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Employer
One Liberty Place, Philadelphia, PA 19103 · EIN 23-2228772 · 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 $50,935
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Assured Partners (Central Pa) | 371 | $32,068 92.8% of $34,546 |
| Dental | Metropolitian Life Insurance Company | Assured Partners (Central Pa) | 806 | $18 0.0% of $452,343 |
| Vision | Vision Service Plan | Digital Insurance, Inc. | 323 | $1,445 4.5% of $31,825 |
| Life | Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 523 | $11,583 3.3% of $353,206 |
| Accident | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 46 | $175 2.7% of $6,522 |
| Critical Illness | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 30 | $174 1.8% of $9,412 |
| Hospital Indemnity | The Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 25 | $150 1.8% of $8,247 |
| Other | Lincoln National Life Insurance Company | Assured Partners (Central Pa) | 436 | $3,371 3.2% of $104,617 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 59 | $1,930 15.7% of $12,258 |
| Legal | Metlife Legal Plans | Assured Partners (Central Pa) | 59 | $19 0.2% of $12,258 |
| Legal | Metlife Legal Plans | Assuredpartners Nl, LLC | 59 | $2 0.0% of $12,258 |
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.
Visible subtotal $99,957
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Spring Health | Tpa | $72,219 | $89.60 |
| Lincoln National Life Insurance Co | Std And Leave Aso Fees | $19,473 | $24.16 |
| Healthequity | Hsa Admin Fees | $8,265 | $10.25 |