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Employer
3455 Germantown Pike, Collegeville, PA 19426 · EIN 23-6395223 · 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.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | The Union Labor Life Insurance Company | — | 1971 | Comp not disclosed Premium $627,978 |
| Vision | Vision Benefits Of America | — | 2126 | Comp not disclosed Premium $284,340 |
| Life | The Union Labor Life Insurance Company | — | 1957 | Comp not disclosed Premium $200,266 |
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 $2,197,024
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Independence Administrators | None | $1,202,136 | $540.77 |
| Morgan Stanley Smith Barney, LLC | None | $176,262 | $79.29 |
| Ibew Local Union No. 126 | Related | $139,039 | $62.55 |
| Lacher & Associates Ins. Agency Inc | None | $123,806 | $55.69 |
| Teladoc Inc | None | $115,441 | $51.93 |
| Principal Custody Solutions | None | $102,294 | $46.02 |
| Delta Dental Of Pennsylvania | None | $85,453 | $38.44 |
| Compusys Of Utah, Inc. | None | $61,507 | $27.67 |
| Guardian Life Insurance | None | $46,954 | $21.12 |
| Bridgeway Benefit Technologies | None | $35,948 | $16.17 |
| Novak Francella, LLC | None | $35,164 | $15.82 |
| Fox Rothschild, LLP | None | $28,269 | $12.72 |
| Sav Rx | None | $17,282 | $7.77 |
| Eyelation | None | $12,076 | $5.43 |
| Summit Actuarial | None | $9,000 | $4.05 |
| Cleary & Josem LLP | None | $6,393 | $2.88 |