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Employer
2929 Walnut Street, Philadelphia, PA 19104 · EIN 94-0479804 · Jan 1, 2024 to Dec 31, 2024
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 $185,603
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Triple-S Salud, Inc | Marsh Saldana | 74 | $33,268 4.0% of $831,692 |
| Medical | Aetna Life Insurance Co | — | 1 | Comp not disclosed Premium $1,763 |
| Medical | Aetna Life Insurance Co. | — | 12 | Comp not disclosed Premium $26,617 |
| Medical | Aetna Life Insurance Co. | — | 1 | Comp not disclosed Premium $1,068 |
| Medical | Aetna Life Insurance Co. | — | 2 | Comp not disclosed Premium $1,643 |
| Medical | Aetna Life Insurance Co. | — | 5 | Comp not disclosed Premium $13,044 |
| Medical | Aetna Life Insurance Co. | — | 33 | Comp not disclosed Premium $72,094 |
| Medical | Aetna Life Insurance Co. | — | 7 | Comp not disclosed Premium $19,680 |
| Medical | Aetna Life Insurance Co. | — | 3 | Comp not disclosed Premium $9,877 |
| Medical | Aetna Life Insurance Co. | — | 12 | Comp not disclosed Premium $29,128 |
| Medical | Highmark New York | Mercer (Us), Inc. | 4 | $672 2.4% of $28,539 |
| Life | Hartford Life And Accident | Mercer (Us), Inc. | 1270 | $56,816 4.6% of $1,235,129 |
| Life | Hartford Life And Accident | Mercer Human Resource Consulting | 1270 | $21,172 1.7% of $1,235,129 |
| Accidental Death And Dismemberment | Federal Insurance Company | — | 2 | Comp not disclosed Premium $37,454 |
| Medical | Aetna Life Insurance Company | — | 14 | Comp not disclosed Premium $131,319 |
| Vision | Vision Service Plan | — | 865 | Comp not disclosed Premium $192,833 |
| Life | Hartford Life And Accident | Mercer (Us), Inc. | 1925 | $47,604 3.7% of $1,296,540 |
| Life | Hartford Life And Accident | Mercer Human Resource Consulting | 1925 | $22,384 1.7% of $1,296,540 |
| Accidental Death And Dismemberment | Federal Insurance Company | — | 1163 | Comp not disclosed Premium $52,376 |
| Legal | Pre-Paid Legal Services, Inc. DBA Legalshield | Mercer (Us), Inc. | 160 | $3,431 11.2% of $30,665 |
| Legal | Pre-Paid Legal Services, Inc. DBA Legalshield | John J Halpin | 160 | $256 0.8% of $30,665 |
| Business Travel Accident | American General Life Insurance Company | — | 1275 | Comp not disclosed Premium $40,000 |
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.