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Employer
100 Witmer Road, Suite 350, Horsham, PA 19044 · EIN 23-1980475 · Dec 1, 2024 to Nov 30, 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 $138,680
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Nfp Corporate Services (Pa), Inc. | 362 | $119,890 4.7% of $2,535,216 |
| Dental | Delta Dental Of Pennsylvania | Nfp Corporate Services (Pa), Inc. | 60 | $464 4.5% of $10,217 |
| Dental | Delta Dental Of Pennsylvania | Nfp Corporate Services (Pa), Inc. | 247 | $5,739 4.6% of $124,343 |
| Vision | Vision Service Plan | Nfp Corporate Services (Pa), Inc. | 157 | $1,153 5.3% of $21,631 |
| Life | Reliance Standard Life Insurance Company | Nfp Corporate Services (Pa), Inc. | 73 | $4,795 17.0% of $28,206 |
| Life | Reliance Standard Life Insurance Company | Nfp Insurance Services Inc | 73 | $329 1.2% of $28,206 |
| Life | Reliance Standard Life Insurance Company | Nfp Corporate Services (Pa), Inc. | 254 | $1,145 13.0% of $8,813 |
| Life | Reliance Standard Life Insurance Company | Nfp Insurance Services Inc | 254 | $116 1.3% of $8,813 |
| Other | Independence Blue Cross | — | 293 | Comp not disclosed Premium $86,299 |
| Other | Reliance Standard Life Insurance Company | Nfp Coprorate Services (Pa), Inc. | 246 | $4,050 12.3% of $32,863 |
| Other | Reliance Standard Life Insurance Company | Nfp Insurance Services Inc | 246 | $413 1.3% of $32,863 |
| Accidental Death And Dismemberment | Reliance Standard Life Insurance Company | Nfp Corporate Services (Pa), Inc. | 46 | $553 17.0% of $3,255 |
| Accidental Death And Dismemberment | Reliance Standard Life Insurance Company | Nfp Insurance Services Inc | 46 | $33 1.0% of $3,255 |
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.