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Employer
2005 Market Street, Philadelphia, PA 19103 · EIN 23-1130381 · 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 $65,845
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross (Keystone) | — | 52 | Comp not disclosed Premium $561,465 |
| Medical | Independence Blue Cross (Personal Choice) | — | 534 | Comp not disclosed Premium $3,879,617 |
| Dental | Delta Dental Of Pennsylvania | Conner Strong & Buckelew Companies | 538 | $12,383 6.5% of $190,510 |
| Dental | Delta Dental Of Pennsylvania | Conner Strong & Buckelew Companies | 18 | $237 6.5% of $3,642 |
| Vision | Vision Service Plan | Conner Strong & Buckelew Companies | 233 | $1,669 4.0% of $41,346 |
| Life | Unum Life Insurance Company Of America | Conner Strong & Buckelew Companies | 392 | $46,504 7.5% of $617,423 |
| Other | Massachusetts Mutual Life Insurance Company | Harris S. Fishman | 6 | $46 1.1% of $4,200 |
| Other | Provident Life And Accident Insurance Company | Conner Strong & Buckelew Companies | 22 | $1,801 6.9% of $26,068 |
| Other | Provident Life And Accident Insurance Company | Tompkins Insurance | 22 | $1,107 4.2% of $26,068 |
| Other | Provident Life And Accident Insurance Company | Conner Strong & Buckelew Companies | 26 | $1,125 8.2% of $13,649 |
| Other | Provident Life And Accident Insurance Company | Tompkins Insurance | 26 | $340 2.5% of $13,649 |
| Other | Provident Life And Accident Insurance Company | Conner Strong & Buckelew Companies | 5 | $523 10.3% of $5,061 |
| Other | Provident Life And Accident Insurance Company | Tompkins Insurance | 5 | $78 1.5% of $5,061 |
| Other | Provident Life And Casualty Insurance Company | Tompkins Insurance | 1 | $32 5.0% of $639 |
| Employee Assistance Program | Carebridge Corporation | — | 393 | Comp not disclosed Premium $11,660 |
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.