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Employer
3333 South Front Street, Philadelphia, PA 19148 · EIN 23-1489642 · Apr 1, 2024 to Mar 31, 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 $22,834
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Brokerage Concepts, Inc. | — | 313 | Comp not disclosed Premium $594,965 |
| Stop-loss | Brokerage Concepts, Inc. | — | 199 | Comp not disclosed Premium $427,993 |
| Dental | Aetna Life Insurance Co. | Fna Insurance Services Inc | 205 | $1,024 4.9% of $20,784 |
| Dental | Aetna Life Insurance Co. | Hub International | 205 | $848 4.1% of $20,784 |
| Dental | Aetna Life Insurance Co. | Hub International | 205 | $724 3.5% of $20,784 |
| Vision | Vision Service Plan | Incentive Systems Inc | 124 | $1,241 5.1% of $24,507 |
| Vision | Vision Service Plan | — | 124 | Comp not disclosed Premium $24,507 |
| Life | Reliance Life Insurance Company | Incentive Systems | 307 | $13,449 14.5% of $93,008 |
| Life | Reliance Life Insurance Company | Gis Benefits Inc. 70-5383 | 307 | $4,651 5.0% of $93,008 |
| Life | Reliance Life Insurance Company | Gis Benefits Inc. 70-8714 | 307 | $126 0.1% of $93,008 |
| Life | Reliance Life Insurance Company | Gis Benefits Inc. 70-5627 | 307 | $771 0.8% of $93,008 |
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.