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Employer
1319 Locust Street, Philadelphia, PA 19107 · EIN 23-2627429 · 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 $53,864
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Hcc Life Insurance Co. (Tokio Marine) | Gallagher Fiduciary Advisors, LLC | 1315 | $33,393 4.0% of $834,829 |
| Dental | Delta Dental Of Pennsylvania | — | 2244 | Comp not disclosed Premium $233,233 |
| Medicare Group Plan D Prescription | Humana Insurance Company | Labor First LLC | 432 | $20,333 1.9% of $1,090,556 |
| Other | Humana Insurance Company Of New York | Labor First LLC | 3 | $138 1.9% of $7,437 |
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 $2,761,802
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Blue Cross | None | $885,118 | $316.57 |
| Pension Fund For Hhce Philadelphia | Related Org. | $363,838 | $130.13 |
| Payer Matrix, LLC | None | $218,141 | $78.02 |
| Gallagher (Arthur J. Gallagher) | None | $150,000 | $53.65 |
| Tina Glenn | Employee | $106,972 | $38.26 |
| Labor First | None | $84,783 | $30.32 |
| Nateshe Williams | Employee | $83,015 | $29.69 |
| Eric Brooks | Employee | $81,964 | $29.31 |
| Bridgeway Benefit Technologies | None | $68,842 | $24.62 |
| Pamela A Smith-Strite | Employee | $63,010 | $22.54 |
| Novak Francella, LLC | None | $61,100 | $21.85 |
| Empirx Health | None | $60,161 | $21.52 |
| Morgan, Lewis & Bockius LLP | None | $56,659 | $20.26 |
| Sheldon Williams | Employee | $53,900 | $19.28 |
| Evan Smith | Employee | $50,437 | $18.04 |
| Benefit3 Inc | None | $47,516 | $16.99 |
| Glendelle Cameron-Dixon | None | $45,389 | $16.23 |
| Adrian Hurst | Employee | $42,329 | $15.14 |
| Evelyn Alameda | Employee | $37,243 | $13.32 |
| Berta Shkodra | Employee | $35,168 | $12.58 |
| Principal Custody Solutions | None | $32,684 | $11.69 |
| Blair Devalia | Employee | $30,904 | $11.05 |
| Investment Performance Services LLC | None | $28,792 | $10.30 |
| O'Donoghue & O'Donoghue LLP | None | $27,146 | $9.71 |
| Segall Bryant & Hamill LLC | None | $19,499 | $6.97 |
| Cynthia Jones-Brooks | None | $18,072 | $6.46 |
| Work & Well Inc | None | $9,120 | $3.26 |