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Employer
330 S. Warminster Rd., Hatboro, PA 19040 · EIN 27-2882810 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $234,928
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Kistler Tiffany Benefits Co | 690 | $193,104 4.3% of $4,528,747 |
| Dental | Delta Dental Of Pennsylvania | Peterman Benefits | 431 | $16,457 5.0% of $329,147 |
| Vision | Eyemed Vision Care | Pcf Insurance Services Of The West | 635 | $5,074 10.0% of $50,753 |
| Life | Reliance Standard | Pcf Insurance Services Of The West | 467 | $4,875 4.3% of $113,731 |
| AD&D | Reliance Standard | Pcf Insurance Services Of The West | 186 | $1,172 15.4% of $7,588 |
| AD&D | Reliance Standard | Pcf Insurance Services Of The West | 467 | $2,994 16.3% of $18,394 |
| Other | Reliance Standard | Pcf Insurance Services Of The West | 13 | $546 11.0% of $4,960 |
| Other | Reliance Standard | Pcf Insurance Services Of The West | 240 | $1,043 11.0% of $9,482 |
| Other | Reliance Standard | Pcf Insurance Services Of The West | 469 | $4,499 7.7% of $58,417 |
| Other | Reliance Standard | Pcf Insurance Services Of The West | 470 | $5,164 10.2% of $50,572 |
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.