Form 5500 · Employee benefit plan · SAN JOSE, CA
PACIFIC GROSERVICE, INC.
The filing calls this plan PITCO FOODS HEALTH AND WELFARE BENEFIT PLAN.
PACIFIC GROSERVICE, INC. of SAN JOSE, CA is a 223-participant wholesale trade employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is EXPERTQUOTE, INC.. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 3 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-2863973 · plan 501 · plan year 2025, filed Dec 17, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
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 4 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 378 people.
Reported premium across the insured contracts is $2,443,936, with $76,730 in disclosed broker commissions — about 3.1% of premium.
The most recent policy period ended in July, and the plan year ends July 31. Group contracts typically renew on that annual cycle.
EXPERTQUOTE, INC. is the broker of record on all 4 contracts.
4 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., DELTA DENTAL OF CALIFORNIA, VISION SERVICE PLAN and EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 378 | Aug 1, 2025 | $2,168,419 | $62,419 |
| DELTA DENTAL OF CALIFORNIA | Dental | 462 | Aug 1, 2025 | $220,761 | $11,375 |
| VISION SERVICE PLAN | Vision | 227 | Aug 1, 2025 | $42,227 | $1,691 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life | 456 | Aug 1, 2025 | $12,529 | $1,245 |
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.
Other plans filed by this employer
How this plan compares
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