| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C PLACAK & ASSOC INC | 790 MISSION AVE SAN RAFAEL, CA 94901 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $853 | — | $853 | 3.38% |
| BRETT WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN RD SAN DIEGO, CA 92123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $525 | — | $525 | 2.08% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $380 | $1 | $381 | 1.51% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEO, CA 94402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $273 | — | $273 | 1.08% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $266 | $2 | $268 | 1.06% |
| CATHERINE LISA LUKE3 | 4787 W HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | $2 | $226 | 0.90% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA ST., 12TH FLOOR SAN FRANCISCO, CA 94111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.40% |
| LAURA RUNYEON3 | 2042 WEATHERBY WAY PETALUMA, CA 94954 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $7 | $27 | 0.11% |
| CHRISTINA MARIE ALTOMARE3 | 1692 CRESCENT DRIVE WALNUT CREEK, CA 94598 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.02% |
| DARRYL W VIDOR3 | 4030 LENNANE AVE SACRAMENTO, CA 95834 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
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 | 528 | 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) | 531 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 491 | $4.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 459 | $438K |
| Vision | VISION SERVICE PLAN | 489 | $53K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 528 | $104K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 528 | $85K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 528 | $85K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 491 | $4.8M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 631 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 631 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.