| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES, INC. | 790 MISSION AVE SAN RAFAEL, CA 949013207 | KAISER FOUNDATION HEALTH PLAN INC | $49K | — | $49K | 4.99% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVE SAN RAFAEL, CA 94901 | HEALTH NET | $38K | — | $38K | 5.47% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $15K | — | $15K | 10.00% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.00% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVE SAN RAFAEL, CA 949013207 | VISION SERVICE PLAN | $983 | — | $983 | 5.94% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $823 | $3K | 20.00% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $370 | $1K | 20.01% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C PLACAK & ASSOC INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 6.11% |
| BRETT WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN RD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $4 | $43 | 3.06% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $1 | $26 | 1.85% |
| WENDY DAWN PACK3 Filed as: WENDY GERSHOW | 3217 STAR AVE OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 1.49% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $2 | $15 | 1.07% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.14% |
| KEVIN FITZGERALD HOWARD3 | 561 BODEN WAY APT 3B OAKLAND, CA 94610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.14% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $132 | $44 | $176 | 19.98% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 162 | $1.7M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 202 | $152K |
| Vision | VISION SERVICE PLAN | 145 | $17K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 198 | $24K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 3 | $1K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 198 | $21K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 198 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.