Loading employer…
Employer
3675 Amber Street, Philadelphia, PA 19134 · EIN 23-2462361 · Jan 1, 2024 to Dec 31, 2024
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $39,366
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Principal Life Insurance Company | Onedigital Premier Services | 143 | $2,400 4.2% of $57,723 |
| Life | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 184 | $6,903 9.7% of $71,402 |
| Life | Unum Life Insurance Company Of America | Onedigital Premier Services LLC | 184 | $5,060 7.1% of $71,402 |
| AD&D | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 54 | $4,063 16.8% of $24,219 |
| AD&D | Unum Life Insurance Company Of America | Centro Benefits Research LLC | 54 | $1,195 4.9% of $24,219 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Premier Worksite Solutions LLC | 95 | $3,665 11.6% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Onedigital (Philadelphia) | 95 | $1,571 5.0% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Leon L. Levy & Associates | 95 | $346 1.1% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Skiles, Timothy Nash | 95 | $126 0.4% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Digital Insurance, Inc. | 95 | $59 0.2% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Marsh & Mclennan Agency, LLC East | 95 | $42 0.1% of $31,526 |
| Accident, Critillnes, Istdprotect, Iswl Stnd, Whole Life | Provident Life And Accident Insurance Company | Levy, Leon Lous | 95 | $2 0.0% of $31,526 |
| Select Long Term Disability | Unum Life Insurance Company Of America | Kistler Tiffany Benefits Co | 29 | $2,249 9.0% of $24,950 |
| Select Long Term Disability | Unum Life Insurance Company Of America | Onedigital Premier Services L | 29 | $1,925 7.7% of $24,950 |
| Select Long Term Disability | Unum Life Insurance Company Of America | Premier Worksite Solutions LLC | 29 | $1,729 6.9% of $24,950 |
| Ci, Acc | Unum Life Insurance Company Of America | Premier Worksite Solutions LLC | 66 | $5,399 23.5% of $23,003 |
| Ci, Acc | Unum Life Insurance Company Of America | Onedigital (Philadelphia) | 66 | $2,315 10.1% of $23,003 |
| Ci, Acc | Unum Life Insurance Company Of America | Skiles, Timothy, Nash | 66 | $222 1.0% of $23,003 |
| Ci, Acc | Unum Life Insurance Company Of America | Digital Insurance, Inc. | 66 | $95 0.4% of $23,003 |
| Stop-loss | HM Life Insurance Company | — | — | Comp not disclosed Premium $668 |
| Stop-loss | Sun Life Assurance Company | — | 93 | Comp not disclosed Premium $462,648 |
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 $96,421
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $49,410 | $520.11 |
| The Benecon Group, LLC | Broker | $23,405 | $246.37 |
| Independence Administrators (Ia) | Admin | $17,435 | $183.53 |
| Connectcare3, LLC | Patient Advocate | $6,171 | $64.96 |