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Employer
1500 Walnut Street, 17th Floor, Philadelphia, PA 19102 · EIN 23-2865855 · Jan 1, 2022 to Dec 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 $91,497
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Nfp Corporate Services (Pa), Inc. | 165 | $33,769 3.0% of $1,122,614 |
| Medical | Independence Blue Cross | Willis Towers Watson Northeast, Inc | 165 | $13,888 1.2% of $1,122,614 |
| Medical | Keystone Health Plan East | Nrp Corporate Services (Pa), Inc | 15 | $2,850 2.7% of $105,887 |
| Medical | Keystone Health Plan East | Willis Towers Watson Northeast, Inc | 15 | $1,455 1.4% of $105,887 |
| Dental | United Concordia Insurance Company | Nfp Corporate Services (Pa), Inc. | 173 | $2,551 3.5% of $73,393 |
| Dental | United Concordia Insurance Company | Willis Towers Watson Northeast, Inc | 173 | $1,868 2.5% of $73,393 |
| Dental | United Concordia Dental Plans Of Pennsylvania, Inc. | Nfp Corporate Services (Pa), Inc. | 18 | $139 3.6% of $3,884 |
| Dental | United Concordia Dental Plans Of Pennsylvania, Inc. | Willis Towers Watson Northeast, Inc | 18 | $94 2.4% of $3,884 |
| Vision | Heartland | — | 184 | Comp not disclosed Premium $8,585 |
| Life | Symetra Life Insurance Company | Nfp Corporate Services (Pa), Inc. | 138 | $17,565 16.1% of $109,325 |
| Life | Symetra Life Insurance Company | Willis Towers Watson Northeast, Inc | 138 | $2,409 2.2% of $109,325 |
| Other | Independence Blue Cross | Nfp Corporate Services (Pa), Inc. | 158 | $10,761 3.3% of $329,310 |
| Other | Independence Blue Cross | Willis Towers Watson Northeast, Inc | 158 | $4,148 1.3% of $329,310 |
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.