401k Plan data: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN plan

ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number	501

ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT 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

ALL3MEDIA USA, INC. has sponsored the creation of one or more 401k plans.

Company Name: ALL3MEDIA USA, INC.

Employer identification number (EIN): 461488886

NAIC Classification: 711510
NAIC Description: Independent Artists, Writers, and Performers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-07-01 KATHRYN BRUTTO KATHRYN BRUTTO 2017-12-13
501 2015-07-01 COLLETTE SOBRAY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2016-07-01	KATHRYN BRUTTO		KATHRYN BRUTTO	2017-12-13
501	2015-07-01	COLLETTE SOBRAY

Plan Statistics for ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2016: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 281
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 336
Number of retired or separated participants receiving benefits 2016-07-01 21
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 357
Total participants 2016-07-01 357
Number of employers contributing to the scheme 2016-07-01 4
2015: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 150
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 140
Number of retired or separated participants receiving benefits 2015-07-01 17
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 157
Total participants 2015-07-01 157
Number of employers contributing to the scheme 2015-07-01 3

Measure	Date	Value
2016: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	281
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	336
Number of retired or separated participants receiving benefits	2016-07-01	21
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	357
Total participants	2016-07-01	357
Number of employers contributing to the scheme	2016-07-01	4
2015: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	150
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	140
Number of retired or separated participants receiving benefits	2015-07-01	17
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	157
Total participants	2015-07-01	157
Number of employers contributing to the scheme	2015-07-01	3

Form 5500 Responses for ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN

2016: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Multi-employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: ALL3MEDIA USA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )

Policy contract number

278386

Policy instance

Insurance contract or identification number	278386
Number of Individuals Covered	145
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $58,964
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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	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	STD
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 $1,609,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58,964
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	PEGASUS FINANCIAL GROUP, INC.

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

Policy contract number

00508004

Policy instance

Insurance contract or identification number	00508004
Number of Individuals Covered	169
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $18,461
Are there contracts with allocated funds for individual policies?	No
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	CANCER, ACCIDENT AND VOLUNTARY CRITICAL ILLNESS
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 $102,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $736
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Amount paid for insurance broker fees	3812
Insurance broker name	PEGASUS FINANCIAL GROUP, INC.

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Company Name:	ALL3MEDIA USA, INC.
Employer identification number (EIN):	461488886
NAIC Classification:	711510
NAIC Description:	Independent Artists, Writers, and Performers