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Employer
P.O. Box 368, Kennett Square, PA 19348 · EIN 23-2444781 · Dec 1, 2023 to Nov 30, 2024
Plan year 2023
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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 $98,420
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Kistler Tiffany Benefits Co | 165 | $66,335 6.7% of $995,708 |
| Medical | Independence Blue Cross | Benefitmall.Com/Centerstone | 165 | $-15 0.0% of $995,708 |
| Dental | The Guardian Life Insurance Company Of America | Creative Benefits, Inc | 125 | $2,998 5.8% of $51,450 |
| Dental | The Guardian Life Insurance Company Of America | Onedigital Premier Services Ll | 125 | $2,573 5.0% of $51,450 |
| Dental | The Guardian Life Insurance Company Of America | Kistler Tiffany Benefits Co | 125 | $1,425 2.8% of $51,450 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Creative Benefits, Inc | 120 | $14,952 11.5% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Roth Voluntary Benefit Services Inc | 120 | $4,693 3.6% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Fulvio A. Acosta | 120 | $1,996 1.5% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | O'Neil Voluntary Benefit Services | 120 | $1,995 1.5% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Brad Lee Mundy | 120 | $528 0.4% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Nicholas Cusmano | 120 | $302 0.2% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Eduardo Tucto | 120 | $165 0.1% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Anthony Mosley | 120 | $116 0.1% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Michael J. Perri | 120 | $106 0.1% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Lisa A. Perri | 120 | $96 0.1% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Lauren Ashley Perri | 120 | $73 0.1% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Tucto & Associates Corp. | 120 | $49 0.0% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Rochelle Diane Kelly-Perry Thomas | 120 | $31 0.0% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Shane Thomas Williams | 120 | $1 0.0% of $129,579 |
| Voluntary Worksite Benefits | Colonial Life & Accident Insurance Company | Edward J. Williams | 120 | $1 0.0% of $129,579 |
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.