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INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 401k Plan overview

Plan NameINTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN
Plan identification number 502

INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)
  • 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.

401k Sponsoring company profile

INTEGRATED ILLUMINATION SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:INTEGRATED ILLUMINATION SYSTEMS, INC.
Employer identification number (EIN):300240064
NAIC Classification:335100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-08-01VANCE KUSAILA2024-01-24
5022021-08-01XIA GLEISSNER2022-10-31
5022020-08-01MAGGIE LABONTE2021-12-14
5022019-08-01MAGGIE LABONTE2021-01-07

Plan Statistics for INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN

401k plan membership statisitcs for INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN

Measure Date Value
2022: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-08-01100
Total number of active participants reported on line 7a of the Form 55002022-08-0198
Number of retired or separated participants receiving benefits2022-08-010
Number of other retired or separated participants entitled to future benefits2022-08-010
Total of all active and inactive participants2022-08-0198
Number of employers contributing to the scheme2022-08-010
2021: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01100
Total number of active participants reported on line 7a of the Form 55002021-08-01100
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01100
Number of employers contributing to the scheme2021-08-010
2020: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01111
Total number of active participants reported on line 7a of the Form 55002020-08-01100
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01100
Number of employers contributing to the scheme2020-08-010
2019: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01125
Total number of active participants reported on line 7a of the Form 55002019-08-01111
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01111
Number of employers contributing to the scheme2019-08-010

Form 5500 Responses for INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN

2022: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – InsuranceYes
2021: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes
2020: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: INTEGRATED ILLUMINATION SYSTEMS, INC. BASIC AD&D PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01First time form 5500 has been submittedYes
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK603736
Policy instance 1
Insurance contract or identification numberSOK603736
Number of Individuals Covered100
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $68
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $68
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK603736
Policy instance 1
Insurance contract or identification numberSOK603736
Number of Individuals Covered100
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $89
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $89
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK603736
Policy instance 1
Insurance contract or identification numberSOK603736
Number of Individuals Covered100
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $137
Total amount of fees paid to insurance companyUSD $13
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $141
Amount paid for insurance broker fees13
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK603736
Policy instance 1
Insurance contract or identification numberSOK603736
Number of Individuals Covered111
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $92
Total amount of fees paid to insurance companyUSD $3
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $92
Amount paid for insurance broker fees3
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3

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