Employer
Glaxosmithkline LLC
5 Crescent Drive, Philadelphia, PA 19112 · EIN 23-1099050 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $315,642
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Accidental Death & Dismemberment, Business Travel Accident | Ace American Insurance Company | — | 12270 | Comp not disclosed Premium $54,258 |
| Medical | Aetna Life Insurance Company | — | 64 | Comp not disclosed Premium $625,412 |
| Medical | United Healthcare Insurance Company | — | 27 | Comp not disclosed Premium $215,925 |
| Dental | Metropolitan Life Insurance Company | — | 2795 | Comp not disclosed Premium $1,255,817 |
| Vision | Fidelity Security Life Insurance Company | — | 21344 | Comp not disclosed Premium $1,119,195 |
| Vision | Fidelity Security Life Insurance Company | — | 237 | Comp not disclosed Premium $32,455 |
| Life | Metropolitan Life Insurance Company | Mercer (Us), Inc. | 29328 | $220,252 1.5% of $14,594,698 |
| Other | Lincoln National Life Insurance Company | Mercer (Us), Inc. | 12225 | $95,390 1.3% of $7,067,554 |
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.