Form 5500 · Employee benefit plan · PALO ALTO, CA
PACKARD MEDICAL GROUP, INC.
The filing calls this plan PACKARD MEDICAL GROUP BENEFIT PLAN.
PACKARD MEDICAL GROUP, INC. of PALO ALTO, CA is a 172-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is VITA INSURANCE ASSOCIATES, INC.. Coverage is written through CALIFORNIA PHYSICIANS SERVICE and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-2420096 · plan 501 · plan year 2025, filed Aug 26, 2026
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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, 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 3 insured contracts covering health, life and disability; the largest, with CALIFORNIA PHYSICIANS SERVICE, covers 415 people.
The filing declares health, life, disability, dental and vision. Dental and vision appear 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 $6,722,624, with $57,530 in disclosed broker commissions — about 0.9% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in November. The plan is on a split renewal cycle.
VITA INSURANCE ASSOCIATES, INC. is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 178 | Jan 1, 2026 | $475,532 | $39,434 |
| COMBINED INSURANCE COMPANY | Life | 184 | Dec 1, 2025 | $79,869 | $18,096 |
| CALIFORNIA PHYSICIANS SERVICE | Health | 415 | Jan 1, 2026 | $6,167,223 | $0 |
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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