Employer

New Rue21, LLC

153 Jefferson Ave #618, Washington, PA 15301 · EIN 82-2784521 · Jan 1, 2024 to May 31, 2024

Plan year 2024

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Schedule A

Direct compensation

Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.

Visible subtotal $25,484

Coverage	Carrier	Broker	Lives	Direct comp
Dental	Delta Dental Of Pennsylvania	Rsc Ins Brokerage Inc	1271	$3,366 3.2% of $104,317
Dental	Delta Dental Of Pennsylvania	Willis Towers Watson Northeast, Inc	1271	$806 0.8% of $104,317
Vision	Highmark, Inc.	Alliant Insurance Services, Inc.	903	$54 0.2% of $28,913
Life	Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	1296	$1,664 2.3% of $72,401
Life	Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	1296	$1,548 2.1% of $72,401
Life	Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	1296	$407 0.6% of $72,401
Accident	The Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	142	$1,404 10.5% of $13,370
Accident	The Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	142	$853 6.4% of $13,370
Accident	The Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	142	$418 3.1% of $13,370
Critical Illness	The Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	167	$1,635 10.3% of $15,843
Critical Illness	The Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	167	$1,044 6.6% of $15,843
Critical Illness	The Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	167	$489 3.1% of $15,843
Hospital Indemnity	The Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	97	$2,628 11.0% of $23,828
Hospital Indemnity	The Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	97	$1,374 5.8% of $23,828
Hospital Indemnity	The Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	97	$764 3.2% of $23,828
Other	Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	252	$1,152 2.3% of $50,841
Other	Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	252	$1,095 2.2% of $50,841
Other	Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	252	$295 0.6% of $50,841
Other	Lincoln National Life Insurance Company	Rsc Insurance Brokerage, Inc.	306	$2,030 2.3% of $89,758
Other	Lincoln National Life Insurance Company	Alliant Insurance Services, Inc.	306	$1,988 2.2% of $89,758
Other	Lincoln National Life Insurance Company	Willis Towers Watson Northeast, Inc	306	$470 0.5% of $89,758