 |
| Life | Aflac | Daniel C Harris | 188 | $20 0.0% of $122,213 |
| Life | Aflac | Leah E Mellay | 188 | $19 0.0% of $122,213 |
| Life | Aflac | Mandelbaum Insurance Services LLC | 188 | $18 0.0% of $122,213 |
| Life | Aflac | Desarno Benefits LLC | 188 | $17 0.0% of $122,213 |
| Life | Aflac | Brian Hanley | 188 | $16 0.0% of $122,213 |
| Life | Aflac | Matthew D Butler | 188 | $15 0.0% of $122,213 |
| Life | Aflac | Kayne R Lanahan | 188 | $15 0.0% of $122,213 |
| Life | Aflac | Sean P Smith | 188 | $14 0.0% of $122,213 |
| Life | Aflac | Brandy T Sharrock | 188 | $14 0.0% of $122,213 |
| Life | Aflac | Phillip Greer | 188 | $13 0.0% of $122,213 |
| Life | Aflac | Michael H Fleming | 188 | $12 0.0% of $122,213 |
| Life | Aflac | Joshua P Sanders | 188 | $11 0.0% of $122,213 |
| Life | Aflac | Michael Anthony Bittel | 188 | $10 0.0% of $122,213 |
| Life | Aflac | Haley E Schmitt | 188 | $8 0.0% of $122,213 |
| Life | Aflac | Heather Bartley | 188 | $8 0.0% of $122,213 |
| Life | Aflac | Daniel Soto | 188 | $7 0.0% of $122,213 |
| Life | Aflac | Janet Logan | 188 | $7 0.0% of $122,213 |
| Life | Aflac | Jessica A Boutilette | 188 | $7 0.0% of $122,213 |
| Life | Aflac | Katherine Anne Petschauer | 188 | $6 0.0% of $122,213 |
| Life | Aflac | Chris H Robinson | 188 | $6 0.0% of $122,213 |
| Life | Aflac | George A Bittel | 188 | $6 0.0% of $122,213 |
| Life | Aflac | Levy Y Isaacson | 188 | $6 0.0% of $122,213 |
| Life | Aflac | Michael S Clise | 188 | $6 0.0% of $122,213 |
| Life | Aflac | Olivia Duvall | 188 | $5 0.0% of $122,213 |
| Life | Aflac | John A Hawley | 188 | $4 0.0% of $122,213 |
| Life | Aflac | Joshua T Hill | 188 | $4 0.0% of $122,213 |
| Life | Aflac | Jason Phillips | 188 | $4 0.0% of $122,213 |
| Life | Aflac | Audrey Lynn Engle | 188 | $4 0.0% of $122,213 |
| Life | Aflac | Amanda L Moore Rhodes | 188 | $3 0.0% of $122,213 |
| Life | Aflac | James E Bacon | 188 | $3 0.0% of $122,213 |
| Life | Aflac | Hub International | 188 | $3 0.0% of $122,213 |
| Life | Aflac | Gina M Purazzo | 188 | $3 0.0% of $122,213 |
| Life | Aflac | Charity Touton | 188 | $3 0.0% of $122,213 |
| Life | Aflac | Joshua Jay Garden | 188 | $3 0.0% of $122,213 |
| Life | Aflac | Deborah Sue White | 188 | $2 0.0% of $122,213 |
| Life | Aflac | Irma D Perez | 188 | $2 0.0% of $122,213 |
| Life | Aflac | Jeffrey Correal | 188 | $2 0.0% of $122,213 |
| Life | Aflac | Audrey Lynn Engle | 188 | $2 0.0% of $122,213 |
| Life | Aflac | Hub International | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Kathy Diane James Carlson | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Levy Y Isaacson | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Joshua Jay Garden | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Marianne E Sullivan | 188 | $1 0.0% of $122,213 |
| Life | Aflac | William D Harrison | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Andrea Dorothy Alama-Smith | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Joshua Jay Garden | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Justin M Sanchez | 188 | $1 0.0% of $122,213 |
| Life | Aflac | Marialena Selvaggio | 188 | $1 0.0% of $122,213 |
| Life | Prudential Insurance Company Of America | Assuredpartners Of Mi LLC | 632 | $42,314 4.7% of $901,065 |
| Life | Prudential Insurance Company Of America | Crawford Advisors LLC | 632 | $34,152 3.8% of $901,065 |
| Life | Prudential Insurance Company Of America | Img | 632 | $122 0.0% of $901,065 |
| Long Term Care Vb-Employee Paid | Genworth Life Insurance Company | Mercer Health & Benefits, LLC | 49 | $11,278 14.7% of $76,486 |
| Accident, Critical Illness | Reliastar Life Insurance Company | Mercer Health & Benefits, LLC | 22636 | $669,112 31.0% of $2,159,321 |
| Accident, Critical Illness | Reliastar Life Insurance Company | Conduent Securities LLC | 22636 | $86,373 4.0% of $2,159,321 |
| Other | Guardian Life Insurance Company Of America | Salus Group | 158 | $5,956 10.0% of $59,555 |
| Other | Life Insurance Company Of North America | Marsh & Mclennan Agency, LLC East | 20194 | $85,314 2.3% of $3,638,056 |
| Disability | Provident Life And Accident Insurance Company | — | 78 | Comp not disclosed Premium $187,427 |
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 $12,647,143
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Meritain Health | Contract Administrator | $4,628,061 | $116.19 |
| Conduent | None | $3,102,887 | $77.90 |
| Evernorth Behavioral Health, Inc. | Contract Administrator | $701,850 | $17.62 |
| Gmr | None | $419,371 | $10.53 |
| Maestro Health | None | $357,972 | $8.99 |
| Morgan Lewis & Bockius | None | $333,971 | $8.38 |
| Multiplan Inc | None | $307,295 | $7.71 |
| Smith Edwards Dunlop | None | $231,645 | $5.82 |
| Webtpa Employer Services Inc | None | $218,600 | $5.49 |
| Baylor Quality Health Care Alliance | None | $180,690 | $4.54 |
| Bswqa Chn Integrated Network LLC | None | $167,055 | $4.19 |
| Scott & White Health Plan | None | $78,299 | $1.97 |
| Healthiest You | None | $45,767 | $1.15 |
| Aetna Life Insurance Company | None | $36,628 | $0.92 |
| Sedgwick Claims Mgmt Services | None | $833,285 | $17.61 |
| Cigna Behavorial Health | None | $680,911 | $10.80 |
| Livongo Health Inc. | None | $186,797 | $2.96 |
| Rethink Autism, Inc. | None | $89,698 | $1.42 |
| Baker Tilly Us, LLP | None | $25,045 | $0.40 |
| Cigna Eap | None | $12,892 | $0.20 |
| Pnc Bank | None | $8,424 | $0.13 |