| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOVI PLATTNER LIFE INS. SVCS.3 Filed as: DOVI PLATTER LIFE INSURANCE SVCS. | 9743 CRESTA DRIVE LOS ANGELES, CA 90035 | KAISER FOUNDATION HEALTH PLAN INC. | $86K | — | $86K | 2.67% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND FIN. SVCS | 4851 LBJ FREEWAY, SUITE 100 DALLAS, TX 75244 | KAISER FOUNDATION HEALTH PLAN INC. | $48K | — | $48K | 1.50% |
| DOVI PLATTNER LIFE INS. SVCS.3 | 9743 CRESTA DRIVE LOS ANGELES, CA 90035 | HARTFORD LIFE AND ACCIDENT | $11K | $6K | $17K | 16.88% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SVCS. | 4851 LBJ FREEWAY, SUITE 100 DALLAS, TX 75244 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 5.45% |
| DOVI PLATTNER LIFE INS. SVCS.3 Filed as: DOVI PLATTNER LIFE INSURANCE SVCS. | 9743 CREST DRIVE LOS ANGELES, CA 90035 | VISION SERVICE PLAN | $2K | — | $2K | 4.12% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSRONE INSURANCE & FIN. SVCS. | 14851 LBJ FREEWAY, SUITE 1100 DALLAS, TX 75244 | VISION SERVICE PLAN | $984 | — | $984 | 2.50% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SVCS. | 4851 LBJ FREEWAY, SUITE 100 DALLAS, TX 75244 | DELTA DENTAL OF CALIFORNIA | $124 | — | $124 | 0.46% |
| DOVI PLATTNER LIFE INS. SVCS.3 | 9743 CRESTA DRIVE LOS ANGELES, CA 90035 | DELTA DENTAL OF CALIFORNIA | $124 | — | $124 | 0.46% |
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 | 558 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 617 | $3.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 299 | $370K |
| Vision | VISION SERVICE PLAN | 326 | $39K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 558 | $101K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 558 | $101K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 558 | $101K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 617 | $3.2M |
| Other | HARTFORD LIFE AND ACCIDENT | 558 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.