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Employer
1025 Andrew Drive, West Chester, PA 19380 · EIN 45-3278558 · Oct 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 $6,245
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Metropolitan Life Insurance Company | Gis Benefits | 581 | $2,579 6.6% of $39,147 |
| Dental | Metropolitan Life Insurance Company | Onedigital (Philadelphia) | 581 | $1,711 4.4% of $39,147 |
| Vision | National Vision Administrators LLC | Onedigital (Philadelphia) | 332 | $445 10.0% of $4,453 |
| Supplemental | Colonial Life & Accident Insurance Company | Synolos Inc | 15 | $269 18.3% of $1,468 |
| Supplemental | Colonial Life & Accident Insurance Company | The Clark Group Of Sc | 15 | $134 9.1% of $1,468 |
| Supplemental | Colonial Life & Accident Insurance Company | Onedigital (Philadelphia) | 15 | $118 8.0% of $1,468 |
| Supplemental | Colonial Life & Accident Insurance Company | Alice Ryan Stribling | 15 | $72 4.9% of $1,468 |
| Supplemental | Colonial Life & Accident Insurance Company | Advanced Benefit System Inc | 15 | $14 1.0% of $1,468 |
| Supplemental | Colonial Life & Accident Insurance Company | Brooke Harmon & Associates LLC | 15 | $3 0.2% of $1,468 |
| Other | Reliance Standard Life Insurance Company | Onedigital (Philadelphia) | 364 | $478 12.7% of $3,752 |
| Other | Colonial Life & Accident Insurance Company | Synolos Inc | 24 | $325 10.8% of $3,016 |
| Other | Colonial Life & Accident Insurance Company | Onedigital (Philadelphia) | 24 | $92 3.1% of $3,016 |
| Other | Colonial Life & Accident Insurance Company | The Clark Group Of Sc | 24 | $3 0.1% of $3,016 |
| Other | Colonial Life & Accident Insurance Company | Alice Ryan Stribling | 24 | $1 0.0% of $3,016 |
| Other | Colonial Life & Accident Insurance Company | Advanced Benefit System Inc | 24 | $1 0.0% of $3,016 |
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | 240 | Comp not disclosed Premium $123,459 |
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.
Visible subtotal $48,587
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $26,363 | $109.85 |
| The Benecon Group | Broker | $11,065 | $46.10 |
| Independence Administrators (Ia) | Admin | $7,321 | $30.50 |
| ConnectCare3 | Patient Advocate | $3,838 | $15.99 |