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Employer
121 S. 13th Street, Philadelphia, PA 19107 · EIN 20-1089772 · 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 $87,755
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Metropolitan Life Insurance Company | Kistler Tiffany Benefits Co | 206 | $6,014 19.3% of $31,118 |
| Medical | Metropolitan Life Insurance Company | Kistler Tiffany Benefits Co | 287 | $7,422 19.3% of $38,465 |
| Medical | Metropolitan Life Insurance Company | Kistler Tiffany Benefits Co | 166 | $5,593 19.3% of $28,924 |
| Medical | Kaiser Foundation Health Plan, Inc | Onedigital (Philadelphia) | 90 | $16,745 3.3% of $511,036 |
| Medical | Kaiser Foundation Health Plan Inc. | Onedigital (Philadelphia) | 22 | $4,454 3.3% of $136,164 |
| Dental | Metropolitan Life Insurance Company | Kistler Tiffany Benefits Co | 1425 | $38,078 3.6% of $1,048,307 |
| Vision | Eyemed Vision Care For Fidelity Security Life Insurance Company | Onedigital (Philadelphia) | 919 | $8,023 10.0% of $80,592 |
| Legal | Metlife Legal Plans | Digital Insurance, Inc. | 53 | $1,356 11.1% of $12,180 |
| Legal | Metlife Legal Plans | Digital Insurance, Inc. | 53 | $70 0.6% of $12,180 |
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.