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Employer
1041 Andrew Dr., West Chester, PA 19380 · EIN 23-3077903 · Apr 1, 2022 to Mar 31, 2023
Plan year 2022
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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 $100,680
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Kistler Tiffany Benefits Co | 150 | $81,215 7.2% of $1,125,052 |
| Dental | Delta Dental Of Pennsylvania | Pcf Insurance Services Of The West | 33 | $1,882 10.1% of $18,717 |
| Vision | Eyemed | Peterman Benefits | 176 | $1,360 10.4% of $13,043 |
| Life | The Standard | Pcf Insurance Services Of The West | 221 | $2,611 9.5% of $27,617 |
| Life | The Standard | Onedigital (Philadelphia) | 221 | $1,614 5.8% of $27,617 |
| Other | The Standard | Pcf Insurance Services Of The West | 101 | $2,709 8.3% of $32,476 |
| Other | The Standard | Onedigital (Philadelphia) | 101 | $1,785 5.5% of $32,476 |
| Indemnity Contracts | The Standard | Pcf Insurance Services Of The West | 69 | $1,523 21.6% of $7,042 |
| Indemnity Contracts | The Standard | Onedigital (Philadelphia) | 69 | $212 3.0% of $7,042 |
| Other | The Standard | Pcf Insurance Services Of The West | 221 | $4,042 12.5% of $32,244 |
| Other | The Standard | Onedigital (Philadelphia) | 221 | $1,727 5.4% of $32,244 |
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.