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Employer
285 E. Waterfront Dr., Homestead, PA 15120 · EIN 77-0486724 · Oct 1, 2024 to Sep 30, 2025
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 $40,739
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | University Health Alliance | — | 67 | Comp not disclosed Premium $551,524 |
| Medical | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 92 | $2,756 20.0% of $13,781 |
| Medical | Reliance Standard Life Insurance Company | Foundation Risk Partners, Corp. | 92 | $107 0.8% of $13,781 |
| Dental | Hawaii Dental Service | — | 72 | Comp not disclosed Premium $30,396 |
| Vision | Eyemed Vision Care | Custom Benefit Consultants, Inc. | 496 | $111 0.3% of $33,101 |
| Life | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 558 | $5,957 10.0% of $59,567 |
| Life | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 124 | $9,153 15.0% of $61,021 |
| AD&D | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 157 | $1,039 15.0% of $6,928 |
| Voluntary Hospital | Reliance Standard Life Insurance Company | Custom Benefit Consultants Inc. | 43 | $2,063 20.0% of $10,316 |
| Voluntary Hospital | Reliance Standard Life Insurance Company | Foundation Risk Partners, Corp. | 43 | $75 0.7% of $10,316 |
| Voluntary Accident | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 122 | $3,951 20.0% of $19,756 |
| Voluntary Accident | Reliance Standard Life Insurance Company | Foundation Risk Partners, Corp. | 122 | $152 0.8% of $19,756 |
| Other | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 95 | $6,273 15.0% of $41,823 |
| Other | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 107 | $5,741 15.0% of $38,275 |
| Legal | Metropolitan General Insurance Company | Custom Benefit Consultants Inc. | 41 | $1,307 10.0% of $13,050 |
| Other | Reliance Standard Life Insurance Company | Custom Benefit Consultants | 100 | $2,054 10.2% of $20,053 |
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.