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Employer
1500 John F. Kennedy Boulevard,, Philadelphia, PA 19102 · EIN 23-2881535 · Oct 1, 2020 to Sep 30, 2021
Plan year 2020
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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 $57,260
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Cigna Health And Life Insurance Company | — | 130 | Schedule A not provided |
| Dental | The Lincoln National Life Insurance Company | Usi Insurance Services (Ri) | 749 | $9,397 10.7% of $87,629 |
| Dental | The Lincoln National Life Insurance Company | Usi Insurance Services (Ri) | 749 | $710 0.8% of $87,629 |
| Vision | Heartland | Usi Insurance Services (Ri) | 667 | $1,306 2.7% of $47,501 |
| Life | Provident Life And Accident Insurance Company | Custom Benefit Programs, Inc. | 125 | $6,455 21.7% of $29,732 |
| Life | Provident Life And Accident Insurance Company | Usi Insurance Services (Ri) | 125 | $804 2.7% of $29,732 |
| Life | Provident Life And Accident Insurance Company | Usi Insurance Services (Ri) | 125 | $174 0.6% of $29,732 |
| Life | First Unum Life Insurance Company | Custom Benefit Programs, Inc. | 4 | $136 25.1% of $542 |
| Life | First Unum Life Insurance Company | Usi Insurance Services (Ri) | 4 | $21 3.9% of $542 |
| Life | First Unum Life Insurance Company | Usi Insurance Services (Ri) | 4 | $3 0.6% of $542 |
| Accident | Unum Life Insurance Company Of America | Custom Benefit Programs, Inc. | 246 | $6,237 11.0% of $56,641 |
| Accident | Unum Life Insurance Company Of America | Usi Insurance Services (Ri) | 246 | $742 1.3% of $56,641 |
| Accident | Unum Life Insurance Company Of America | Usi Insurance Services (Ri) | 246 | $336 0.6% of $56,641 |
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.