Form 5500 · Employee benefit plan · NEWCOMERSTOWN, OH
BOLTARON INC
The filing calls this plan BOLTARON INC HEALTH AND WELFARE PLAN.
Public Form 5500 records show how BOLTARON INC of NEWCOMERSTOWN, OH, a manufacturing employer, structures its employee benefits. Its broker of record is KEYSTONE INS & BENEFITS GROUP LLC. Coverage is written through METROPOLITAN LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-5164540 · plan 501 · plan year 2025, filed Sep 14, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering dental, vision, life and disability; the largest, with METROPOLITAN LIFE INSURANCE COMPANY, covers 223 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $205,023, with $30,820 in disclosed broker commissions — about 15% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
KEYSTONE INS & BENEFITS GROUP LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Vision | 223 | Jan 1, 2026 | $123,082 | $20,192 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life, Disability | 127 | Jan 1, 2026 | $81,941 | $10,628 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 136 employees, 4 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
Subscribers see how this compares with similar plans in Ohio. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Ohio — largest plans, brokers, carriers and renewal months.