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Employer
500 Office Center Dr, Fort Washington, PA 19034 · EIN 23-2003056 · 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 $59,582
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health Unimerica Insurance Company | — | 293 | Comp not disclosed Premium $1,192,066 |
| Dental | Aetna Life Insurance Co | Onedigital (Philadelphia) | 474 | $13,044 7.9% of $165,309 |
| Dental | Aetna Life Insurance Co | Patriot Growth Insurance Services D | 474 | $4,069 2.5% of $165,309 |
| Life | United Of Omaha Life Insurance Company | Kistlertiffany Benfits General Agen | 440 | $2,689 5.6% of $47,943 |
| Life | United Of Omaha Life Insurance Company | Patriot Growth Insurance Svcs LLC | 440 | $2,533 5.3% of $47,943 |
| Life | United Of Omaha Life Insurance Company | Onedigital Premier Services | 440 | $2,397 5.0% of $47,943 |
| Life | United Of Omaha Life Insurance Company | Kistlertiffany Benfits General Agen | 440 | $1,782 3.7% of $47,943 |
| AD&D | United Of Omaha Life Insurance Company | Patriot Growth Insurance Services | 71 | $3,837 11.4% of $33,780 |
| AD&D | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 71 | $2,919 8.6% of $33,780 |
| AD&D | United Of Omaha Life Insurance Company | Onedigital Premier Services | 71 | $1,689 5.0% of $33,780 |
| AD&D | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 71 | $1,600 4.7% of $33,780 |
| Other | United Of Omaha Life Insurance Company | Patriot Growth Insurance Svcs LLC | 440 | $2,492 5.3% of $47,195 |
| Other | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 440 | $2,411 5.1% of $47,195 |
| Other | United Of Omaha Life Insurance Company | Onedigital Premier Services | 440 | $2,360 5.0% of $47,195 |
| Other | United Of Omaha Life Insurance Company | Kistlertiffany Benfits General Agen | 440 | $1,756 3.7% of $47,195 |
| Other | United Of Omaha Life Insurance Company | Patriot Growth Insurance Svcs | 440 | $3,871 5.3% of $73,287 |
| Other | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 440 | $3,744 5.1% of $73,287 |
| Other | United Of Omaha Life Insurance Company | Onedigital Premier Services | 440 | $3,664 5.0% of $73,287 |
| Other | United Of Omaha Life Insurance Company | Kistler Tiffany Benefits Co | 440 | $2,725 3.7% of $73,287 |
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 $317,004
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $66,123 | $225.68 |
| The Benecon Group | Broker | $49,725 | $169.71 |
| Patriot (Exude, Inc.) | Broker | $46,737 | $159.51 |
| Aetna Health Plans | Carrier | $138,905 | $474.08 |
| Connectcare 3 | Patient Advocate | $15,514 | $52.95 |