Employer
Di Bruno Bros. Holdings, Inc.
1730 Chestnut Street, Philadelphia, PA 19103 · EIN 47-2593694 · Jul 1, 2023 to Jun 30, 2024
Plan year 2023
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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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | The Guardian Life Insurance Company Of America | — | — | Schedule A not provided |
| Voluntary | Massachusetts Mutual Life Insurance Company | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | 102 | Comp not disclosed Premium $241,211 |
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.
Visible subtotal $103,761
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $59,715 | $473.93 |
| The Benecon Group, LLC | Broker | $20,982 | $166.52 |
| Independence Administrators | Admin | $16,096 | $127.75 |
| ConnectCare3 | Patient Advocate | $6,968 | $55.30 |