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Employer
Cira Centre, 2929 Arch Street, Philadelphia, PA 19104 · EIN 23-1425587 · 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 $279,528
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Aetna Life Insurance Co. | — | 1042 | Comp not disclosed Premium $1,200,604 |
| Medical | Aetna Life Insurance Company | — | 35 | Comp not disclosed Premium $392,115 |
| Vision | Vision Service Plan | — | 836 | Comp not disclosed Premium $115,071 |
| Life | Unum Life Insurance Company Of America | Schott,Christopher D | 1136 | $130,278 6.4% of $2,027,387 |
| Life | Unum Life Insurance Company Of America | — | 269 | Comp not disclosed Premium $353,699 |
| Life | Metropolitan Life Insurance Company | Kestra Investment Services LLC | 50 | $5,057 1.6% of $321,927 |
| Life | Metropolitan Life Insurance Company | Nfp Executive Benefits | 50 | $2,310 0.7% of $321,927 |
| Other | Unum Life Insurance Company Of America | Schott, Christopher D | 36 | $8,085 7.0% of $115,502 |
| Other | Provident Life And Accident Insurance Company | Wisted, Daniel, J | 81 | $42,752 12.1% of $353,476 |
| Other | Provident Life And Accident Insurance Company | Wisted, Daniel, J | 81 | $5,466 1.5% of $353,476 |
| Other | Provident Life And Accident Insurance Company | Alliant Insurance Services, Inc. | 81 | $4,790 1.4% of $353,476 |
| Other | Provident Life And Accident Insurance Company | Alliant Insurance Services, Inc. | 81 | $3,924 1.1% of $353,476 |
| Other | Provident Life And Accident Insurance Company | Wisted, Daniel, J | 8 | $3,001 6.8% of $44,127 |
| Other | Provident Life And Accident Insurance Company | Alliant Insurance Services, Inc. | 8 | $2,958 6.7% of $44,127 |
| Other | Provident Life And Accident Insurance Company | Alliant Insurance Services, Inc. | 8 | $934 2.1% of $44,127 |
| Other | Provident Life And Accident Insurance Company | Wisted, Daniel, J | 8 | $246 0.6% of $44,127 |
| Other | Provident Life And Casualty Insurance Company | Wisted, Daniel, J | 32 | $18,088 13.8% of $130,817 |
| Other | Provident Life And Casualty Insurance Company | Wisted, Daniel, J | 32 | $1,694 1.3% of $130,817 |
| Other | Provident Life And Casualty Insurance Company | Alliant Insurance Services, Inc. | 32 | $1,339 1.0% of $130,817 |
| Other | Provident Life And Casualty Insurance Company | Alliant Insurance Services, Inc. | 32 | $1,152 0.9% of $130,817 |
| Grp Accident | Unum Insurance Company | Alliant Insurance Services, Inc. | 225 | $9,956 22.7% of $43,863 |
| Attained Age Critical Illness | Unum Insurance Company | Alliant Insurance Services, Inc. | 193 | $16,335 22.0% of $74,251 |
| Hospital Ee Paid | Unum Insurance Company | Alliant Insurance Services, Inc. | 189 | $10,424 22.8% of $45,739 |
| Accidental Death & Dismemberment | Ace American Insurance Company | Aon Consulting, Inc. | 1136 | $10,739 20.0% of $53,693 |
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 $917,082
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Aetna Life Insurance Company | Contract Administrator | $911,053 | $759.84 |
| Wex | Contract Administrator | $6,029 | $5.03 |