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Employer
1845 Walnut Street, Philadelphia, PA 19103 · EIN 23-2734102 · 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 $48,647
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Vision | Eyemed Vision Care On Behalf Of Fidelity Security Life Insurance Co. | Acrisure, LLC DBA Ashton Benefits | 274 | $1,766 8.0% of $21,958 |
| Life | Hartford Life And Accident | Group Benefits Limited | 263 | $14,779 12.7% of $116,025 |
| Life | Hartford Life And Accident | Acrisure, LLC DBA Ashton Benefits | 263 | $6,975 6.0% of $116,025 |
| Life | Hartford Life And Accident | Acrisure, LLC DBA Ashton Benefits | 263 | $1,468 1.3% of $116,025 |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Life | Colonial Life And Accident Insurance Company | — | 105 | Schedule A not provided |
| Employee Assistance Program | Main Line Health | — | 345 | Comp not disclosed Premium $4,802 |
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.