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Employer
301 South 8th Street, Philadelphia, PA 19106 · EIN 23-3030169 · Jan 1, 2025 to Dec 31, 2025
Plan year 2025
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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 $143,445
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Highmark Inc. | Lisa J Severo | 128 | $98,085 4.0% of $2,476,010 |
| Dental | United Concordia Insurance Company | Onedigital (Philadelphia) | 106 | $5,142 5.9% of $87,255 |
| Dental | United Concordia Insurance Company | Emerson Rogers LLC | 106 | $4,404 5.0% of $87,255 |
| Life | Prudential Insurance Company Of America | — | 64 | Comp not disclosed Premium $29,686 |
| AD&D | Prudential Insurance Company Of America | — | 118 | Comp not disclosed Premium $5,717 |
| Other | Prudential Insurance Company Of America | Elite Group LLC | 142 | $35,788 43.7% of $81,827 |
| Other | Prudential Insurance Company Of America | Img | 142 | $26 0.0% of $81,827 |
| Ltd Buy Up | Prudential Insurance Company Of America | — | 43 | Comp not disclosed Premium $73,179 |
| Supplemental Dependent Life | Prudential Insurance Company Of America | — | 12 | Comp not disclosed Premium $461 |
| Supplemental Dependent Life Spouse | Prudential Insurance Company Of America | — | 22 | Comp not disclosed Premium $8,136 |
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.
No Schedule C parties in this year.