Employer
Upper Darby Sign Company
251 Boot Road, Downingtown, PA 19335 · EIN 23-1741447 · Jul 1, 2024 to Jun 30, 2025
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 $33,907
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | 53 | Comp not disclosed Premium $45,220 |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | — | Comp not disclosed Premium $47,509 |
| Medical | Independence Blue Cross | Risk Placement Services Inc DBA Don | 79 | $22,217 5.8% of $382,662 |
| Medical | Independence Blue Cross | Acrisure Mid-Atlantic Partners Insu | 79 | $10,731 2.8% of $382,662 |
| Medical | Independence Blue Cross | Risk Placement Services Inc DBA Don | 54 | $959 1.1% of $88,369 |
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 $14,395
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Acrisure, LLC | Broker | $7,052 | $117.53 |
| The Benecon Group | Broker | $3,328 | $55.47 |
| Meritain Health, An Aetna Company | Admin | $1,496 | $24.93 |
| ConnectCare3 | Patient Advocate | $939 | $15.65 |
| The Benecon Group | Broker | $1,580 | $20.00 |