401k Plan data: ZIMMER BIOMET NORTHEAST GUARDIAN PLAN plan

ZIMMER BIOMET NORTHEAST GUARDIAN PLAN 401k Plan overview

Plan Name	ZIMMER BIOMET NORTHEAST GUARDIAN PLAN
Plan identification number	503

ZIMMER BIOMET NORTHEAST GUARDIAN PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover

401k Sponsoring company profile

ZIMMER BIOMET NORTHEAST has sponsored the creation of one or more 401k plans.

Company Name: ZIMMER BIOMET NORTHEAST

Employer identification number (EIN): 461626155

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ZIMMER BIOMET NORTHEAST GUARDIAN PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2020-04-01

Plan Statistics for ZIMMER BIOMET NORTHEAST GUARDIAN PLAN

401k plan membership statisitcs for ZIMMER BIOMET NORTHEAST GUARDIAN PLAN

Measure Date Value
2020: ZIMMER BIOMET NORTHEAST GUARDIAN PLAN 2020 401k membership
Total participants, beginning-of-year 2020-04-01 120
Total number of active participants reported on line 7a of the Form 5500 2020-04-01 0
Number of retired or separated participants receiving benefits 2020-04-01 0
Number of other retired or separated participants entitled to future benefits 2020-04-01 0
Total of all active and inactive participants 2020-04-01 0

Measure	Date	Value
2020: ZIMMER BIOMET NORTHEAST GUARDIAN PLAN 2020 401k membership
Total participants, beginning-of-year	2020-04-01	120
Total number of active participants reported on line 7a of the Form 5500	2020-04-01	0
Number of retired or separated participants receiving benefits	2020-04-01	0
Number of other retired or separated participants entitled to future benefits	2020-04-01	0
Total of all active and inactive participants	2020-04-01	0

Form 5500 Responses for ZIMMER BIOMET NORTHEAST GUARDIAN PLAN

2020: ZIMMER BIOMET NORTHEAST GUARDIAN PLAN 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	First time form 5500 has been submitted	Yes
2020-04-01	Submission has been amended	No
2020-04-01	This submission is the final filing	Yes
2020-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-04-01	Plan is a collectively bargained plan	No
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00466478

Policy instance

Insurance contract or identification number	00466478
Number of Individuals Covered	116
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $16,477
Total amount of fees paid to insurance company	USD $5,412
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D, OPTIONAL LIFE
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $89,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,622
Amount paid for insurance broker fees	5412
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4959856

Policy instance

Insurance contract or identification number	4959856
Number of Individuals Covered	203
Insurance policy start date	2020-04-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $17,947
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $795,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,397
Insurance broker organization code?	3

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Company Name:	ZIMMER BIOMET NORTHEAST
Employer identification number (EIN):	461626155
NAIC Classification:	339110