Employer
Pjtc Holdings, Inc. Health And Welfare Plan
30 Isabella St Ste 500, Pittsburgh, PA 15212 · EIN 85-3282184 · Sep 1, 2024 to Aug 31, 2025
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 $51,383
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Upmc Health Plan | Henderson Brothers Inc. | 1457 | $33,394 5.0% of $672,723 |
| Stop-loss | Upmc Health Plan | Henderson Brothers Inc. | 209 | Comp not disclosed Premium $73,974 |
| Dental | Metropolitan Life Insurance Company | Henderson Brothers Inc. | 1754 | $6,941 1.7% of $396,655 |
| Vision | Upmc Health Plan | Henderson Brothers Inc. | 1229 | Comp not disclosed Premium $87,931 |
| Vision | Upmc Health Plan | Henderson Brothers Inc. | 209 | Comp not disclosed Premium $14,709 |
| Life | Metropolitan Life Insurance Company | Henderson Brothers Inc. | 1754 | $4,294 2.0% of $217,205 |
| Other | Metropolitan Life Insurance Company | Henderson Brothers Inc. | 1754 | $6,754 2.8% of $239,284 |
Schedule C
Additional compensation
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 $478,344
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Upmc Health Plan | Admin | $478,344 | $272.72 |