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Employer
749 Norway Rd., Chadds Ford, PA 19317 · EIN 23-2459092 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $691
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 24 | Comp not disclosed Premium $114,024 |
| Dental | Metropolitan Life Insurance Company | — | 32 | Comp not disclosed Premium $8,624 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Bernard L. Jessup Iii | 9 | $205 3.0% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Life And Health Ins Svcs | 9 | $167 2.5% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Michael F. Randler Jr. | 9 | $160 2.4% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Chris Walker | 9 | $73 1.1% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Kenneth B Cofer | 9 | $22 0.3% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Stephen Stefanick | 9 | $16 0.2% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Rosa Liliana Ortiz | 9 | $12 0.2% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Lisa Capozzi | 9 | $11 0.2% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | John T. Capozzi | 9 | $10 0.1% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Michael Hensh | 9 | $6 0.1% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Michael C. Walker | 9 | $6 0.1% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Frederick W. Wilson Iii | 9 | $2 0.0% of $6,729 |
| Voluntary Accident, Hospital, Critical Care, Cancer | Aflac | Gregory D. Hill | 9 | $1 0.0% of $6,729 |
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.