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Employer
275 Commerce Drive, Suite 100, Ft Washington, PA 19034 · EIN 23-2221740 · 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 $84,328
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | 86 | Comp not disclosed Premium $117,832 |
| Dental | The Guardian Life Insurance Company Of America | — | — | Schedule A not provided |
| Life | Mony Life Insurance Company Of America | — | — | Schedule A not provided |
| Medical | Highmark, Inc. | Donald C Savoy Inc | 194 | $9,250 0.8% of $1,151,333 |
| Medical | Highmark, Inc. | Wehmeyer, William H | 194 | $46,578 4.0% of $1,151,333 |
| Medical | Highmark, Inc. | Risk Placement Services Inc | 194 | $1,840 0.2% of $1,151,333 |
| Dental + Vision | Guardian Life Insurance Company | Onedigital Premier Services Ll | 124 | $8,212 5.0% of $164,238 |
| Dental + Vision | Guardian Life Insurance Company | Kistler Tiffany Benefits Co | 124 | $18,448 11.2% of $164,238 |
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 $22,744
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Michael Kelly | Broker | $10,349 | $120.34 |
| The Benecon Group | Broker | $5,262 | $61.19 |
| Independence Administrators (Ia) | Admin | $5,692 | $66.19 |
| ConnectCare3 | Patient Advocate | $1,441 | $16.76 |