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Employer
1735 Market St, Philadelphia, PA 19103 · EIN 23-0888490 · Mar 1, 2024 to Feb 28, 2025
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 $97,769
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Marsh & Mclennan Agency, LLC East | 103 | $38,460 3.6% of $1,065,545 |
| Medical | Keystone Health Plan East | Marsh & Mclennan Agency, LLC East | 35 | $14,487 3.8% of $378,397 |
| Dental | United Concordia Insurance Company | Marsh & Mclennan Agency, LLC East | 147 | $5,445 9.1% of $59,565 |
| Vision | National Vision Administrators, LLC | Marsh & Mclennan Agency, LLC East | 114 | $676 10.0% of $6,756 |
| Life | Aflac -Continental American Insurance Company | See Attached | 1 | $54 10.9% of $496 |
| Life | Aflac -Continental American Insurance Company | See Attached | 5 | $767 9.5% of $8,059 |
| Life | The Guardian Life Insurance Company Of America | Marsh & Mclennan Agency, LLC East | 139 | $32,337 16.0% of $202,140 |
| Life | The Guardian Life Insurance Company Of America | Amerihealth Administrators, Inc. | 139 | $4,043 2.0% of $202,140 |
| Life | Aflac -Continental American Insurance Company | See Attached | 2 | $240 10.6% of $2,270 |
| Business Travel Accident | Federal Insurance Company | Marcer Health And Benefit LLC | 139 | $1,260 30.0% of $4,200 |
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.