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Employer
400 Reed Road, Broomall, PA 19008 · EIN 23-1660294 · Dec 1, 2020 to Nov 30, 2021
Plan year 2020
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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 $5,315
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross (Personal Choice) | — | 88 | Schedule A not provided |
| Medical | Aflac | Dorothy M Parra | 8 | $339 2.8% of $12,291 |
| Medical | Aflac | Andrew Parra | 8 | $209 1.7% of $12,291 |
| Medical | Aflac | Melanie R Palubicki | 8 | $112 0.9% of $12,291 |
| Medical | Aflac | Patriot (Exude, Inc.) | 8 | $111 0.9% of $12,291 |
| Medical | Aflac | Dorothy Ann Leary | 8 | $95 0.8% of $12,291 |
| Medical | Aflac | Exseptional Services Inc. | 8 | $90 0.7% of $12,291 |
| Medical | Aflac | Rita M Herington | 8 | $87 0.7% of $12,291 |
| Medical | Aflac | Svetlana Zeitlin | 8 | $66 0.5% of $12,291 |
| Medical | Aflac | Thomas J Poppert | 8 | $50 0.4% of $12,291 |
| Medical | Aflac | Tony J Delben | 8 | $43 0.3% of $12,291 |
| Medical | Aflac | Suzanne M Pratowski | 8 | $29 0.2% of $12,291 |
| Medical | Aflac | Caesar D Williams Jr | 8 | $26 0.2% of $12,291 |
| Medical | Aflac | Jose A Schieneman | 8 | $22 0.2% of $12,291 |
| Medical | Aflac | Supplemental Benefits Grp Of Pa Inc | 8 | $17 0.1% of $12,291 |
| Medical | Aflac | Laurie L Smith | 8 | $5 0.0% of $12,291 |
| Medical | Aflac | Michele L Bogrette | 8 | $5 0.0% of $12,291 |
| Medical | Aflac | Deborah L Poppert | 8 | $3 0.0% of $12,291 |
| Medical | Aflac | Eric Macdougall & Assoc Inc | 8 | $2 0.0% of $12,291 |
| Medical | Aflac | Darlene S Dillon | 8 | $2 0.0% of $12,291 |
| Dental | The Guardian Life Insurance Company Of America | Conner Strong & Buckelew Companies | 118 | $2,283 7.3% of $31,335 |
| Dental | The Guardian Life Insurance Company Of America | Independence Planning Group, L | 118 | $23 0.1% of $31,335 |
| Vision | Eyemed Vision Care (Fidelity Security Life Insurance Company) | Conner Strong & Buckelew Companies | 88 | $596 11.1% of $5,376 |
| Vision | Eyemed Vision Care (Fidelity Security Life Insurance Company) | — | 1 | Comp not disclosed Premium $75 |
| Life | Hartford Life And Accident | Conner Strong & Buckelew Companies | 193 | $1,100 10.0% of $11,007 |
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.