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Employer
12275 Townsend Road, Philadelphia, PA 19154 · EIN 23-1685740 · 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 $23,471
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Gerber Life Insurance Company | Labor First LLC | 55 | $22,715 12.0% of $189,288 |
| Life | Unum Life Insurance Company Of America | Gallagher Belmont | 31 | $672 9.8% of $6,837 |
| Life | Unum Life Insurance Company Of America | Gallagher Fiduciary Advisors, LLC | 31 | $84 1.2% of $6,837 |
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 $593,360
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| John C. Dulczak | Employee | $211,946 | $1,843.01 |
| Deborah Pietkowski | None | $69,179 | $601.56 |
| Pamela Palmer | Employee | $64,082 | $557.23 |
| Bridgeway Benefit Technologies | None | $54,544 | $474.30 |
| Horizon Healthcare Services | None | $50,864 | $442.30 |
| Richard Mcneil | Employee | $44,022 | $382.80 |
| Wells Fargo Advisors | None | $33,765 | $293.61 |
| Fischer Dorwart, Pc | None | $26,505 | $230.48 |
| Beacon Administrators | None | $25,892 | $225.15 |
| Old Glory Asset Management | None | $12,561 | $109.23 |
| Labor First, LLC | None | Comp not disclosed | — |