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Employer
2701 E Luzerne Street, Philadelphia, PA 19137 · EIN 23-2894146 · 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 $1,394
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pennsylvania | — | 411 | Comp not disclosed Premium $123,827 |
| Vision | Heartland | Alera Group, Inc. DBA Pentra, LLC | 331 | Comp not disclosed Premium $18,557 |
| Life | Reliance Standard Life Insurance Company | Recode Health, LLC | 286 | $624 2.0% of $31,188 |
| Life | Reliance Standard Life Insurance Company | Pentra, LLC | 286 | Comp not disclosed Premium $31,188 |
| AD&D | Reliance Standard Life Insurance Company | Recode Health, LLC | 244 | $97 2.0% of $4,847 |
| AD&D | Reliance Standard Life Insurance Company | Pentra, LLC | 244 | Comp not disclosed Premium $4,847 |
| AD&D | Reliance Standard Life Insurance Company | Hoy, Stephen | 244 | Comp not disclosed Premium $4,847 |
| (Voluntary) | Reliance Standard Life Insurance Company | Pentra, LLC | 150 | Comp not disclosed Premium $66,026 |
| Other | Reliance Standard Life Insurance Company | Recode Health, LLC | 286 | $673 2.0% of $33,672 |
| Other | Reliance Standard Life Insurance Company | Pentra, LLC | 286 | Comp not disclosed Premium $33,672 |
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.