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| Plan Name | PACIFIC RETIREMENT SERVICES, INC. CALIFORNIA MEDICAL PLAN |
| Plan identification number | 512 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PACIFIC RETIREMENT SERVICES, INC. |
| Employer identification number (EIN): | 931067253 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about PACIFIC RETIREMENT SERVICES, INC.
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 1990-11-20 |
| Company Identification Number: | 22564181 |
| Legal Registered Office Address: |
1 WEST MAIN ST STE 303 MEDFORD United States of America (USA) 97501 |
More information about PACIFIC RETIREMENT SERVICES, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 512 | 2022-10-01 | EMILY PERRY | 2024-04-24 | ||
| 512 | 2021-10-01 | EMILY PERRY | 2023-07-13 |
| 2022: PACIFIC RETIREMENT SERVICES, INC. CALIFORNIA MEDICAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: PACIFIC RETIREMENT SERVICES, INC. CALIFORNIA MEDICAL PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | First time form 5500 has been submitted | Yes |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 39196 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 39196 |
| Policy instance | 1 |
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