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Employer
3737 Market Street, Philadelphia, PA 19104 · EIN 46-2654405 · 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 $414,623
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Flexible Benefit Plans, Inc. | 1573 | $217,016 2.2% of $9,662,459 |
| Dental | Metropolitan Life Insurance Company | Pentra LLC | 1475 | $19,243 2.5% of $764,537 |
| Vision | Fidelity Security Life Insurance Company | Pentra, LLC | 1553 | $13,188 10.1% of $131,015 |
| Vision | Fidelity Security Life Insurance Company | Pentra, LLC | 165 | $294 10.1% of $2,921 |
| Life | Life Insurance Company Of North America | Pentra LLC | 925 | $15,334 4.0% of $383,298 |
| Life | Life Insurance Company Of North America | American Insurance Administrators | 925 | $6,733 1.8% of $383,298 |
| AD&D | Life Insurance Company Of North America | Pentra LLC | 878 | $2,402 2.6% of $92,633 |
| AD&D | Life Insurance Company Of North America | American Insurance Administrators | 878 | $1,660 1.8% of $92,633 |
| AD&D | National Union Fire Ins. Co. Of Pittsburgh, Pa | Aon Consulting, Inc. | 840 | $1,340 20.0% of $6,701 |
| Other | Independence Blue Cross | Flexible Benefit Plans, Inc. | 1070 | $101,245 2.4% of $4,287,041 |
| Other | Life Insurance Company Of North America | Pentra LLC | 687 | $30,120 8.4% of $360,089 |
| Other | Life Insurance Company Of North America | American Insurance Administrators | 687 | $6,048 1.7% of $360,089 |
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.