401k Plan data: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN plan

LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 401k Plan overview

Plan Name	LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN
Plan identification number	501

LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Vision
Temporary disability (accident and sickness)
Long-term disability cover
Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

LUMASENSE TECHNOLOGIES INC. has sponsored the creation of one or more 401k plans.

Company Name: LUMASENSE TECHNOLOGIES INC.

Employer identification number (EIN): 134229723

NAIC Classification: 334410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-01-01 PAT WINTER
501 2012-01-01 JOYCE IRBY
501 2009-01-01 JOYCE IRBY
501 2009-01-01 HELEN FIELER

Plan id#	Filing Submission Date	Name of Administrator
501	2013-01-01	PAT WINTER
501	2012-01-01	JOYCE IRBY
501	2009-01-01	JOYCE IRBY
501	2009-01-01	HELEN FIELER

Plan Statistics for LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN

401k plan membership statisitcs for LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN

Measure Date Value
2013: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
2012: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 98
Number of retired or separated participants receiving benefits 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 106
2009: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 51
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 51
Total participants 2009-01-01 110

Measure	Date	Value
2013: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
2012: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	98
Number of retired or separated participants receiving benefits	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	106
2009: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	51
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	51
Total participants	2009-01-01	110

Form 5500 Responses for LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN

2013: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2009: LUMASENSE TECHNOLOGIES INC. MEDICAL PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Potentially related plans

LUMASENSE TECHNOLOGIES HOLDINGS, INC. 401K PLAN [EIN = 203457059]

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Company Name:	LUMASENSE TECHNOLOGIES INC.
Employer identification number (EIN):	134229723
NAIC Classification:	334410