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Employer
600 North Baker Station Road, West Grove, PA 19390 · EIN 23-1675800 · May 1, 2024 to Apr 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 $49,794
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Carolyn Mclaughlin-Smith | 51 | $29,106 6.0% of $482,076 |
| Dental | United Concordia Insurance Company | Kistler Tiffany Benefits Co | 118 | $4,800 12.6% of $38,179 |
| Dental | United Concordia Insurance Company | Creative Benefits, Inc | 118 | $490 1.3% of $38,179 |
| Vision | Eyemed Vision Care | — | 87 | Comp not disclosed Premium $3,905 |
| Life | Equitable Financial Life Insurance Company Of America | Creative Benefits, Inc | 152 | $720 15.0% of $4,801 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Creative Benefits, Inc | 81 | $6,556 10.5% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Roth Voluntary Benefit Services Inc | 81 | $3,444 5.5% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Fulvio A. Acosta | 81 | $1,922 3.1% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | O'Neill Voluntary Benefit Services | 81 | $847 1.4% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Geneva Hodge | 81 | $519 0.8% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Lauren Ashley Perri | 81 | $323 0.5% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Lisa A. Perri | 81 | $208 0.3% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Brad Lee Mundy | 81 | $202 0.3% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Michael Urban | 81 | $191 0.3% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Nicholas Cusmano | 81 | $190 0.3% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Micahel J. Perri | 81 | $80 0.1% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Emanuel Julian Asurza | 81 | $79 0.1% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Eduardo Tucto | 81 | $50 0.1% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Tucto & Associates Corp | 81 | $47 0.1% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Rochelle Diane Kelly-Perry Thomas | 81 | $12 0.0% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Em Property & Casualty LLC | 81 | $3 0.0% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Tulasi Angelica Asurza | 81 | $3 0.0% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Shane Thomas Williams | 81 | $1 0.0% of $62,603 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Edward J. Williams | 81 | $1 0.0% of $62,603 |
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.