Employer
Local 360 Health Fund
Tri-State Adm C/O Frank Vaccaro A, Newtown, PA 18940 · EIN 22-6084338 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $11,718
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Cigna Health And Life Insurance Company And Affiliates | Alliant Insurance Services, Inc. | 1353 | $11,718 2.0% of $586,414 |
Schedule C
Additional compensation
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 $1,542,668
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Tri-State Administrators | None | $718,941 | $461.75 |
| Inedpendence Blue Cross | None | $481,887 | $309.50 |
| Morgan, Lewis & Brockius, LLP | None | $162,906 | $104.63 |
| Express Scripts, Inc | None | $52,245 | $33.55 |
| Baratz & Associates, Pa | None | $36,225 | $23.27 |
| Spear Wilderman Pc | None | $35,845 | $23.02 |
| Magna Care Administrators, Inc | None | $29,705 | $19.08 |
| Merrill Lynch Pierce Fenner & Smith | None | $14,914 | $9.58 |
| Richard Gabriel & Associates, Pa | None | $10,000 | $6.42 |