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Employer
1501 North Cedar Crest Boulevard, Allentown, PA 18104 · EIN 23-2137906 · 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 $20,403
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 128 | Comp not disclosed Premium $539,451 |
| Dental + Vision | Metropolitan Life Insurance Company | Bsi Corporate Benefits, Inc. | 219 | $8,930 9.9% of $90,358 |
| Life | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 129 | $606 15.5% of $3,909 |
| Other | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 129 | $4,989 15.4% of $32,431 |
| Other | United Of Omaha Life Insurance Company | Bsi Corporate Benefits, Inc. | 129 | $5,878 15.4% of $38,197 |
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 $81,356
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Bsi Corporate Benefits | Broker | $79,565 | $363.31 |
| The Benecon Group | Broker | $25,819 | $117.89 |
| Connectcare 3 | Patient Advocate | $8,007 | $36.56 |
| Innovu | Other | $6,290 | $28.72 |
| Capital Blue Cross | Admin | $-38,325 | $-175.00 |