| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 301 EDGEWATER PL SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $79K | $17K | $96K | 28.84% |
| JARED BOLOTIN3 | 301 EDGEWATER PL SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.13% |
| CLARK & LAVEY BENEFIT SOLUTIONS3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS IN | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $550 | — | $550 | 0.17% |
| NEIL BLICHER3 | 300 EDGEWATER PL SUITE 200 WAKEFIELD, MA 01880 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $314 | — | $314 | 0.09% |
| JON BLANCHARD3 | 20 CONGRESS STREET MARSHFIELD, MA 02050 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $188 | — | $188 | 0.06% |
| TROY ZERVESKES3 | BAY STATE FINANCIAL 149 WATER STREET EXETER, NH 03833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.01% |
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 3-1 EDGEWATER PL SUITE 2001 WAKEFIELD, MA 01880 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $0 | $28K | 20.09% |
| ALAN C BOLOTIN3 Filed as: ALAN BOLOTIN | 301 EDGEWATER PL SUITE 100 WAKEFIELD, MA 01880 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.96% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: METLIFE FINANCIAL/SECURITIES | 1095 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.62% |
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 | 537 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 537 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 537 | $65K |
| Long-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 132 | $333K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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.