Employer
Qualtek LLC
475 Sentry Parkway East, Suite 200, Blue Bell, PA 19422 · EIN 46-0777008 · Jan 1, 2023 to Dec 31, 2023
Plan year 2023
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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 $619,361
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Cigna Health And Life Insurance Company And Affiliates | Gallagher Fiduciary Advisors, LLC | 1044 | $492,727 4.0% of $12,192,152 |
| Medical | Kaiser Foundation Health Plan Inc | Gallagher Fiduciary Advisors, LLC | 251 | $66,517 4.1% of $1,628,858 |
| Vision | Eyemed Vision Care On Behalf Of Fidelity Security Life Insurance Co. | Gallagher Fiduciary Advisors, LLC | 1793 | $4,743 3.7% of $127,411 |
| Life | Life Insurance Company Of North America | — | 1044 | Schedule A not provided |
| Life | Life Insurance Company Of North America | — | 1044 | Schedule A not provided |
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.
No Schedule C parties in this year.