401k Plan data: ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN plan

ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN
Plan identification number	502

ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT 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 Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ONE CALLS OF AMERICA INC VEBA TRUST has sponsored the creation of one or more 401k plans.

Company Name: ONE CALLS OF AMERICA INC VEBA TRUST

Employer identification number (EIN): 311513644

NAIC Classification: 525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2016-01-01 DANIEL CANTER DANIEL CANTER 2017-10-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2016-01-01	DANIEL CANTER		DANIEL CANTER	2017-10-16

Plan Statistics for ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN

Measure Date Value
2016: ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 480
Total of all active and inactive participants 2016-01-01 480
Total participants 2016-01-01 480
Number of employers contributing to the scheme 2016-01-01 13

Measure	Date	Value
2016: ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	480
Total of all active and inactive participants	2016-01-01	480
Total participants	2016-01-01	480
Number of employers contributing to the scheme	2016-01-01	13

Financial Data on ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN

Measure	Date	Value
2016 : ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$984,113
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$191,107
Total income from all sources (including contributions)	2016-12-31	$5,309,735
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$5,837,578
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$5,827,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$5,309,735
Value of total assets at end of year	2016-12-31	$758,189
Value of total assets at beginning of year	2016-12-31	$493,026
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$10,057
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$2,925
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$493,026
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$113,516
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$191,107
Administrative expenses (other) incurred	2016-12-31	$132
Total non interest bearing cash at end of year	2016-12-31	$754,736
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-527,843
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$-225,924
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$301,919
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$1,140,515
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$5,309,735
Employer contributions (assets) at end of year	2016-12-31	$3,453
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$4,687,006
Contract administrator fees	2016-12-31	$7,000
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$870,597
Did the plan have assets held for investment	2016-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No

Form 5500 Responses for ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN

2016: ONE-CALLS PSF VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Multi-employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	ONE CALLS OF AMERICA INC VEBA TRUST
Employer identification number (EIN):	311513644
NAIC Classification:	525100
NAIC Description:	Insurance and Employee Benefit Funds