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Employer
Po Box 834, Valley Forge, PA 19482 · EIN 86-2551862 · 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 $292,935
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Cigna Health And Life Insurance Company And Affiliates | Assured Partners (Central Pa) | 744 | $89,971 7.9% of $1,134,719 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 888 | $20,255 13.1% of $154,144 |
| AD&D | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 210 | $8,083 18.1% of $44,651 |
| Accidental Injury | Cigna Health And Life Insurance Company | Assured Partners (Central Pa) | 258 | $6,461 17.0% of $37,910 |
| Critical Illness, Spouse Critical Illness, Child Critical Illness | Cigna Health And Life Insurance Company | Assured Partners (Central Pa) | 236 | $13,367 17.1% of $78,343 |
| Voluntary Hospital Care | Cigna Health And Life Insurance Company | Assured Partners (Central Pa) | 160 | $10,332 17.1% of $60,449 |
| Voluntary Ltd | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 830 | $65,583 13.8% of $474,437 |
| Voluntary Life, Voluntary Spouse Life, Voluntary Child Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 459 | $74,008 18.3% of $405,266 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 78 | $1,963 10.9% of $17,999 |
| Business Travel Accident | Zurich American Insurance Company | Assured Partners (Central Pa) | 888 | $1,248 15.0% of $8,322 |
| Business Travel Accident | Zurich American Insurance Company | Reuben Warner Associates, Inc. | 888 | $1,664 20.0% of $8,322 |
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 $1,220,229
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Cigna Life And Health Insurance Co | Med/Den Administration | $1,205,440 | $1,357.48 |
| Ap Benefit Advisors, LLC | Cobra/Hsa/Hra Admin | $14,789 | $16.65 |