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Employer
441 North 5th Street 4th Floor, Philadelphia, PA 19123 · EIN 23-2341897 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $15,987
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Optum Health (Unimerica Insurance Company) | — | — | Comp not disclosed Premium $328 |
| Stop-loss | Crum & Forster | — | 97 | Comp not disclosed Premium $430,384 |
| Dental | Standard Insurance Company | Corporate Synergies Group, LLC | 95 | $5,348 9.0% of $59,416 |
| Vision | Unitedhealthcare Insurance Company | Corporate Synergies Group, LLC | 42 | $897 10.0% of $8,973 |
| Vision | Standard Insurance Company | Corporate Synergies Group, LLC | 95 | $327 9.0% of $3,632 |
| Life | Standard Insurance Company | Corporate Synergies Group, LLC | 45 | $2,429 16.3% of $14,892 |
| Other | Standard Insurance Company | Corporate Synergies Group, LLC | 36 | $2,716 15.2% of $17,924 |
| Other | Standard Insurance Company | Corporate Synergies Group, LLC | 124 | $4,270 5.1% of $82,996 |
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 $142,204
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group, LLC | Broker | $81,842 | $660.02 |
| Corporate Synergies Group, LLC | Broker | $44,156 | $356.10 |
| Meritain Health, An Aetna Company | Admin | $16,206 | $130.69 |