Employer
Elliott-Lewis Corporation
2900 Black Lake Place, Philadelphia, PA 19154 · EIN 23-2974096 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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.
Visible subtotal $51,370
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 87 | Comp not disclosed Premium $1,139,889 |
| Medical | Independence Blue Cross | — | 63 | Comp not disclosed Premium $737,671 |
| Medical | Amerihealth Insurance Company | — | 3 | Comp not disclosed Premium $34,825 |
| Dental | United Concordia Insurance Company | — | 153 | Comp not disclosed Premium $120,538 |
| Vision | Standard Insurance Company | Simkiss & Block | 233 | $51,370 20.3% of $253,354 |
| Other | Independence Blue Cross | — | 65 | Comp not disclosed Premium $270,312 |
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.
No Schedule C parties in this year.