Employer
Versalus Health Management, LLC
17 Campus Boulevard, Newtown Square, PA 19073 · EIN 30-0954711 · Jan 1, 2021 to Dec 31, 2021
Plan year 2021
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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 $150,114
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 327 | Schedule A not provided |
| Medical | Independence Blue Cross | — | 327 | Schedule A not provided |
| Dental | United Concordia Insurance Company | — | 316 | Schedule A not provided |
| Dental | United Concordia Insurance Company | — | 316 | Schedule A not provided |
| Vision | Ngl | Brown & Brown Of Pennsylvania | 285 | $666 5.6% of $11,838 |
| Vision | Ngl | Lockton Companies, LLC | 285 | $517 4.4% of $11,838 |
| Life | The Lincoln National Life Insurance Company | Brown & Brown Of Pennsylvania | 180 | $11,195 10.0% of $112,274 |
| Life | The Lincoln National Life Insurance Company | Lockton Companies, LLC | 180 | $8,111 7.2% of $112,274 |
| Life | The Lincoln National Life Insurance Company | Lockton Companies, LLC | 180 | $408 0.4% of $112,274 |
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.
No Schedule C parties in this year.