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Employer
1000 Madison Ave, Norristown, PA 19403 · EIN 01-0661910 · Jul 1, 2024 to Jun 30, 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 $230,609
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Cigna Health And Life Insurance Company | Assured Partners (Central Pa) | 1732 | $35,095 4.9% of $712,392 |
| Vision | Vision Service Plan | Assured Partners (Central Pa) | 1495 | $6,294 3.0% of $209,832 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2248 | $8,839 9.0% of $98,207 |
| Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2248 | $7,843 8.0% of $98,207 |
| AD&D | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 930 | $3,438 13.0% of $26,445 |
| AD&D | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 930 | $2,093 7.9% of $26,445 |
| Opt Ltd | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2248 | $18,891 7.5% of $251,876 |
| Opt Ltd | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2248 | $19,818 7.9% of $251,876 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2247 | $8,893 3.0% of $296,443 |
| Other | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 2247 | $23,625 8.0% of $296,443 |
| Vol Child Life, Vol Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 930 | $28,810 13.0% of $221,616 |
| Vol Child Life, Vol Spouse Life, Voluntary Life | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 930 | $17,567 7.9% of $221,616 |
| Vol. Accident | Metropolitain Life Insurance Company | Assured Partners (Central Pa) | 507 | $18,210 20.9% of $87,141 |
| Vol. Accident | Metropolitain Life Insurance Company | Plan Source Benefits Admin. Inc. | 507 | $-8 0.0% of $87,141 |
| Vol. Critical Illness | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 703 | $20,089 20.7% of $96,915 |
| Vol. Critical Illness | Metropolitan Life Insurance Company | Plan Source Benefits Admin. Inc. | 703 | $11 0.0% of $96,915 |
| Vol. Hospital Indemnity | Metropolitan Life Insurance Company | Assured Partners (Central Pa) | 427 | $11,101 20.7% of $53,716 |
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 $824,397
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Administrators | Health/Rx Admin | $783,480 | $348.52 |
| Vsp | Vision Admin Fees | $40,917 | $18.20 |