401k Plan data: THE WET SEAL CAFETERIA PLAN plan

THE WET SEAL CAFETERIA PLAN 401k Plan overview

Plan Name	THE WET SEAL CAFETERIA PLAN
Plan identification number	501

THE WET SEAL CAFETERIA 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

THE WET SEAL, LLC has sponsored the creation of one or more 401k plans.

Company Name: THE WET SEAL, LLC

Employer identification number (EIN): 473502741

NAIC Classification: 448120
NAIC Description: Women's Clothing Stores

Additional information about THE WET SEAL, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5712137

More information about THE WET SEAL, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WET SEAL CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-08-23 JUDD P TIMAUER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2015-08-23	JUDD P TIMAUER

Plan Statistics for THE WET SEAL CAFETERIA PLAN

401k plan membership statisitcs for THE WET SEAL CAFETERIA PLAN

Measure Date Value
2015: THE WET SEAL CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-23 607
Total number of active participants reported on line 7a of the Form 5500 2015-08-23 645
Number of retired or separated participants receiving benefits 2015-08-23 0
Number of other retired or separated participants entitled to future benefits 2015-08-23 0
Total of all active and inactive participants 2015-08-23 645

Measure	Date	Value
2015: THE WET SEAL CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-23	607
Total number of active participants reported on line 7a of the Form 5500	2015-08-23	645
Number of retired or separated participants receiving benefits	2015-08-23	0
Number of other retired or separated participants entitled to future benefits	2015-08-23	0
Total of all active and inactive participants	2015-08-23	645

Form 5500 Responses for THE WET SEAL CAFETERIA PLAN

2015: THE WET SEAL CAFETERIA PLAN 2015 form 5500 responses
2015-08-23	Type of plan entity	Single employer plan
2015-08-23	First time form 5500 has been submitted	Yes
2015-08-23	Submission has been amended	No
2015-08-23	This submission is the final filing	No
2015-08-23	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-08-23	Plan is a collectively bargained plan	No
2015-08-23	Plan funding arrangement – Insurance	Yes
2015-08-23	Plan funding arrangement – General assets of the sponsor	Yes
2015-08-23	Plan benefit arrangement – Insurance	Yes
2015-08-23	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3213728

Policy instance

Insurance contract or identification number	3213728
Number of Individuals Covered	192
Insurance policy start date	2015-09-01
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $100
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	No
Dental Insurance Welfare Benefit	Yes
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 $18,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $100
Insurance broker organization code?	3
Insurance broker name	INTERCARE INSURANCE SOLUTIONS, INC.

HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )

Policy contract number

26561 & 96176

Policy instance

Insurance contract or identification number	26561 & 96176
Number of Individuals Covered	6
Insurance policy start date	2015-09-01
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $0
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	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 $16,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

097872

Policy instance

Insurance contract or identification number	097872
Number of Individuals Covered	440
Insurance policy start date	2015-08-23
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $10,396
Total amount of fees paid to insurance company	USD $1,300
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $103,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,396
Amount paid for insurance broker fees	1300
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH AND BENEFITS, LLC

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

097873

Policy instance

Insurance contract or identification number	097873
Number of Individuals Covered	98
Insurance policy start date	2015-08-23
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $2,123
Total amount of fees paid to insurance company	USD $265
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	No
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
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 $18,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,123
Amount paid for insurance broker fees	265
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH AND BENEFITS, LLC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30032286

Policy instance

Insurance contract or identification number	30032286
Number of Individuals Covered	219
Insurance policy start date	2015-09-01
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $1,509
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	No
Dental Insurance Welfare Benefit	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,509
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH AND BENEFITS, LLC

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Company Name:	THE WET SEAL, LLC
Employer identification number (EIN):	473502741
NAIC Classification:	448120
NAIC Description:	Women's Clothing Stores

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5712137