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Employer
63 Lancaster Avenue, Malvern, PA 19355 · EIN 38-1686453 · 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 $139,998
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Independence Blue Cross | — | 1 | Comp not disclosed Premium $19,008 |
| Medical | Kaiser Foundation Health Plan, Inc. | — | 41 | Comp not disclosed Premium $449,801 |
| Medical | Unitedhealthcare Insurance Company | — | 83 | Comp not disclosed Premium $4,098 |
| Medical | Kaiser Foundation Health Plan, Inc. | — | 178 | Comp not disclosed Premium $2,118,255 |
| Medical | Independence Blue Cross | — | 7 | Comp not disclosed Premium $60,035 |
| Vision | Vision Service Plan | — | 1772 | Comp not disclosed Premium $357,999 |
| Life | Lincoln National Life Insurance Company | Willis Towers Watson Northeast, Inc | 2244 | $84,863 2.9% of $2,893,221 |
| Life | Lincoln National Life Insurance Company | Willis Towers Watson | 2244 | $44,726 1.5% of $2,893,221 |
| Other | United Healthcare Insurance Company | — | 148 | Comp not disclosed Premium $24,313 |
| Other | Independence Blue Cross | — | 7 | Comp not disclosed Premium $15,009 |
| Accidental Death And Dismemberment, Business Travel Accident | Federal Insurance Company | Willis Towers Watson Northeast, Inc | 2168 | $10,409 25.0% of $41,635 |
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.