401k Plan data: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN plan

SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN
Plan identification number	501

SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Other welfare benefit cover

401k Sponsoring company profile

SPIEGELWORLD HOLDING COMPANY LLC has sponsored the creation of one or more 401k plans.

Company Name: SPIEGELWORLD HOLDING COMPANY LLC

Employer identification number (EIN): 463513906

NAIC Classification: 711300
NAIC Description: Promoters of Performing Arts, Sports, and Similar Events

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 LESLEY BROUSSEAU 2023-07-17
501 2021-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	LESLEY BROUSSEAU	2023-07-17
501	2021-01-01

Plan Statistics for SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN

Measure Date Value
2022: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 235
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 257
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 257
Number of employers contributing to the scheme 2022-01-01 0
2021: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 235
Total of all active and inactive participants 2021-01-01 235
Total participants 2021-01-01 235

Measure	Date	Value
2022: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	235
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	257
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	257
Number of employers contributing to the scheme	2022-01-01	0
2021: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	235
Total of all active and inactive participants	2021-01-01	235
Total participants	2021-01-01	235

Form 5500 Responses for SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN

2022: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: SPIEGELWORLD HOLDING COMPANY EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

922911

Policy instance

Insurance contract or identification number	922911
Number of Individuals Covered	374
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $123,938
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,709,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $93,236
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

580624

Policy instance

Insurance contract or identification number	580624
Number of Individuals Covered	257
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $16,856
Total amount of fees paid to insurance company	USD $5,343
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $194,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,856
Amount paid for insurance broker fees	5343
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

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

Policy contract number

00580624

Policy instance

Insurance contract or identification number	00580624
Number of Individuals Covered	235
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $14,105
Total amount of fees paid to insurance company	USD $464
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	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 $148,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,105
Amount paid for insurance broker fees	464
Additional information about fees paid to insurance broker	GENERAL AGENT FEES
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0922911

Policy instance

Insurance contract or identification number	0922911
Number of Individuals Covered	214
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $44,129
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,457
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	SPIEGELWORLD HOLDING COMPANY LLC
Employer identification number (EIN):	463513906
NAIC Classification:	711300
NAIC Description:	Promoters of Performing Arts, Sports, and Similar Events