401k Plan data: LUMAVERSE TECHNOLOGIES 5500 PLAN plan

LUMAVERSE TECHNOLOGIES 5500 PLAN 401k Plan overview

Plan Name	LUMAVERSE TECHNOLOGIES 5500 PLAN
Plan identification number	501

LUMAVERSE TECHNOLOGIES 5500 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

401k Sponsoring company profile

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

Company Name: LUMAVERSE TECHNOLOGIES

Employer identification number (EIN): 821948607

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUMAVERSE TECHNOLOGIES 5500 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01

Plan Statistics for LUMAVERSE TECHNOLOGIES 5500 PLAN

401k plan membership statisitcs for LUMAVERSE TECHNOLOGIES 5500 PLAN

Measure Date Value
2023: LUMAVERSE TECHNOLOGIES 5500 PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 96
Number of retired or separated participants receiving benefits 2023-01-01 2
Number of other retired or separated participants entitled to future benefits 2023-01-01 2
Total of all active and inactive participants 2023-01-01 100

Measure	Date	Value
2023: LUMAVERSE TECHNOLOGIES 5500 PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	96
Number of retired or separated participants receiving benefits	2023-01-01	2
Number of other retired or separated participants entitled to future benefits	2023-01-01	2
Total of all active and inactive participants	2023-01-01	100

Form 5500 Responses for LUMAVERSE TECHNOLOGIES 5500 PLAN

2023: LUMAVERSE TECHNOLOGIES 5500 PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14167833

Policy instance

Insurance contract or identification number	14167833
Number of Individuals Covered	90
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $24,128
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 $1,245,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1166220

Policy instance

Insurance contract or identification number	1166220
Number of Individuals Covered	108
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $15,146
Total amount of fees paid to insurance company	USD $3,000
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	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $124,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

LUMAVERSE TECHNOLOGIES 401K PLAN [EIN = 550871115]

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Company Name:	LUMAVERSE TECHNOLOGIES
Employer identification number (EIN):	821948607
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services