401k Plan data: PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN plan

PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	501

PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental 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

PLUS COMMUNICATIONS D/B/A CHARISMA MEDIA has sponsored the creation of one or more 401k plans.

Company Name: PLUS COMMUNICATIONS D/B/A CHARISMA MEDIA

Employer identification number (EIN): 592184864

NAIC Classification: 323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-06-01

Plan Statistics for PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2017: PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-06-01 101
Total number of active participants reported on line 7a of the Form 5500 2017-06-01 84
Number of retired or separated participants receiving benefits 2017-06-01 1
Number of other retired or separated participants entitled to future benefits 2017-06-01 0
Total of all active and inactive participants 2017-06-01 85

Measure	Date	Value
2017: PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-06-01	101
Total number of active participants reported on line 7a of the Form 5500	2017-06-01	84
Number of retired or separated participants receiving benefits	2017-06-01	1
Number of other retired or separated participants entitled to future benefits	2017-06-01	0
Total of all active and inactive participants	2017-06-01	85

Form 5500 Responses for PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN

2017: PLUS COMMUNICATIONS, INC. HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-06-01	Type of plan entity	Single employer plan
2017-06-01	First time form 5500 has been submitted	Yes
2017-06-01	Plan funding arrangement – Insurance	Yes
2017-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B5159

Policy instance

Insurance contract or identification number	B5159
Number of Individuals Covered	14
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $5,847
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,847
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	BROWN AND BROWN OF FLORIDA, INC.

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )

Policy contract number

B5159

Policy instance

Insurance contract or identification number	B5159
Number of Individuals Covered	66
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $27,050
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,050
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	BROWN AND BROWN OF FLORIDA, INC.

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AJ4F

Policy instance

Insurance contract or identification number	GLUG0AJ4F
Number of Individuals Covered	84
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $6,138
Total amount of fees paid to insurance company	USD $1,297
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $59,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,138
Amount paid for insurance broker fees	1297
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	BROWN AND BROWN OF FLORIDA, INC.

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Company Name:	PLUS COMMUNICATIONS D/B/A CHARISMA MEDIA
Employer identification number (EIN):	592184864
NAIC Classification:	323100