| 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 94901 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $57K | — | $57K | 6.64% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | UNITED CONCORDIA INSURANCE COMPANY | $79K | $3K | $82K | 20.02% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | UNITED CONCORDIA INSURANCE COMPANY | $8K | — | $8K | 2.06% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 382 GREENWOOD BEACH RD TIBURON, CA 94920 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $141 | $14K | 4.46% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.27% |
| BENEFITMALL3 Filed as: MATHER & STROHL BDA BENEFITMALL | 501 FAIRMOUNT AVE SUITE 400 TOWSON, MD 21286 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $9K | $520 | $10K | 3.90% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $2K | — | $2K | 0.64% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | STANDARD INSURANCE COMPANY | $21K | $431 | $21K | 23.61% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | STANDARD INSURANCE COMPANY | $4K | $154 | $4K | 4.80% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $5K | — | $5K | 7.00% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES, INC. | 790 MISSION AVE SAN RAFAEL, CA 94901 | BLUE CROSS OF CALIFORNIA | $2K | — | $2K | 4.26% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS LLC | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | — | $796 | $796 | 1.92% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK & ASSOCIATES INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | STANDARD INSURANCE COMPANY | $3K | $192 | $4K | 9.13% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD 2ND FLOOR HAUPPAUGE, NY 11788 | STANDARD INSURANCE COMPANY | $1K | $101 | $1K | 2.85% |
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 | 2,199 | 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) | 2,199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 190 | $1.5M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 911 | $452K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 493 | $81K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,045 | $91K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 190 | $1.5M |
| Other | STANDARD INSURANCE COMPANY | 1,045 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,045 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.