Employer
Self, Inc.
1500 Walnut Street,, Philadelphia, PA 19102 · EIN 23-2650217 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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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 $15,627
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Life | Equitable Financial Life Insurance Company Of America | — | 123 | Schedule A not provided |
| Life | Equitable Financial Life Insurance Company Of America | — | 123 | Schedule A not provided |
| Life | Equitable Financial Life Insurance Company Of America | — | 123 | Schedule A not provided |
| Employee Assistance Program | Main Line Health | — | 133 | Comp not disclosed Premium $3,384 |
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.