| 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. | $84K | — | $84K | 5.52% |
| 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. | $7K | — | $7K | 0.48% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES, INC. | 382 GREENWOOD BEACH RD TIBURON, CA 949202213 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 5.92% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES,INC. | 790 MISSION AVE SAN RAFAEL, CA 94901 | AETNA LIFE INSURANCE CO. | $23K | — | $23K | 5.62% |
| 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 | 0.49% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C. PLACAK & ASSOC INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $32K | — | $32K | 20.72% |
| PROFESSIONAL GROUP PLANS INC3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 5.18% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT PLACAK | 790 MISSION AVE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $5K | — | $5K | 3.28% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK & ASSOCIATES | 790 MISSION AVENUE SAN RAFAEL, CA 949013207 | VISION SERVICE PLAN | $3K | — | $3K | 14.99% |
| ROBERT C PLACAK & ASSOCIATES3 | 790 MISSION ST SAN RAFAEL, CA 94901 | CALIFORNIA DENTAL NETWORK, INC. | $278 | — | $278 | 10.00% |
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 | 256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 47 | $970K |
| Dental(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 277 | $160K |
| Vision | VISION SERVICE PLAN | 82 | $17K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 277 | $157K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 277 | $157K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 277 | $157K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 277 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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.