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Employer
20 Stanwix Street, Pittsburgh, PA 15222 · EIN 25-0749630 · 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 $594,420
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | Hub International | 1551 | $244,709 8.2% of $2,984,259 |
| Medical | Highmark, Inc. | — | 6 | Comp not disclosed Premium $24,102 |
| Medical | Kaiser Foundation Health Plan, Inc. | Hub International | 59 | $15,291 2.4% of $637,443 |
| Medical | Kaiser Foundation Health Plan, Inc. | Hub International | 45 | $9,914 2.5% of $400,094 |
| Medical | Aetna Life Insurance Company | — | 4 | Comp not disclosed Premium $57,648 |
| Dental | Metropolitan Life Insurance Company | Hub International | 2958 | $36,071 3.0% of $1,214,255 |
| Dental | Metropolitan Life Insurance Company | Hub International | 2958 | $12,498 1.0% of $1,214,255 |
| Vision | Vision Service Plan | Hub International | 1356 | $4,939 2.0% of $247,157 |
| Life | Sun Life Assurance Company Of Canada | The Hdh Group, Inc. | 1941 | $24,254 2.0% of $1,195,878 |
| AD&D | Zurich American Insurance Company | Hub International | 2982 | $26,997 15.0% of $179,982 |
| AD&D | Zurich American Insurance Company | Hub International | 589 | $17,420 15.0% of $116,133 |
| Other | Highmark, Inc. | — | 779 | Comp not disclosed Premium $21,382 |
| Other | Unum Life Insurance Company Of America | The Hdh Group, Inc. | 1294 | $131,929 8.7% of $1,516,614 |
| Critical Illness, Accident, Hospital Indemnity | Unum Life Insurance Company Of America | Hub International | 1607 | $70,398 15.3% of $459,507 |
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 $1,652,541
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Highmark | None | $1,490,584 | $499.86 |
| Hub International | None | $54,739 | $18.36 |
| Oasis Software Ii, LLC | None | $47,950 | $16.08 |
| Wex, Inc. | None | $37,015 | $12.41 |
| Baker Tilly Usa | None | $16,300 | $5.47 |
| Bank Of New York Mellon | None | $5,953 | $2.00 |