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Employer
308 7th Avenue, Pittsburgh, PA 15222 · EIN 25-1121408 · Jul 1, 2022 to Oct 31, 2022
Plan year 2022
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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 $12,006
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Aetna Life Insurance Co. | — | — | Comp not disclosed Premium $92,989 |
| Dental | Aetna Life Insurance Co. | Babb Inc | — | $2,321 5.7% of $40,755 |
| Vision | Highmark | Babb Inc | — | $224 2.0% of $11,082 |
| Life | Life Insurance Company Of North America | Babb Inc | — | $3,323 5.0% of $66,453 |
| Other | Life Insurance Company Of North America | Babb Inc | — | $1,400 11.7% of $11,924 |
| Voluntary Critical Illness | Cigna Health And Life Insurance Company | Babb Inc | — | $572 15.0% of $3,815 |
| Other | Life Insurance Company Of North America | Babb Inc | — | $3,064 12.1% of $25,353 |
| Accidental Death & Dismemberment | Life Insurance Company Of North America | Babb Inc | — | $1,102 17.5% of $6,297 |
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 $36,780
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Aetna Life Insurance Company | Contract Administrator | $24,775 | $100.71 |
| Babb Inc | Insurance Broker | $12,005 | $48.80 |