| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDEPENDENT FINANCIAL INSURANCE3 Filed as: INDEPENDENT FINANCIAL GROUP INC | 300 N. LAKE AVENUE, SUITE 210 PASADENA, CA 91101 | JOHN HANCOCK USA | $30K | — | $30K | — |
| QBI, LLC5 | 114 PACIFICA, SUITE 150 IRVINE, CA 92618 | JOHN HANCOCK USA | — | $8K | $8K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| QBI, LLC THIRD PARTY ADMINISTRATO | Consulting (pension); Consulting fees; Contract Administrator; Direct payment from the plan; Participant loan processing Service code 13 | 114 PACIFICA, SUITE 150 IRVINE, CA 92618 | $16K |
| WINDES, INC. EIN 95-3001179 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $8K |
| INDEPENDENT FINANCIAL GROUP INC. BROKER | Accounting (including auditing); Direct payment from the plan Service code 10 | 300 N. LAKE AVENUE, SUITE 210 PASADENA, CA 91101 | $6K |
| JOHN HANCOCK USA EIN 01-0233346 RECORDKEEPER | Shareholder servicing fees; Soft dollars commissions; Sub-transfer agency fees; Investment management; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Distribution (12b-1) fees Service code 15 | — | $4K |
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 | 683 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 87 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 770 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | JOHN HANCOCK USA | 683 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.