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Employer
4 Campus Boulevard, Newtown Square, PA 19073 · EIN 23-2063718 · Jul 1, 2024 to Jun 30, 2025
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 $110,511
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Assurance Company | Flexible Benefit Plans, LLC | 253 | $64,118 4.0% of $1,612,682 |
| Medical | Reliance Standard Life Insurance Company | Pentra, LLC | 48 | $2,208 17.1% of $12,935 |
| Medical | Reliance Standard Life Insurance Company | American Insurance Administrators | 48 | $226 1.7% of $12,935 |
| Medical | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 48 | $83 0.6% of $12,935 |
| Medical | Reliance Standard Life Insurance Company | Pentra, LLC | 39 | $3,330 17.1% of $19,486 |
| Medical | Reliance Standard Life Insurance Company | American Insurance Administrators | 39 | $346 1.8% of $19,486 |
| Medical | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 39 | $111 0.6% of $19,486 |
| Medical | Reliance Standard Life Insurance Company | Pentra, LLC | 32 | $1,566 16.9% of $9,260 |
| Medical | Reliance Standard Life Insurance Company | American Insurance Administrators | 32 | $142 1.5% of $9,260 |
| Medical | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 32 | $40 0.4% of $9,260 |
| Dental + Vision | Reliance Standard Life Insurance Company | Pentra LLC | 316 | $9,929 5.4% of $183,095 |
| Life | Reliance Standard Life Insurance Company | Pentra, LLC | 146 | $6,979 12.1% of $57,895 |
| Life | Reliance Standard Life Insurance Company | American Insurance Administrators | 146 | $965 1.7% of $57,895 |
| Life | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 146 | $292 0.5% of $57,895 |
| Life | Reliance Standard Life Insurance Company | Pentra, LLC | 35 | $2,599 15.0% of $17,294 |
| Life | Reliance Standard Life Insurance Company | American Insurance Administrators | 35 | $289 1.7% of $17,294 |
| Life | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 35 | $94 0.5% of $17,294 |
| AD&D | Reliance Standard Life Insurance Company | Pentra, LLC | 54 | $236 17.2% of $1,374 |
| AD&D | Reliance Standard Life Insurance Company | American Insurance Administrators | 54 | $25 1.8% of $1,374 |
| AD&D | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 54 | $10 0.7% of $1,374 |
| Other | Qcc Insurance Company | Flexible Benefit Plans, LLC | 39 | $737 0.9% of $83,527 |
| Other | Reliance Standard Life Insurance Company | Pentra, LLC | 146 | $7,590 12.0% of $63,122 |
| Other | Reliance Standard Life Insurance Company | American Insurance Administrators | 146 | $1,027 1.6% of $63,122 |
| Other | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 146 | $307 0.5% of $63,122 |
| Other | Reliance Standard Life Insurance Company | Pentra, LLC | 146 | $6,176 12.0% of $51,362 |
| Other | Reliance Standard Life Insurance Company | American Insurance Administrators | 146 | $836 1.6% of $51,362 |
| Other | Reliance Standard Life Insurance Company | Benefit Advisors Network LLC | 146 | $250 0.5% of $51,362 |
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.