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Employer
1600 Market Street, Philadelphia, PA 19103 · EIN 23-2516349 · Sep 1, 2024 to Aug 31, 2025
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 $60,216
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | Risk Placement Services Inc DBA Don | 152 | $44,431 3.3% of $1,330,810 |
| Dental | Standard Insurance Company | Tompkins Insurance | 98 | $5,642 10.0% of $56,423 |
| Dental | Standard Insurance Company | James R Nelligan & Associates | 98 | $3,524 6.2% of $56,423 |
| Vision | Standard Insurance Company | Tompkins Insurance | 97 | $738 10.0% of $7,384 |
| Vision | Standard Insurance Company | James R Nelligan & Associates | 97 | $461 6.2% of $7,384 |
| Life | Hartford Life And Accident | Tompkins Insurance | 122 | $864 12.0% of $7,198 |
| Supplemental | Colonial Life & Accident Insurance Company | Tompkins Insurance | 14 | $2,823 16.7% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Jennifer Mcclellan | 14 | $706 4.2% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Melinda Diane Swartley | 14 | $517 3.1% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | David J Mcclellan | 14 | $333 2.0% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Mark Joseph Weishaar | 14 | $71 0.4% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Lorenzo V Cutaia | 14 | $29 0.2% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Parks Benefits & Enrollment LLC | 14 | $28 0.2% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Marks Benefit Management LLC | 14 | $28 0.2% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Vincent J Rowan | 14 | $15 0.1% of $16,948 |
| Supplemental | Colonial Life & Accident Insurance Company | Gary D Davis | 14 | $6 0.0% of $16,948 |
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.