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Employer
340 North 12th Street, Philadelphia, PA 19107 · EIN 23-3032718 · Aug 1, 2024 to Jul 31, 2025
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 $384,800
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Cbiz Benefits & Ins. Services | 494 | $309,298 5.8% of $5,370,072 |
| Dental | United Concordia Insurance Company | Cbiz Benefits & Ins. Services | 563 | $8,795 5.0% of $174,998 |
| Vision | Eyemed Vision Care | Cbiz - Dublin, Oh | 505 | $2,527 9.2% of $27,590 |
| Vision | Eyemed Vision Care | Cbiz - Dublin, Oh | 1 | $5 9.4% of $53 |
| Life | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 860 | $4,012 5.0% of $80,248 |
| Life | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 860 | $4,012 5.0% of $80,248 |
| Life | Provident Life And Accident Insurance Company | Cbiz Benefits & Ins. Services | — | $7,264 57.9% of $12,539 |
| Life | Provident Life And Accident Insurance Company | Mcclellan, David J | — | $2,825 22.5% of $12,539 |
| Life | Provident Life And Accident Insurance Company | Mcclellan, David | — | $1,682 13.4% of $12,539 |
| Life | Provident Life And Accident Insurance Company | Cbiz Benefits & Ins. Services | — | $404 3.2% of $12,539 |
| Other | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 22 | $1,615 17.1% of $9,436 |
| Other | Unum Life Insurance Company Of America | Cbiz Benefits & Ins. Services | 22 | $472 5.0% of $9,436 |
| Grp Accident | Unum Insurance Company | Cbiz Benefits & Ins. Services | 286 | $4,087 15.1% of $27,101 |
| Grp Accident | Unum Insurance Company | Mcclellan, David | 286 | $3,693 13.6% of $27,101 |
| Grp Accident | Unum Insurance Company | Mcclellan, David J | 286 | $1,362 5.0% of $27,101 |
| Grp Accident | Unum Insurance Company | Cbiz Benefits & Ins. Services | 286 | $968 3.6% of $27,101 |
| Attained Age Critical Illness | Unum Insurance Company | Cbiz Benefits & Ins. Services | 172 | $6,594 15.0% of $43,930 |
| Attained Age Critical Illness | Unum Insurance Company | Mcclellan, David | 172 | $6,580 15.0% of $43,930 |
| Attained Age Critical Illness | Unum Insurance Company | Mcclellan, David J | 172 | $2,202 5.0% of $43,930 |
| Attained Age Critical Illness | Unum Insurance Company | Cbiz Benefits & Ins. Services | 172 | $1,654 3.8% of $43,930 |
| Hospital Ee Paid | Unum Insurance Company | Cbiz Benefts & Insurance Serv | 157 | $5,787 15.0% of $38,481 |
| Hospital Ee Paid | Unum Insurance Company | Mcclellan, David | 157 | $5,603 14.6% of $38,481 |
| Hospital Ee Paid | Unum Insurance Company | Mcclellan, David J | 157 | $1,933 5.0% of $38,481 |
| Hospital Ee Paid | Unum Insurance Company | Cbiz Benefts & Insurance Serv | 157 | $1,426 3.7% of $38,481 |
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.