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Employer
410-424 North Eighth Street, Philadelphia, PA 19123 · EIN 23-1661924 · 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 $41,117
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 2453 | Comp not disclosed Premium $798,103 |
| Medical | Keystone Health Plan East | — | 3963 | Comp not disclosed Premium $19,227,754 |
| Medical | Amerihealth Insurance Company | — | 11 | Comp not disclosed Premium $65,298 |
| Dental | United Concordia Insurance Company | — | 2453 | Comp not disclosed Premium $445,022 |
| Life | Reliance Standard Life Insurance Company | Steven Rodia | 2840 | $41,117 7.8% of $528,221 |
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 $848,194
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Usw District 10 Local 286 Union | Sponsoring Labor Org. | $604,901 | $152.64 |
| Conner Strong Companies | None | $102,533 | $25.87 |
| Novak Francella LLC | None | $33,668 | $8.50 |
| Spear Wilderman Pc | Legal Counsel To Usw L286 | $32,000 | $8.07 |
| Sobol Group, P.C. | None | $32,000 | $8.07 |
| Boyd Watterson Asset Management LLC | None | $11,335 | $2.86 |
| Xpan Law Partners, LLC | None | $10,800 | $2.73 |
| Wedge Capital Management | None | $8,490 | $2.14 |
| Health Advocate Solutions, Inc. | None | $7,467 | $1.88 |
| Investment Performance Services | None | $5,000 | $1.26 |
| Carlo Simone, Iii. | Employee | Comp not disclosed | — |