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Employer
790 Township Line Road, Morrisville, PA 19067 · EIN 30-0022418 · Feb 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $57,960
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 152 | Schedule A not provided |
| Medical | Independence Blue Cross | — | 152 | Schedule A not provided |
| Medical | Amerihealth | — | 2 | Schedule A not provided |
| Medical | Amerihealth | — | 2 | Schedule A not provided |
| Medical | Keystone | — | 81 | Schedule A not provided |
| Medical | Keystone | — | 81 | Schedule A not provided |
| Dental | Metlife | — | 100 | Schedule A not provided |
| Vision | Vision Service Plan | Mercer (Us), Inc. | 95 | $525 5.0% of $10,424 |
| Vision | Vision Service Plan | The Hdh Group, Inc. | 95 | $241 2.3% of $10,424 |
| Life | Symetra Life Insurance Company | Mercer (Us), Inc. | 147 | $7,189 7.7% of $93,176 |
| Life | Symetra Life Insurance Company | The Hdh Group, Inc. | 147 | $3,906 4.2% of $93,176 |
| Employee Assistance Program | Health Advocate Solutions, Inc. | — | 107 | Schedule A not provided |
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.