| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C. PLACAK AND ASSOC., INC. | 382 GREENWOOD BEACH ROAD TIBURON, CA 94920 | KAISER FOUNDATION HEALTH PLAN, INC. | $374K | $0 | $374K | 4.76% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C. PLACAK AND ASSOC., INC. | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | HARTFORD LIFE AND ACCIDENT | $79K | $0 | $79K | 12.91% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | HARTFORD LIFE AND ACCIDENT | — | $33K | $33K | 5.39% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK AND ASSOCIATES | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | VISION SERVICE PLAN | $18K | $0 | $18K | 5.43% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE DALLAS, TX 75201 | AETNA LIFE INSURANCE COMPANY | $724 | $0 | $724 | 1.83% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: DRIVER ALLIANT INSURANCE SERVICES | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA LIFE INSURANCE COMPANY | $354 | $0 | $354 | 0.89% |
| ALLIANT INSURANCE SERVICES, INC.3 | UNKNOWN SAN JOSE, CA 95128 | AETNA LIFE INSURANCE COMPANY | $0 | $345 | $345 | 0.87% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | METLIFE LEGAL PLANS | $2K | $260 | $2K | 7.77% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN. & COMP. SYSTEMS, INC. | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | METLIFE LEGAL PLANS | $0 | $1K | $1K | 6.21% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | METLIFE LEGAL PLANS | $643 | $0 | $643 | 2.75% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C. PLACAK AND ASSOC., INC. | 790 MISSION AVENUE SAN RAFAEL, NY 94901 | METLIFE LEGAL PLANS | $322 | $0 | $322 | 1.38% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK ROAD, SUITE 3 FARMINGTON, CT 06032 | METLIFE LEGAL PLANS | $0 | $133 | $133 | 0.57% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | METLIFE GENERAL INSURANCE COMPANY | $1K | $257 | $1K | 9.08% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN. & COMP. SYSTEMS, INC. | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | METLIFE GENERAL INSURANCE COMPANY | — | $468 | $468 | 2.89% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK ROAD, SUITE 3 FARMINGTON, CT 06032 | METLIFE GENERAL INSURANCE COMPANY | $0 | $129 | $129 | 0.80% |
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 | 1,913 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,913 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 981 | $7.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 207 | $40K |
| Vision | VISION SERVICE PLAN | 1,394 | $332K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,913 | $616K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,913 | $616K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,913 | $616K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 981 | $7.9M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,913 | $720K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,913 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.