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Employer
1400 N. Providence Rd, Media, PA 19063 · EIN 43-2071188 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $62,120
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Kistler Tiffany Benefits Co | 194 | $23,814 1.7% of $1,400,647 |
| Medical | Independence Blue Cross | Emerson Rogers LLC | 194 | $23,128 1.7% of $1,400,647 |
| Medical | Dominion National | Emerson, Reid & Company | 95 | $5,409 9.6% of $56,560 |
| Medical | Colonial Life & Accident Insurance Company | Roth Voluntary Benefit Services Inc | 15 | $892 5.8% of $15,413 |
| Medical | Colonial Life & Accident Insurance Company | Nicholas Cusmano | 15 | $800 5.2% of $15,413 |
| Medical | Colonial Life & Accident Insurance Company | James C Vanderwaal | 15 | $793 5.1% of $15,413 |
| Medical | Colonial Life & Accident Insurance Company | O'Neill Voluntary Benefit Services | 15 | $311 2.0% of $15,413 |
| Vision | Vision Benefits Of America | — | 83 | Comp not disclosed Premium $15,604 |
| Life | Reliance Standard Life Insurance Company | Ecbm Lp | 104 | $1,753 3.6% of $48,071 |
| AD&D | Reliance Standard Life Insurance Company | Ecbm Lp | 104 | $936 15.0% of $6,243 |
| AD&D | Life Insurance Company Of North America | Ecbm,Lp.-Evans Conger Broussard & M | 27 | $380 16.4% of $2,313 |
| Other | Independence Blue Cross | — | — | Comp not disclosed |
| Other | Independence Blue Cross | — | 194 | Comp not disclosed Premium $436,916 |
| Other | Reliance Standard Life Insurance Company | Ecbm Lp | 103 | $3,904 7.7% of $50,727 |
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.