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Employer
1500 Market Street, Suite 3500e, Philadelphia, PA 19102 · EIN 23-1398811 · 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 $82,882
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 110 | $1,269 10.0% of $12,694 |
| Life | Provident Life And Accident Insurance Company | Cbiz Benefits & Insurance | 71 | $3,140 7.1% of $44,520 |
| Life | Provident Life And Accident Insurance Company | Charles D Block | 71 | $1,135 2.5% of $44,520 |
| Life | Provident Life And Accident Insurance Company | James H Van Epps | 71 | $1,135 2.5% of $44,520 |
| Accidental Death And Dismemberment | Reliance Standard Life Insurance Company | Cbiz Benefits & Insurance | 82 | $1,085 15.0% of $7,236 |
| Other | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 174 | $24,689 10.0% of $246,889 |
| Attained Age Critical Illness | Unum Insurance Company | Cbiz Benefits & Ins. Services | 34 | $890 7.5% of $11,868 |
| Attained Age Critical Illness | Unum Insurance Company | Charles D Block | 34 | $482 4.1% of $11,868 |
| Medical | Independence Blue Cross | Conner Strong & Buckelew Companies | 102 | $32,956 1.7% of $1,962,425 |
| Medical | Independence Blue Cross-Keystone | Conner Strong & Buckelew Companies | 14 | $4,783 1.5% of $311,978 |
| Medical | Amerihealth Insurance Company | Conner Strong & Buckelew Companies | 1 | $338 0.9% of $35,781 |
| Dental | Delta Dental Of Pennsylvania | Conner Strong & Buckelew Companies | 111 | $3,995 5.0% of $79,977 |
| Dental | Delta Dental Of Pennsylvania | Conner Strong & Buckelew Companies | 6 | $60 5.0% of $1,202 |
| Vision | Independence Blue Cross | Conner Strong & Buckelew Companies | 102 | $3,881 40.2% of $9,651 |
| Other | Independence Blue Cross | Conner Strong & Buckelew Companies | 80 | $3,044 0.9% of $345,938 |
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.