LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview
| Plan Name | LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN |
| Plan identification number | 502 |
LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Life insurance
- Dental
- Vision
- Long-term disability cover
|
401k Sponsoring company profile
LUMOS PHARMA, INC. has sponsored the creation of one or more 401k plans.
Additional information about LUMOS PHARMA, INC.
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2014-05-09 |
| Company Identification Number: | 0801987242 |
| Legal Registered Office Address: |
2503 S LOOP DR STE 5100
AMES
United States of America (USA)
50010
|
More information about LUMOS PHARMA, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 502 | 2021-01-01 | MAGGI GENTLE | 2022-09-28 | | |
Plan Statistics for LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2021: LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 305 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 305 |
Form 5500 Responses for LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN
| 2021: LUMOS PHARMA, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
Insurance Providers Used on plan
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 433651 |
| Policy instance | 1 |
| Insurance contract or identification number | 433651 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,490 | | Total amount of fees paid to insurance company | USD $1,693 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,452 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,490 | | Amount paid for insurance broker fees | 1693 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 444738 |
| Policy instance | 2 |
| Insurance contract or identification number | 444738 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,253 | | Total amount of fees paid to insurance company | USD $281 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,253 | | Amount paid for insurance broker fees | 281 |
|
| GRAVIE, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | GRV10581 |
| Policy instance | 3 |
| Insurance contract or identification number | GRV10581 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $9,570 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $404,182 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,570 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5975102 |
| Policy instance | 4 |
| Insurance contract or identification number | 5975102 | | Number of Individuals Covered | 305 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,348 | | Total amount of fees paid to insurance company | USD $53 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,921 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,348 | | Amount paid for insurance broker fees | 53 | | Insurance broker organization code? | 3 |
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