| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES, INC. | 382 GREENWOOD BEACH RD TIBURON, CA 949202213 | KAISER FOUNDATION HEALTH PLAN INC | $279K | $0 | $279K | 2.60% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B. STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $3K | $3K | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 911098299 | KAISER FOUNDATION HEALTH PLAN INC | -$2K | $0 | -$2K | -0.02% |
| ROBERT C PLACAK & ASSOCIATES3 | 382 GREENWOOD BEACH RD TIBURON, CA 94920 | KAISER FOUNDATION HEALTH PLAN | $35K | $0 | $35K | 3.11% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN | $0 | $341 | $341 | 0.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN | -$189 | $0 | -$189 | -0.02% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C PLACAK & ASSOC | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | HARTFORD LIFE AND ACCIDENT | $133K | $0 | $133K | 12.22% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD 2ND FLOOR HAUPPAUGE, NY 11788 | HARTFORD LIFE AND ACCIDENT | $0 | $59K | $59K | 5.44% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | HARTFORD LIFE AND ACCIDENT | $0 | -$8K | -$8K | -0.72% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES, INC. | 790 MISSION AVE SAN RAFAEL, CA 94920 | VISION SERVICE PLAN | $18K | $0 | $18K | 6.52% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 911098299 | VISION SERVICE PLAN | -$7 | $0 | -$7 | -0.00% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT PLACAK | 790 MISSION AVE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $9K | $0 | $9K | 3.38% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: DRIVER ALLIANT INSURANCE SVCS | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.52% |
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 | 2,051 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 126 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,267 | $12.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 305 | $50K |
| Vision | VISION SERVICE PLAN | 1,695 | $282K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,045 | $1.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,045 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,045 | $1.1M |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,267 | $12.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,052 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,052 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.