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Employer
930 Harvest Dr, Suite 400, Blue Bell, PA 19422 · EIN 26-3161292 · 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 $21,240
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | — | Schedule A not provided |
| Dental | United Concordia Life And Health Insurance Company | Emerson Rogers LLC | 204 | $3,792 5.1% of $74,702 |
| Vision | Eyemed | Nfp Corporate Service Se | 187 | $1,095 9.9% of $11,032 |
| Life | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 160 | $1,030 15.1% of $6,802 |
| Life | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 160 | $73 1.1% of $6,802 |
| AD&D | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 74 | $6,344 19.6% of $32,446 |
| AD&D | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 74 | $308 0.9% of $32,446 |
| Other | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 11 | $808 20.4% of $3,952 |
| Other | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 11 | $45 1.1% of $3,952 |
| Voluntary Std | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 75 | $3,390 14.8% of $22,883 |
| Voluntary Std | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 75 | $229 1.0% of $22,883 |
| Other | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 11 | $334 15.5% of $2,159 |
| Other | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 11 | $24 1.1% of $2,159 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Nfp Corporate Services Se Inc | 52 | $3,590 18.1% of $19,848 |
| Voluntary Ltd | United Of Omaha Life Insurance Company | Nfp Insurance Services Inc | 52 | $178 0.9% of $19,848 |
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.