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Employer
500 Chesterfield Pkwy, Malvern, PA 19355 · EIN 20-0903358 · 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 $28,248
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 119 | Comp not disclosed Premium $155,659 |
| Dental | Metropolitan Life Insurance Company | Digital Insurance, Inc. | 207 | $6,760 6.1% of $110,248 |
| Dental | Metropolitan Life Insurance Company | Onedigital Premier Services | 207 | $6,233 5.7% of $110,248 |
| Dental | Metropolitan Life Insurance Company | Centro Benefits Research LLC | 207 | $260 0.2% of $110,248 |
| Dental | Metropolitan Life Insurance Company | Digital Insurance, Inc. | 225 | $8,469 6.5% of $129,527 |
| Dental | Metropolitan Life Insurance Company | Onedigital Premier Services | 225 | $6,526 5.0% of $129,527 |
| EAP | Revivehealth | — | — | Schedule A not provided |
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $1,050 |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | 112 | Comp not disclosed Premium $749,822 |
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 $167,040
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Onedigital (Philadelphia) | Broker | $15,930 | $133.87 |
| The Benecon Group, LLC | Broker | $9,377 | $78.80 |
| Independence Administrators | Admin | $5,288 | $44.44 |
| Connectcare 3 | Patient Advocate | $1,933 | $16.24 |
| Onedigital (Philadelphia) | Broker | $69,133 | $580.95 |
| The Benecon Group, LLC | Broker | $40,572 | $340.94 |
| Independence Administrators | Admin | $24,807 | $208.46 |