Employer
Evergreen Senior Management
660 Sentry Parkway, Blue Bell, PA 19422 · EIN 46-3140763 · 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 $63
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Corporate Synergies Group, LLC | 450 | $-4,249 -0.4% of $981,537 |
| Medical | Independence Blue Cross | Alliant Insurance Services, Inc. | 631 | $-7,784 -0.1% of $5,237,517 |
| Medical | Independence Blue Cross | Corporate Synergies Group, LLC | 631 | $-22,318 -0.4% of $5,237,517 |
| Dental | United Concordia Insurance Company | — | 856 | Comp not disclosed Premium $237,087 |
| Vision | Heartland | — | 961 | Comp not disclosed Premium $58,334 |
| Life | Life Insurance Company Of North America | Corporate Synergies Group, LLC | 1084 | $25,527 8.2% of $310,444 |
| Employee Assistance Program | Integrated Behavioral Health | — | 1850 | Comp not disclosed Premium $55,610 |
| Accident And Critical Illness | Reliastar Life Insurance Company | Corporate Synergies Group, LLC | 168 | $8,887 23.3% of $38,142 |
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.