| 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 | AETNA HEALTH, INC. | $79K | — | $79K | 5.42% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN INC | 721 S PARKER STE 300 ORANGE, CA 92868 | AETNA HEALTH, INC. | $6K | — | $6K | 0.44% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES,INC. | 790 MISSION AVE SAN RAFAEL, CA 94901 | AETNA LIFE INSURANCE CO. | $23K | — | $23K | 5.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN INC | 721 S PARKER STE 300 ORANGE, CA 92868 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 0.44% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES, INC. | 790 MISSION AVE SAN RAFAEL, CA 949013207 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $7 | $15K | 5.99% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT PLACAK | 790 MISSION AVE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $4K | — | $4K | 3.27% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C PLACAK AND ASSOC INC | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | STANDARD INSURANCE COMPANY | $14K | — | $14K | 14.99% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVENUE SAN RAFAEL, CA 949013207 | VISION SERVICE PLAN | $992 | — | $992 | 5.87% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C PLACAK | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $638 | — | $638 | 13.24% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION ST SAN RAFAEL, CA 94901 | CALIFORNIA DENTAL NETWORK, INC. | $422 | — | $422 | 10.01% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION AVE SAN RAFAEL, CA 94901 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $245 | — | $245 | 20.02% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 49 | $850K |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 120 | $98K |
| Vision | VISION SERVICE PLAN | 85 | $17K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 249 | $13K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 4 | $1K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 248 | $37K |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 249 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.