Employer
Success Rehabilitation, Inc.
5666 Clymer Rd, Quakertown, PA 18951 · EIN 23-2590923 · Jan 1, 2024 to Dec 31, 2024
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 $15,579
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | HM Life Insurance Company | — | — | Comp not disclosed Premium $39,522 |
| Stop-loss | Sun Life Assurance Company | — | 145 | Comp not disclosed Premium $678,560 |
| Dental | Aetna Life Insurance Co. | Patriot Growth Insurance Services | 211 | $4,325 5.1% of $85,217 |
| Vision | Eyemed Vision Care | Patriot Growth Insurance Services L | 177 | $1,035 6.9% of $14,930 |
| Life | Hartford Life And Accident | Patriot Growth Insurance Svcs LLC | 174 | $9,461 6.1% of $155,759 |
| Life | Hartford Life And Accident | Patriot Growth Insurance Services | 174 | $758 0.5% of $155,759 |
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.
Visible subtotal $134,982
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Patriot (Exude, Inc.) | Broker | $69,785 | $481.28 |
| The Benecon Group | Broker | $35,654 | $245.89 |
| Independence Administrators (Ia) | Admin | $20,299 | $139.99 |
| ConnectCare3 | Patient Advocate | $9,244 | $63.75 |