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Employer
485 Devon Park Dr Ste 102, Wayne, PA 19087 · EIN 23-2079619 · Jan 1, 2024 to Dec 31, 2024
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 $180,732
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross Ppo | Emerson Rogers LLC | 287 | $2,203 1.2% of $177,829 |
| Medical | Keystone Health Plan | Emerson Rogers LLC | 231 | $64,623 3.7% of $1,738,686 |
| Medical | Independence Blue Cross Ppo | Emerson Rogers LLC | 250 | $74,715 4.0% of $1,876,095 |
| Dental | Delta Dental | Oneill Consulting Corp | 363 | $3,944 4.0% of $98,612 |
| Dental | Delta Dental | Oneill Consulting Corp | 312 | $4,107 4.0% of $102,687 |
| Dental | Delta Dental | Oneill Consulting Corp | 549 | $6,137 4.0% of $153,427 |
| Vision | Vision Bnenfits Of America | Oneill Consulting Corp | 227 | $427 4.3% of $10,002 |
| Vision | Vision Bnenfits Of America | Oneill Consulting Corp | 637 | $997 42.6% of $2,339 |
| Life | The Hartford | Oneill Consulting Corp | 1402 | $23,579 11.3% of $209,345 |
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 $12,000
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Anthony Pontarelli Cpa, LLC | None | $7,000 | $4.99 |
| Spear Wilderman | None | $5,000 | $3.57 |