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Form 5500 · Employee benefit plan · FAIRFIELD, OH

PACIFIC INDUSTRIES USA

The filing calls this plan PACIFIC INDUSTRIES USA EMPLOYEE BENEFIT PLAN.

PACIFIC INDUSTRIES USA of FAIRFIELD, OH spreads its employee benefits across 5 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is MCGOHAN BRABENDER. Coverage is written through COMMUNITY INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in June.

Benefits broker of record
Policy year ends
Juneas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 31-1253660 · plan 501 · plan year 2025, filed Dec 19, 2025

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

264 other employer plans in Ohio have policy years ending in June. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.

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.

All participants at the start of the year
1,080
Active at start of year
1,080
Active at end of year
1,162
Disclosed commissions
$279,593
Typical renewal
July 1

Benefits declared on this filing

Healthinsured — COMMUNITY INSURANCE COMPANY1,601 of 1,080 participants
Dentalinsured — SUN LIFE ASSURANCE COMPANY OF CANADA1,432 of 1,080 participants
Visioninsured — COMMUNITY INSURANCE COMPANY1,601 of 1,080 participants
Lifeinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY1,195 of 1,080 participants
Disabilityinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY509 of 1,080 participants (47%) on the largest contract

Also declared: 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.

Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.

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 8 insured contracts covering health, dental, vision, life and disability; the largest, with COMMUNITY INSURANCE COMPANY, covers 1,601 people.

Reported premium across the insured contracts is $11,669,882, with $279,593 in disclosed broker commissions — about 2.4% of premium.

The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.

MCGOHAN BRABENDER is the broker of record on 7 of the 8 contracts; the rest name a different broker or none.

5 carriers appear on the filing, including COMMUNITY INSURANCE COMPANY, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, METROPOLITAN LIFE INSURANCE COMPANY and SUN LIFE ASSURANCE COMPANY OF CANADA. COMMUNITY INSURANCE COMPANY writes the largest contract by premium.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
COMMUNITY INSURANCE COMPANYHealth, Vision1,601Jul 1, 2025$10,610,331$101,879
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDisability509Jul 1, 2025$333,547$50,032
METROPOLITAN LIFE INSURANCE COMPANY—190Jul 1, 2025$230,372$45,121
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDisability1,225Jul 1, 2025$216,272$32,441
SUN LIFE ASSURANCE COMPANY OF CANADADental1,432Jul 1, 2025$54,205$20,640
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY—290Jul 1, 2025$124,198$18,630
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYLife1,195Jul 1, 2025$50,321$7,548
BOSTON MUTUAL LIFE INSURANCE COMPANY—147Jul 1, 2025$50,636$3,302

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
PACIFIC INDUSTRIES USA
EIN 31-1253660

The plan administrator is from line 3a of the main form. We publish company names only.

Other plans filed by this employer

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