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Employer
400 Valley Rd., Warrington, PA 18976 · EIN 23-2739647 · 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 $47,463
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Sun Life Assurance Company Of Canada | — | 186 | Comp not disclosed Premium $718,266 |
| Dental + Vision | Sun Life Assurance Company Of Canada | Birch Benefits, LLC | 48 | $7,782 5.7% of $136,064 |
| Life | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 253 | $7,396 15.0% of $49,305 |
| Life | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 253 | $865 1.8% of $49,305 |
| AD&D | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 103 | $3,081 15.0% of $20,538 |
| AD&D | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 103 | $587 2.9% of $20,538 |
| Other | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 217 | $13,071 15.0% of $87,138 |
| Other | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 217 | $1,636 1.9% of $87,138 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 55 | $532 10.0% of $5,318 |
| Voluntary Critical Illness | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 55 | $100 1.9% of $5,318 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 62 | $982 10.0% of $9,817 |
| Voluntary Accident | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 62 | $173 1.8% of $9,817 |
| Other | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 217 | $7,235 10.0% of $72,353 |
| Other | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 217 | $1,375 1.9% of $72,353 |
| Voluntary Hospital Indemnity | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 41 | $2,434 20.0% of $12,168 |
| Voluntary Hospital Indemnity | United Of Omaha Life Insurance Company | Birch Benefits, LLC | 41 | $214 1.8% of $12,168 |
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 $351,574
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Birch Benefits, LLC | Broker | $117,660 | $449.08 |
| Umr | Admin | $233,914 | $892.80 |