Form 5500 · Employee benefit plan · MORGAN HILL, CA
PACIFIC STATES INDUSTRIES, INC.
PACIFIC STATES INDUSTRIES, INC.'s employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is RSC INSURANCE BROKERAGE INC. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-2565203 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 85 | December | $23,481 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 103 | December | $989 |
| STANDARD INSURANCE COMPANY | Life | 154 | December | $955 |
| ANTHEM LIFE INSURANCE COMPANY | Life | 170 | March | $225 |
| QBE INSURANCE CORPORATION | Stop-loss | 84 | December | $0 |
| UNITED HEALTHCARE INSURANCE COMPANY | — | 84 | December | $0 |
Questions
Who is PACIFIC STATES INDUSTRIES, INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, PACIFIC STATES INDUSTRIES, INC.'s broker of record is RSC INSURANCE BROKERAGE INC.
What insurance carrier does PACIFIC STATES INDUSTRIES, INC. use?
PACIFIC STATES INDUSTRIES, INC.'s benefit plan is written through KAISER FOUNDATION HEALTH PLAN, INC., among 6 disclosed carriers.
When does PACIFIC STATES INDUSTRIES, INC.'s group plan renew?
The most recent Schedule A policy period for PACIFIC STATES INDUSTRIES, INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from PACIFIC STATES INDUSTRIES, INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.