Employer
David'S Bridal LLC
1001 Washington Street, Conshohocken, PA 19428 · EIN 65-0214563 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $184,390
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Hawaii Medical Service Association | — | 6 | Comp not disclosed Premium $64,365 |
| Dental | Cigna Health And Life Insurance Company And Affiliates | Mercer (Us), Inc. | 1876 | $70,766 10.0% of $705,973 |
| Vision | Fidelity Security Life Insurance Company | — | 1973 | Comp not disclosed Premium $127,447 |
| Vision | Fidelity Security Life Insurance Company | — | 18 | Comp not disclosed Premium $1,268 |
| Life | Lincoln National Life Insurance Company | Mercer (Us), Inc. | 1912 | $26,463 11.0% of $239,997 |
| Business Travel Accident | National Union Fire Insurance Company Of Pittsburgh, Pa | Mercer (Us), Inc. | 1912 | $998 25.0% of $3,990 |
| Other | Lincoln National Life Insurance Company | Mercer (Us), Inc. | 352 | $30,343 11.0% of $275,398 |
| Other | Lincoln National Life Insurance Company | Mercer (Us), Inc. | 1912 | $55,820 11.0% of $505,502 |
Schedule C
Additional compensation
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.