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Employer
1515 Market Street, Suite 1020, Philadelphia, PA 19102 · EIN 23-6487259 · 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 $161,844
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | The Union Labor Life Insurance Company | The Segal Comapny Inc | 3040 | $117,966 5.5% of $2,159,313 |
| Stop-loss | The Union Labor Life Insurance Company | Contemporary Strategic Solutions | 3040 | $43,186 2.0% of $2,159,313 |
| Life | Hartford Life And Accident | Aon Risk Service Central, Inc. | 3125 | $669 0.2% of $362,971 |
| Life | Hartford Life And Accident | Aon Consulting, Inc. | 3125 | $23 0.0% of $362,971 |
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 $6,059,794
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Keystone Health Plan East | None | $3,439,970 | $1,100.79 |
| Bridgeway Benefit Technologies | None | $266,561 | $85.30 |
| The Segal Company | None | $218,014 | $69.76 |
| Sarah Millinghausen | Employee | $152,524 | $48.81 |
| John J Rongione | Employee | $143,074 | $45.78 |
| Judy O'Meara | Employee | $123,409 | $39.49 |
| Mental Health Consultants, Inc. | None | $120,809 | $38.66 |
| Cynthia Leahy | Employee | $116,036 | $37.13 |
| Linda Mccullough | Employee | $115,314 | $36.90 |
| Maria Grillo | Employee | $108,319 | $34.66 |
| Smith Edwards And Dunlap, Co. | None | $97,361 | $31.16 |
| Veronica Moore | Employee | $94,875 | $30.36 |
| Tyema Sanchez | Employee | $94,860 | $30.36 |
| Sonia Rodriguez | Employee | $90,406 | $28.93 |
| Donna Heston | Employee | $89,909 | $28.77 |
| Jharna Agarwal | Employee | $84,061 | $26.90 |
| Novak Francella LLC | None | $82,462 | $26.39 |
| Erica Harrell | Employee | $76,689 | $24.54 |
| Daniel Brown | Employee | $74,732 | $23.91 |
| Stevens & Lee Pc | None | $66,023 | $21.13 |
| Spear Wilderman P.C. | None | $63,149 | $20.21 |
| Joanna Olejniczak | Employee | $59,256 | $18.96 |
| Local 36 Bolr Pension Plan | Related Fund | $56,013 | $17.92 |
| Pnc Bank National Association | None | $42,784 | $13.69 |
| Garson M. Caruso, Md, Mph, Pa. | None | $40,900 | $13.09 |
| Bluewater Consulting Group Inc | None | $38,287 | $12.25 |
| Meketa Investments Group | None | $34,849 | $11.15 |
| Cvs Caremark | None | $28,314 | $9.06 |
| National Vision Administrators LLC | None | $18,598 | $5.95 |
| Studio Lustro Inc. | None | $12,650 | $4.05 |
| Proforma Industries | None | $9,586 | $3.07 |