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Employer
150 Gordon Drive, Exton, PA 19341 · EIN 47-4495315 · 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.
Visible subtotal $74,654
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Equitable Financial Life Insurance Company Of America | Brown & Brown Of Pennsylvania | 276 | $11,595 12.8% of $90,435 |
| Medical | Equitable Financial Life Insurance Company Of America | Brown Brown Insurance Services, Inc | 276 | $2,277 2.5% of $90,435 |
| Medical | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 100 | $3,595 20.0% of $17,977 |
| Medical | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 100 | $4,905 20.0% of $24,527 |
| Medical | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 56 | $3,031 20.0% of $15,157 |
| Vision | National Vision Administrators | Brown & Brown Of Pennsylvania | 363 | $1,438 4.9% of $29,162 |
| Vision | National Vision Administrators | Brown & Brown Insurance Services, I | 363 | $1,233 4.2% of $29,162 |
| Vision | National Vision Administrators | Marsh & Mclennan Companies | 363 | $246 0.8% of $29,162 |
| Life | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 316 | $14,851 15.0% of $99,004 |
| Life | Reliance Standard Life Insurance Company | Brown & Brown Insurance Services, I | 316 | $3,407 3.4% of $99,004 |
| AD&D | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 314 | $850 15.0% of $5,668 |
| AD&D | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 188 | $916 15.0% of $6,108 |
| Other | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 317 | $17,069 15.0% of $113,797 |
| Other | Reliance Standard Life Insurance Company | Brown & Brown Of Pennsylvania | 317 | $7,467 15.0% of $49,783 |
| Other | Reliance Standard Life Insurance Company | Brown & Brown Insurance Services, I | 317 | $1,774 3.6% of $49,783 |
| Stop-loss | HM Life Insurance Company | — | 259 | Comp not disclosed Premium $586,158 |
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 $214,424
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| Brown & Brown Of Pennsylvania | Broker | $105,502 | $407.34 |
| The Benecon Group | Broker | $65,970 | $254.71 |
| Innovu | Broker | $12,412 | $47.92 |
| ConnectCare3 | Patient Advocate | $17,130 | $66.14 |
| Umr | Admin | $13,410 | $51.78 |