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Employer
1500 Spring Garden Street, Philadelphia, PA 19130 · EIN 23-2088266 · 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 $51,401
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Gallagher Fiduciary Advisors, LLC | 88 | $27,183 4.2% of $642,916 |
| Medical | Keystone | Gallagher Benfit Services, Inc. | 52 | $14,432 5.3% of $274,296 |
| Dental | Metropolitan Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 213 | $3,642 5.7% of $64,394 |
| Dental | Metropolitan Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 213 | $905 1.4% of $64,394 |
| Vision | Vision Service Plan | Gallagher Fiduciary Advisors, LLC | 86 | $616 8.4% of $7,291 |
| Life | American Heritage Life Insurance Company | Kelly & Assocs Insurance Grp, Inc. | 4 | $35 1.8% of $1,949 |
| Life | American Heritage Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 4 | $18 0.9% of $1,949 |
| Life | Prudential Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 109 | $2,599 5.0% of $51,989 |
| Life | Prudential Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 109 | $1,320 2.5% of $51,989 |
| Life | Prudential Life Insurance Company | Img | 109 | $25 0.0% of $51,989 |
| Accident, Critical Illness, Hospital, Cancer | Symetra Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 7 | $515 23.7% of $2,177 |
| Accident, Critical Illness, Hospital, Cancer | Symetra Life Insurance Company | Gallagher Fiduciary Advisors, LLC | 7 | $111 5.1% of $2,177 |
| Other | Independence Blue Cross | — | 52 | Comp not disclosed Premium $82,906 |
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.