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LUMENIS BE, INC HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameLUMENIS BE, INC HEALTH AND WELFARE PLAN
Plan identification number 503

LUMENIS BE, INC HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

LUMENIS BE, INC. has sponsored the creation of one or more 401k plans.

Company Name:LUMENIS BE, INC.
Employer identification number (EIN):863941027
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUMENIS BE, INC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-09-01SUSIE STORMANN2024-03-18
5032021-09-01SUSIE STORMANN2023-01-25

Plan Statistics for LUMENIS BE, INC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for LUMENIS BE, INC HEALTH AND WELFARE PLAN

Measure Date Value
2022: LUMENIS BE, INC HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01288
Total number of active participants reported on line 7a of the Form 55002022-09-010
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-010
Number of employers contributing to the scheme2022-09-010
2021: LUMENIS BE, INC HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01234
Total number of active participants reported on line 7a of the Form 55002021-09-01283
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01283
Number of employers contributing to the scheme2021-09-010

Form 5500 Responses for LUMENIS BE, INC HEALTH AND WELFARE PLAN

2022: LUMENIS BE, INC HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01This submission is the final filingYes
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: LUMENIS BE, INC HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01First time form 5500 has been submittedYes
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number24826
Policy instance 1
Insurance contract or identification number24826
Number of Individuals Covered378
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $114,373
Total amount of fees paid to insurance companyUSD $18,831
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $668,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $114,373
Amount paid for insurance broker fees18831
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number24826
Policy instance 1
Insurance contract or identification number24826
Number of Individuals Covered318
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $94,564
Total amount of fees paid to insurance companyUSD $8,797
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $553,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $94,564
Amount paid for insurance broker fees8797
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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