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Employer
75 Hopper Place, Pittsburgh, PA 15222 · EIN 85-3101739 · 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 $96,484
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Kaiser Foundation Health Plan, Inc. | Willis Towers Watson Northeast, Inc | 18 | $4,040 2.4% of $168,905 |
| Medical | Kaiser Foundation Health Plan, Inc. | Mercer (Us), Inc. | 18 | $281 0.2% of $168,905 |
| Medical | Kaiser Foundation Health Plan, Inc. | Willis Towers Watson Northeast, Inc | 16 | $783 1.6% of $48,845 |
| Medical | Kaiser Foundation Health Plan, Inc. | Willis Towers Watson Northeast, Inc | 6 | $1,687 2.8% of $60,883 |
| Medical | Kaiser Foundation Health Plan, Inc. | Mercer (Us), Inc. | 6 | $172 0.3% of $60,883 |
| Medical | Triple S Salud, Inc | — | 27 | Comp not disclosed Premium $182,244 |
| Dental | Delta Dental Of Pennsylvania | Willis Towers Watson Northeast, Inc | 1814 | $37,410 6.0% of $623,698 |
| Vision | Vision Service Plan | Willis Towers Watson Northeast, Inc | 990 | $13,733 10.0% of $137,182 |
| Vision | Vision Service Plan | Mercer (Us), Inc. | 990 | $-1 0.0% of $137,182 |
| Life | Hartford Life And Accident | Willis Towers Watson Northeast, Inc | 2024 | $22,183 2.9% of $765,450 |
| Life | Hartford Life And Accident | Willis Towers Watson | 2024 | $8,889 1.2% of $765,450 |
| Life | Hartford Life And Accident | Mercer Human Resource Consulting | 2024 | $2,779 0.4% of $765,450 |
| Life | Hartford Life And Accident | Mercer (Us), Inc. | 2024 | $116 0.0% of $765,450 |
| Legal | Metlife Legal Plans | Willis Towers Watson Northeast, Inc | 88 | $2,042 10.7% of $19,091 |
| Legal | Metlife Legal Plans | Businessolver.Com, Inc. | 88 | $481 2.5% of $19,091 |
| Legal | Metlife Legal Plans | Willis Towers Watson Northeast, Inc | 88 | $179 0.9% of $19,091 |
| Legal | Metlife Legal Plans | Mercer H&B Administration | 88 | $22 0.1% of $19,091 |
| Accidental Death And Dismemberment | Hartford Life And Accident Insurance Co | Willis Towers Watson Northeast, Inc | 2273 | $1,503 5.5% of $27,251 |
| Accidental Death And Dismemberment | Hartford Life And Accident Insurance Co | Mercer (Us), Inc. | 2273 | $185 0.7% of $27,251 |
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.