| 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 | $56K | $14 | $56K | 5.54% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVE SAN RAFAEL, CA 94901 | BLUE SHIELD OF CALIFORNIA | $46K | — | $46K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S PARKER ST 8TH FL ORANGE, CA 92868 | BLUE SHIELD OF CALIFORNIA | $15K | — | $15K | 2.00% |
| ROBERT C PLACAK & ASSOCIATES3 | — | UNITED CONCORDIA INSURANCE COMPANY | $20K | — | $20K | 11.04% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $996 | $4K | 20.00% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $922 | $4K | 20.00% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVE SAN RAFAEL, CA 949013207 | VISION SERVICE PLAN | $954 | — | $954 | 6.07% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $397 | $2K | 19.99% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $82 | $27 | $109 | 19.96% |
| 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 | $29 | — | $29 | 6.99% |
| BRETT WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN RD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 2.65% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 2.65% |
| WENDY DAWN PACK3 Filed as: WENDY GERSHOW | 3217 STAR AVE OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 1.69% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 1.45% |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 152 | $1.8M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 317 | $185K |
| Vision | VISION SERVICE PLAN | 131 | $16K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 178 | $26K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 3 | $415 |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 178 | $20K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 70 | $773K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 178 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.