| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 301 EDGEWATER PLACE SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $57K | $6K | $63K | 23.22% |
| JARED BOLOTIN3 | 301 EDGEWATER PLACE SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $656 | — | $656 | 0.24% |
| CLARK & LAVEY BENEFIT SOLUTIONS3 Filed as: CLARK & LAVEY BENEFIT SOLUTION INC | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $529 | — | $529 | 0.19% |
| NEIL BLICHER3 | 300 EDGEWATER PLACE SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $385 | — | $385 | 0.14% |
| ANDREW BLANCHARD3 | 20 CONGRESS STREET MARSHFIELD, MA 02050 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $193 | — | $193 | 0.07% |
| TROY ZERVESKES3 | 149 WATER STREET EXETER, NH 03833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 0.04% |
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 301 EDGEWATER PLACE SUITE 200 WAKEFIELD, MA 01880 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 20.32% |
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 301 EDGEWTER PLACE SUITE 200 WAKEFIELD, MA 01880 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.13% |
| NE FINANCIAL/NE SECURITIES INC3 | 1095 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.87% |
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 | 559 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 556 | $61K |
| Long-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 134 | $272K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 559 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 559 | — |
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.