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Employer
1350 Welsh Rd, North Wales, PA 19454 · EIN 23-6050758 · Jan 1, 2024 to Dec 31, 2024
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 $52,908
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance | — | 229 | Comp not disclosed Premium $730,986 |
| Dental | Metropolitan Life Insurance Company | Brown & Brown Of Pennsylvania | 741 | $29,252 8.6% of $338,675 |
| Dental | Metropolitan Life Insurance Company | Brown & Brown Of Pennsylvania | 741 | $15,439 4.6% of $338,675 |
| Dental | Metropolitan Life Insurance Company | Strategic Non-Medical Solutions LLC | 741 | $4,874 1.4% of $338,675 |
| Dental | Metropolitan Life Insurance Company | Brown & Brown Of Pennsylvania | 741 | $2,760 0.8% of $338,675 |
| Vision | National Vision Administrators, LLC | Brown & Brown Of Pennsylvania | 446 | $292 5.0% of $5,826 |
| Vision | National Vision Administrators, LLC | Brown & Brown Insurance Services, I | 446 | $291 5.0% of $5,826 |
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 $205,630
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pa | Broker | $114,924 | $155.09 |
| The Benecon Group, LLC | Broker | $42,402 | $57.22 |
| Independence Administrators | Carrier | $33,595 | $45.34 |
| ConnectCare3 | Patient Advocate | $14,709 | $19.85 |