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Employer
1600 Market St., Suite 3600, Philadelphia, PA 19103 · EIN 23-1383844 · Jan 1, 2022 to Dec 31, 2022
Plan year 2022
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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 $133,022
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Carebridge Corporation | — | 199 | Comp not disclosed Premium $5,670 |
| Medical | Hartford Life And Accident | William A Graham Company | 75 | $9,298 15.4% of $60,241 |
| Medical | Independence Blue Cross | William A Graham Company | 245 | $89,059 4.4% of $2,043,316 |
| Medical | Unum Life Insurance Company Of America | Pacific Resources Benefits Adv | 48 | $1,416 5.6% of $25,281 |
| Medical | Unum Life Insurance Company Of America | William A Graham Company | 48 | $758 3.0% of $25,281 |
| Dental | United Concordia Insurance Company | William A Graham Company | 259 | $6,867 6.0% of $114,452 |
| Vision | Vision Benefits Of America | The Graham Company | 109 | $630 5.0% of $12,592 |
| Life | Unum Life Insurance Company Of America | William A Graham Company | 197 | $24,994 7.7% of $322,504 |
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 $257,804
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Schwab Retirement Plan Services,Inc | None | $191,432 | $651.13 |
| The Haverford Trust Company | None | $66,052 | $224.67 |
| Charles Schwab & Co., Inc. | None | $320 | $1.09 |