rp-15-34.pdf

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Application Procedures for Approval of Benefit Suspensions for Certain
Multiemployer Defined Benefit Pension Plans under § 432(e)(9)

Revenue Procedure 2015-34

SECTION 1. BACKGROUND AND PURPOSE

Section 201 of the Multiemployer Pension Reform Act of 2014, Division O of the
Consolidated and Further Continuing Appropriations Act, 2015, Public Law 113-235
(128 Stat. 2130 (2014)) (MPRA), amended the Internal Revenue Code (Code) and the
Employee Retirement Income Security Act of 1974, Public Law 93-406 (88 Stat. 829
(1974)), as amended (ERISA), to permit the sponsor of a multiemployer defined benefit
plan in critical and declining status to suspend benefits in certain situations.

In particular, MPRA amended § 432(e)(9) of the Code and section 305(e)(9) of
ERISA to permit the sponsor of a multiemployer defined benefit plan in critical and
declining status to submit to the Secretary of the Treasury (Secretary) a proposal to
suspend benefits in certain situations. MPRA requires the Secretary to approve a plan
sponsor’s proposed suspension if the plan is eligible for the proposed suspension and
the proposed suspension satisfies § 432(e)(9)(C) through (F).
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On February 18, 2015, the Treasury Department issued a Request for
Information on benefit suspensions under MPRA in the Federal Register (80 FR 8578).
The Request for Information stated that the Treasury Department intends to issue
guidance implementing § 432(e)(9) and that a plan sponsor should not submit an
application for a suspension of benefits until a date specified in that future guidance.

Applications for a suspension of benefits under a multiemployer defined benefit
pension plan that is in critical and declining status under § 432(e)(9) will be accepted on
or after June 19, 2015. This revenue procedure prescribes the application process for
approval of a proposed benefit suspension in accordance with § 432(e)(9)(G) and

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The Secretary’s approval of a proposed suspension would apply for purposes of section 305(e)(9) of
ERISA, as well for purposes of § 432(e)(9) of the Code. Accordingly, the provisions of this revenue
procedure pertaining to § 432(e)(9) of the Code apply also for purposes of the corresponding provisions
of section 305(e)(9) of ERISA.

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provides a model notice that a plan sponsor proposing a benefit suspension may use to
satisfy the content and readability requirements of § 432(e)(9)(F)(ii) and (iii)(II). See
Appendix A for the model notice. This revenue procedure does not affect the standards
that will be applied in reviewing an application for a suspension of benefits under
§ 432(e)(9).

Proposed and temporary regulations under § 432(e)(9) were published in the
Federal Register on June 19, 2015. The provisions of this revenue procedure should be
interpreted in a manner consistent with the provisions of the proposed and temporary
regulations under § 432(e)(9). Final regulations will be issued following a public hearing
and consideration of public comments. If, and to the extent that, the final regulations
differ from the proposed and temporary regulations in a manner that affects the
provisions of this revenue procedure, or if changes to the application process are
identified that would be necessary or helpful, a revised revenue procedure will be issued
to take those changes into account.

While proposed and temporary regulations have been issued (and, as noted,
applications proposing a benefit suspension will be accepted on or after June 19, 2015),
it is expected that any such applications will not be approved prior to consideration of
public comments on the regulations and subsequent issuance of final regulations. If a
plan sponsor chooses to submit an application for approval of a proposed benefit
suspension in accordance with the proposed and temporary regulations before the
issuance of final regulations, then the plan sponsor may need to revise the proposed
suspension (and potentially the related notices to plan participants) or supplement the
application to take into account any differences in the regulatory provisions that might
be included in the final regulations.

SECTION 2. APPLICATION PROCEDURES

This section prescribes procedures for applying for approval of a proposed
suspension of benefits, including information that must be included in the application. A
plan sponsor may be required to provide additional information with respect to any
application after it is submitted. For example, the plan sponsor may be required to
provide individual participant data that would permit the Secretary to confirm that the
sample and actuarial calculations provided in the application, such as those provided for
purposes of section 4 of this revenue procedure, are accurate and applied in a
consistent manner.

.01 Who may submit application. An application for approval of a proposed
benefit suspension under § 432(e)(9) must be submitted by the plan sponsor as
defined in § 432(j)(9) (generally, the joint board of trustees of the plan) or by an
authorized representative of the plan sponsor. The application must be signed
and dated by an authorized trustee who is a current member of the board of

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trustees or by an authorized representative of the plan sponsor who is described
in section 7.01(13) of Rev. Proc. 2015-1, 2015-1 I.R.B. 1.
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.02 Terms of proposed benefit suspension. The application must include a
description of the proposed benefit suspension. The description must include the
following information:

(1) The effective date of the proposed suspension.

(2) If the proposed suspension will expire by its own terms, the expiration
date.

(3) The categories or groups of individuals who would be affected by the
proposed suspension and how those categories or groups are defined. If
the proposed suspension would have a different effect on different
categories or groups, the description must describe the differences,
including the formula used to calculate the amount of the proposed benefit
suspension for individuals in each category or group. Although any
benefit suspension must take into account the limitations on a benefit
suspension under the rules of § 432(e)(9)(D)(i), (ii) and (iii), for ease of
presentation and understanding the amount of the proposed benefit
suspension described in this section 2.02 for an individual must be
calculated as if the limitations of § 432(e)(9)(D)(i), (ii) and (iii) did not apply
to that individual. (Note that the application of those limitations must be
described pursuant to section 4.01 of this revenue procedure, below.)

.03 Penalties of perjury. The following statement signed by an authorized trustee
on behalf of the board of trustees that the application is submitted under
penalties of perjury: “Under penalties of perjury, I declare that I have examined
this request, including accompanying documents, and, to the best of my
knowledge and belief, the request contains all the relevant facts relating to the
request, and such facts are true, correct, and complete.”

.04 Public disclosure. A statement signed by an authorized trustee on behalf of
the board of trustees acknowledging that, pursuant to § 432(e)(9)(G)(ii), the
application for approval of the proposed suspension of benefits, and the
application’s supporting material, will be publicly disclosed through publication on
the Treasury Department website.

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Section 7.01(13) of Rev. Proc. 2015-1 provides that the following parties may be authorized
representatives if appropriately accredited or authorized: attorney, certified public accountant, enrolled
agent, enrolled actuary, and enrolled retirement plan agent.

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.05 Where to submit application. An application must be submitted to:

www.treasury.gov
/mpra

.06 Signature. Any signature required by this revenue procedure must be
submitted electronically in Portable Document Format as part of the application.
A stamped signature is not permitted.

.07 Duty to correct. If, after submission of an application for a suspension of
benefits, any error in that application is discovered, the plan sponsor must
provide prompt notice to the Treasury Department.

SECTION 3. DEMONSTRATION THAT PLAN IS ELIGIBLE FOR SUSPENSION

The application must include the following information providing support for the
plan sponsor’s method of satisfying the benefit suspension criteria under § 432(e)(9),
including the plan’s eligibility for the suspension:

.01 Plan actuary’s certification of critical and declining status. The plan actuary’s
certification required under § 432(b)(3)(B)(iv) that the plan is in critical and
declining status as defined in § 432(b)(6) for the plan year in which the
application is submitted. Documentation supporting the actuarial certification of
status must be included with the certification, including a year-by-year projection
of the available resources as defined in § 418E(b)(3) and the benefits under the
plan, demonstrating that the plan is projected to become insolvent during the
relevant period. The documentation must include a description of each of the
assumptions used, including the total contribution base units and average
contribution rates. The year-by-year projection must separately identify the
market value of assets as of the beginning and end of each year in the relevant
period and the following cash-flow items for each of those years:

(1) Contributions.

(2) Withdrawal liability payments.

(3) Benefit payments.

(4) Administrative expenses.

(5) Investment returns.

.02 Plan actuary’s certification that the plan is projected to avoid insolvency. The

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plan actuary’s certification to the plan sponsor under § 432(e)(9)(C)(i) that the
plan is projected to avoid insolvency within the meaning of § 418E, taking into
account the proposed benefit suspension (and, if applicable, a proposed partition
of the plan under section 4233 of ERISA) and assuming that the proposed
suspension continues until it expires by its own terms or, if no such expiration
date is set, indefinitely. Documentation supporting the actuarial certification
under § 432(e)(9)(C)(i) must be included with the certification, including a year-
by-year projection of the available resources within the meaning of § 418E(b)(3)
and the benefits under the plan demonstrating the avoidance of insolvency of the
plan over the relevant period. The documentation must include a description of
each of the assumptions used, including the total contribution base units and
average contribution rates. The year-by-year projection must separately identify
the market value of assets as of the beginning and end of each year in the
relevant period and the following cash-flow items for each of those years:

(1) Contributions.

(2) Withdrawal liability payments.

(3) Benefit payments.

(4) Administrative expenses.

(5) Investment returns.

.03 Plan sponsor’s determination of projected insolvency. The plan sponsor’s
determination under § 432(e)(9)(C)(ii) that the plan is projected to become
insolvent unless benefits are suspended, even though all reasonable measures
to avoid insolvency have been taken. The determination must include the
documentation set forth in section 5 of this revenue procedure.

SECTION 4. DEMONSTRATION THAT THE PROPOSED SUSPENSION SATISFIES
THE STATUTORY REQUIREMENTS

The application must include the following information to demonstrate that certain
statutory limitations and notice requirements are satisfied with respect to the proposed
suspension of benefits:

.01 Demonstration that limitations on individual suspensions are satisfied. A
demonstration of how the proposed suspension satisfies the limitations described

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in § 432(e)(9)(D)(i), (ii), and (iii).
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The demonstration must include:

(1) A sample calculation applying the 110 percent limitation under
§ 432(e)(9)(D)(i) for an individual in each category or group identified in
accordance with section 2.02(3) of this revenue procedure. Each sample
calculation must identify how the monthly benefit that would be
guaranteed under section 4022A of ERISA is calculated (assuming, for
this purpose, that no portion of the individual’s benefit under the plan is
subject to permitted forfeiture under § 411(a), due, for example, to a
failure to vest in accordance with the vesting schedule specified under the
plan). The calculation must identify the extent, if any, to which the monthly
guaranteed benefit calculated under section 4022A is reduced on account
of any of the following limitations or exclusions:

(a) The section 4022A(a) exclusion of certain forfeitable benefits (for
example, increased benefits that have not become part of the accrued
benefit).

(b) The section 4022A(b)(1)(A) exclusion of certain benefits and benefit
increases in effect for less than 60 months.

(c) The limitations contained in the section 4022A(c)(2) definition of the
accrual rate used for calculating the monthly guaranteed benefit (the
accrual rate must be based on a benefit that is no greater than the
monthly benefit payable under the plan at normal retirement age in the
form of a single life annuity (for example, if the benefit reflected an
actuarial increase related to delayed retirement or is paid in the form of
a social security level income option) and must be calculated without
regard to any reduction under § 411(a)(3)(E), divided by years of
credited service (credited service cannot exceed 1 year for any year of
participation)).

(d) The section 4022A(d) limitation that the guaranteed benefit will not
exceed the benefit calculated under the plan as reduced under
§ 411(a)(3)(E).

(e) The section 4022A(e) exclusion, pursuant to section 4022(b)(6), of
benefits that would not be guaranteed if paid under a single-employer

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The sample calculations submitted pursuant to this section 4.01 must not include personally identifiable
information relating to any individual.

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plan (benefits paid from a plan that does not satisfy the requirements
of § 401(a) or § 404(a)(2)).

(2) With respect to benefits based on disability, as calculated using the plan’s
definition of disability:

(a) A description of each benefit based on disability, as defined under the
plan, that is paid to an individual under the plan, and

(b) A sample calculation under § 432(e)(9)(D)(iii) for an individual in each
category or group identified in accordance with section 2.02(3) of this
revenue procedure for each type of benefit based on disability that
shows how the plan determines the extent to which any retirement
benefit paid with respect to a participant who commenced benefits as a
result of disability is, or is not, treated as a benefit based on disability.
If the plan provides to a disabled individual a benefit that is not
described in the plan as a disability benefit (for example, a retirement
benefit paid at normal retirement age that is greater than a disability
benefit paid before normal retirement age), then the calculation must
show the extent to which the retirement benefit is, or is not, a benefit
based on disability.

(3) A sample calculation for an individual in each category or group identified
in accordance with section 2.02(3) of this revenue procedure that shows
how the proposed suspension satisfies the age-based limitations of
§ 432(e)(9)(D)(ii), taking into account the guarantee-based limitation of
§ 432(e)(9)(D)(i). If the plan provides a benefit of the type described in the
second sentence of paragraph 4.01(2)(b) of this revenue procedure, then
the sample calculation must show how the proposed suspension satisfies
the age-based limitations taking into account both the guarantee-based
limitation and the disability-based limitation.

.02 Demonstration that the proposed suspension is reasonably estimated to
enable the plan to avoid insolvency. A demonstration that, in accordance with
§ 432(e)(9)(D)(iv), the proposed benefit suspension (considered, if applicable, in
combination with a proposed partition of the plan under section 4233 of ERISA)
is reasonably estimated to enable the plan to avoid insolvency. The
demonstration must include:

(1) An illustration, prepared on a deterministic basis, showing that:

(a) For each plan year beginning on the effective date of the proposed
suspension and throughout an extended period as described in

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regulations under § 432(e)(9), the plan’s solvency ratio – the ratio of
the plan’s available resources (as defined in § 418E(b)(3)) to the
scheduled benefits payable under the plan for the plan year – is
projected to be at least 1.0.

(b) If the plan’s projected funded percentage at the end of the extended
period is less than or equal to 100 percent, then neither the plan’s
solvency ratio nor its available resources are projected to decrease in
any of the last five plan years of the extended period.

(2) An illustration using stochastic projections that reflect variance in
investment return that the probability the plan will avoid insolvency
throughout the extended period as a result of the proposed suspension is
greater than 50 percent. (The plan sponsor of a plan that is not described
in § 432(e)(9)(B)(v)(I) is not required to use stochastic projections in
demonstrating that the plan will avoid insolvency; however, if the plan
sponsor chooses to use stochastic projections for this purpose, then it
must provide this illustration.)

(3) A description of each of the assumptions used, including:

(a) If the actuarial assumptions used for the deterministic projections differ
from those used under section 3.01 of this revenue procedure, a
justification for that difference.

(b) With respect to the stochastic projections described in section 4.02(2)
of this revenue procedure, the assumed mix of assets (and how it
compares with the current mix of assets), the distribution of returns for
each asset class, and the correlation among those rates of returns and
any other economic variables in the projections.

(c) If the actuarial assumptions used for stochastic projections as
described in section 4.02(2) of this revenue procedure differ from those
used for deterministic projections as described in section 4.02(1) of this
revenue procedure (other than those related to investment returns), a
justification for that difference.

.03 Demonstration that the proposed suspension is reasonably estimated to not
materially exceed the level necessary to avoid insolvency. In the case of a plan
that is not applying for a partition in combination with a suspension, a
demonstration that, in accordance with § 432(e)(9)(D)(iv), the proposed benefit
suspension is reasonably estimated to not materially exceed the level necessary
to enable the plan to avoid insolvency. For this purpose, the assumptions used

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must be the same as those used for purposes of 4.02 of this revenue procedure.
The demonstration must include an illustration of the measures described in
section 4.02(1) of this revenue procedure (and, if applicable to the plan, section
4.02(2) of this revenue procedure) showing that, if the dollar amount of the
proposed suspension for each participant and beneficiary were reduced by 5
percent, then the proposed suspension would not reasonably be estimated to
enable the plan to avoid insolvency.

.04 Demonstration that the proposed benefit suspension is distributed equitably.
A demonstration that, in accordance with § 432(e)(9)(D)(vi), the proposed benefit
suspension is distributed in an equitable manner across the participant and
beneficiary population.

(1) With respect to this demonstration, the application must identify the factors
(for example, those listed in section § 432(e)(9)(D)(vi)(I) through (XI)) that
were taken into account in designing the proposed suspension.

(2) If none of the factors listed in § 432(e)(9)(D)(vi)(I) through (XI) were taken
into account, then the application must explain why those factors were not
considered relevant in designing the proposed suspension.

(3) If the proposed suspension applies differently to different categories or
groups of individuals, then the application must state the approximate
number of individuals in each category or group, the average monthly
benefit before and after the suspension for individuals in that category or
group, and the aggregate present value of the reduction in benefits for all
individuals in that category or group. The application must also explain
how any differences in the applicable benefit suspension formulas for the
different categories or groups of individuals result from a reasonable
application of the relevant factors.

(4) A demonstration of the distribution of the benefit suspension within each
different category or group of individuals referred to in section 4.04(3) of
this revenue procedure, taking into account the effect of the individual
limitations under § 432(e)(9)(D)(i), (ii), and (iii). This can be expressed as
a count of individuals within the category or group whose benefits are not
reduced, or are reduced by a percentage within a range not exceeding 10
percent. For example, the distribution could show a count of the
individuals who have no reduction, a reduction of 10 percent or less, a
reduction of 20 percent or less but more than 10 percent, etc.

.05 Notice. A description of the plan sponsor’s method for satisfying the notice
requirements under § 432(e)(9)(F), including the following information:

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(1) For each category or group of individuals described in section 2.02(3) of
this revenue procedure, a copy of each type of actual notice
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that has
been or will be given to an individual in that category or group. (This is
required even if the plan sponsor uses the model notice in Appendix A.)

(2) A description of the efforts that are being made to contact participants,
beneficiaries and alternate payees.

(3) A description of the steps the plan sponsor has taken to ensure that any
electronically delivered notices are reasonably accessible to the
recipients.

(4) A list of:

(a) Each employer that has an obligation to contribute within the meaning
of section 4212(a) of ERISA, and

(b) Each employee organization representing participants under the plan.

SECTION 5. PLAN SPONSOR DETERMINATION RELATING TO REASONABLE
MEASURES TAKEN TO AVOID INSOLVENCY

With respect to the plan sponsor’s determination required under section 3.03 of
this revenue procedure that the plan is projected to become insolvent unless benefits
are suspended, the application must include the following information:

.01 Measures taken to avoid insolvency. A detailed description of measures
taken in order to avoid insolvency over the past 10 plan years immediately
preceding the plan year in which the application is submitted.

.02 Plan factors. In accordance with § 432(e)(9)(C)(ii), the following specific
information with respect to the plan:

(1) For the past 10 plan years immediately preceding the plan year in which
the application is submitted:

(a) Contribution levels.

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The copy of the notice(s) attached to the application must not include personally identifiable information
with respect to any individual, such as a name or social security number.

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(b) Levels of benefit accruals, including any prior reductions in the rate of
benefit accruals.

(c) Prior reductions, if any, of adjustable benefits under § 432(e)(8).

(d) Any prior suspension of benefits under § 432(e)(9).

(e) Measures undertaken by the plan sponsor to retain or attract
contributing employers.

(2) The impact on plan solvency of the subsidies and ancillary benefits, if any,
available to active participants.

(3) Compensation levels of active participants relative to employees in the
participants’ industry generally.

(4) Competitive and other economic factors facing contributing employers.

.03 How plan factors were taken into account. For each of the factors listed
under section 5.02 of this revenue procedure and the factors described in
§ 432(e)(9)(C)(ii)(VIII) (the impact of benefit and contribution levels on retaining
active participants and bargaining groups under the plan) and
§ 432(e)(9)(C)(ii)(IX) (the impact of past and anticipated contribution increases
under the plan on employer attrition and retention levels), the application must
describe how that factor was taken into account (or why that factor was not taken
into account) in the plan sponsor’s determination that all reasonable measures
have been taken to avoid insolvency.

.04 Other factors considered. If the plan sponsor considered any other factors,
then the application must discuss how and why that factor was taken into
account in the plan sponsor’s determination that all reasonable measures have
been taken to avoid insolvency.

SECTION 6. OTHER REQUIRED INFORMATION.

The application must also include the following information:

.01 Ballot. A proposed ballot intended to satisfy the requirements of
§ 432(e)(9)(H)(iii) (without the statement in opposition to the proposed benefit
suspension described in § 432(e)(9)(H)(iii)(II) or the individualized estimate that
was provided as part of the notice described in § 432(e)(9)(F)).

.02 Partition. Whether the plan sponsor is requesting approval from the PBGC of

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a proposed partition under section 4233 of ERISA. If the plan sponsor is
requesting approval of a proposed partition, then the application for the proposed
benefit suspension must include the proposed effective date of the partition and a
year-by-year projection of the amount of the reduction in benefit payments (that
is, the guaranteed amounts covered by financial assistance under the successor
plan for each year) attributable to the partition.

.03 Ten-year experience for certain critical assumptions. With respect to each of
the 10 plan years immediately preceding the plan year in which the application is
submitted, a disclosure that separately identifies:

(1) Total contributions.

(2) Total contribution base units.

(3) Average contribution rates.

(4) Withdrawal liability payments.

(5) Rate of return on plan assets.

.04 Demonstration of sensitivity of projections. The application must include
deterministic projections of the sensitivity of the plan’s solvency ratio throughout
the extended period to certain key assumptions. For this purpose, the
application must include the following separate projections calculated using the
same assumptions as those used under section 4.02(1) of this revenue
procedure, except that:

(1) The assumed rate of return is reduced by 1 percentage point.

(2) The assumed rate of return is reduced by 2 percentage points.

(3) Future contribution base units increase or decrease at a rate equal to the
average annual rate of increase or decrease that the plan experienced
over the period of years described in section 6.03 of this revenue
procedure.

(4) Future contribution base units increase or decrease at a rate equal to the
rate described in section 6.04(3) of this revenue procedure reduced by 1
percentage point.

.05 Projection of funded percentage. The plan sponsor must include an
illustration, prepared on a deterministic basis, of the projected value of plan

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assets, the accrued liability of the plan (calculated using the unit credit funding
method) and the funded percentage for each year in the extended period.

.06 Plan sponsor certifications relating to plan amendments. The plan sponsor
must certify that if it receives final authorization to implement the suspension as
described in § 432(e)(9)(H)(vi) and chooses to implement the authorized
suspension, then, in addition to the plan amendment implementing the
suspension, the following plan amendments will be timely adopted and not
modified at any time thereafter before the suspension of benefits expires:

(1) A plan amendment providing that in accordance with § 432(e)(9)(C)(ii) the
benefit suspension will cease as of the first day of the first plan year
following the plan year in which the plan sponsor fails to determine that
both:

(a) All reasonable measures to avoid insolvency continue to be taken
during the period of the benefit suspension.

(b) The plan is projected to become insolvent unless benefits continue to
be suspended.

(2) A plan amendment providing that any future benefit improvements must
satisfy the requirements of § 432(e)(9)(E).

.07 Whether a plan is described in § 432(e)(9)(D)(vii)(III). Whether the plan is a
plan described in § 432(e)(9)(D)(vii)(III) and, if so, how that fact is reflected in the
proposed benefit suspension.

.08 Optional additional information. The plan sponsor may include other
information about the plan, such as a narrative statement of the reasons the plan
is in critical and declining status.

SECTION 7. IDENTIFICATION AND BACKGROUND INFORMATION ON THE PLAN

The application must include the following identification and background
information:

.01 Plan sponsor. Name, contact information (for example, address, telephone
number, email address and fax number) and employer identification number
(EIN) of the plan sponsor.

.02 Plan identification. Name of the plan, plan number and plan EIN (if different
from the plan sponsor EIN) for which the application is submitted.

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.03 Retiree representative. If applicable, name and contact information of the
retiree representative for the plan described in § 432(e)(9)(B)(v).

.04 Plan’s enrolled actuary. Name, enrollment number, and contact information
of the plan’s enrolled actuary within the meaning of § 7701(a)(35).

.05 Power of Attorney. A designation of power of attorney for each authorized
representative who will represent the plan sponsor in connection with the
application. See Appendix B.

.06 Plan documents. With respect to the plan document, the most recent plan
document, including all amendments adopted since the last restatement
5
as well
as the following documents related to that plan document:

(1) The most recent summary plan description as defined under section 102
of ERISA and any subsequent summaries of material modification.

(2) The most recent determination letter issued to the plan.

.07 Collective bargaining and side agreements. Excerpts from collective
bargaining agreements and side agreements (such as participation agreements
or reciprocity agreements) pursuant to which the plan is maintained. The plan
sponsor must not submit the entire collective bargaining or side agreement. The
required excerpts are:

(1) Language from any portions of a collective bargaining agreement that are
relevant to the plan or the proposed suspension, and

(2) Language from any portions of a side agreement that are relevant to the
plan or the proposed suspension.

.08 Annual return. Excerpts from the most recently filed Form 5500, Annual
Return/Report of Employee Benefit Plan. The required excerpts are:

(1) Pages 1 and 2 of the Form 5500, without attachments or schedules.

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Submission of the plan document and amendments to the Treasury Department as part of the
application for approval of a proposed suspension under this revenue procedure will not be treated as a
request to the IRS for a favorable determination on the qualified status of the plan under § 401 or the
exempt status of the related trust under § 501(a). For procedures governing an application to the IRS for
a favorable determination under §§ 401 and 501(a), see Rev. Proc. 2015-6, 2015-1 I.R.B. 194, and Rev.
Proc. 2007-44, 2007-2 C.B. 54, as modified.

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(2) The Schedule MB, including attachments, and
(3) The Schedule R, including attachments.
.09 Rehabilitation plan. The rehabilitation plan described in § 432(e)(3) as most
recently updated. If the rehabilitation plan includes more than one contribution or
benefit schedule, then the application must specify the extent to which each
schedule applies (either pursuant to collective bargaining or, with respect to the
designated default schedule, as imposed on an employer), expressed as a
percentage of the total contributions for the most recent year for which the
information is available.

.10 Completed checklist. A completed checklist of information required to be
included in the application. See Appendix C.

SECTION 8. PAPERWORK REDUCTION ACT

The collections of information contained in this revenue procedure have been
approved by the Office of Management and Budget in accordance with the Paperwork
Reduction Act of 1995 (44 U.S.C. 3507(c)) under control number 1545-2260.

An agency may not conduct or sponsor, and a person is not required to respond
to, a collection of information unless the collection of information displays a valid OMB
control number.

The collections of information in this revenue procedure appear in Appendix B
(sample Power of Attorney form) and Appendix C (checklist for completeness of the
application). Burden estimates with respect to information described in sections 2, 3, 4,
5, 6 and 7 of this revenue procedure are reported in the preamble to the proposed
regulations under §1.432(e)(9)-1.

We estimate the total number of respondents to be 28.

We estimate it will take 2 hours to comply. The estimated total annual and/or
recordkeeping burden is 56 hours.

Estimates of the annualized cost to respondents for the hour burdens shown are
not available at this time.

CONTACT INFORMATION

For general information regarding this revenue procedure, please contact the Treasury
Department MPRA guidance information line at (202) 622-1559 (not a toll-free

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number). For information regarding a specific application for benefit suspension, please
contact the Treasury Department at (202) 622-1534 (not a toll-free number).

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Appendix A

MODEL NOTICE OF APPLICATION FOR APPROVAL OF A PROPOSED
REDUCTION OF BENEFITS

[This is a model notice that can be used to satisfy the requirements of § 432(e)(9)(F). If
the plan sponsor applies for a partition of the Plan under section 4322 of ERISA, then
this notice can be combined with the notice required under section 4322 assuming all
other requirements, such as the timing of providing each notice, are satisfied.]

[DATE]

NOTICE OF APPLICATION FOR APPROVAL OF A PROPOSED REDUCTION OF
BENEFITS UNDER [Insert name of plan]

This notice is to inform you that, on [insert date], the joint board of trustees of the [insert
Plan name] (“Board of Trustees”) [insert submitted/will submit] an application to the U.S.
Treasury Department for approval to reduce benefits under the [insert Plan name]
(“Plan”), effective [insert effective date of proposed suspension of benefits]. If the
application is approved and other requirements are satisfied, then the Board of Trustees
will be permitted to reduce, by plan amendment, benefits otherwise payable to
participants or beneficiaries. This type of benefit reduction is authorized by the
Multiemployer Pension Reform Act of 2014, which refers to it as a “suspension” of
benefits. It is a reduction of any current or future payments from a multiemployer
defined benefit pension plan to any participant or beneficiary, including retirees and
beneficiaries who are receiving benefits at the time of the reduction.

Federal law requires the Board of Trustees to send this notice to contributing
employers, unions representing participants, and every plan participant and beneficiary,
even if his or her benefit is not being reduced. To see whether and how the proposed
reduction applies to you, go to “How the proposed reduction in benefits would
affect you” on page [insert page number] of this notice.

PLAN’S ELIGIBILITY TO REDUCE BENEFITS

Federal law permits the Board of Trustees to apply for a proposed reduction of benefits
because the Plan’s actuary certified that the Plan is in “critical and declining” status for
the plan year beginning [insert first day of plan year]. This means that the Plan is
experiencing funding and/or liquidity problems, such that it is in “critical” status, and it is
projected to become insolvent (that is, not have enough assets to pay benefits) in the
year [insert year].

The Board of Trustees determined that it has taken “all reasonable measures” to avoid
insolvency of the Plan, but that those measures have been insufficient to meet that goal,
and that the proposed reduction of benefits is necessary to avoid insolvency. If the Plan
were to become insolvent, benefits could be reduced below the proposed reduction. If

18

this were to happen, the Pension Benefit Guaranty Corporation (“PBGC”) would be
required to provide a guarantee for a certain level of benefits that is set by federal law
(“PBGC-guaranteed level”).
6

DESCRIPTION OF THE PROPOSED BENEFIT REDUCTION AND FACTORS
CONSIDERED BY THE BOARD OF TRUSTEES IN DESIGNING THE REDUCTION

Federal law imposes limits on how a reduction of benefits can be designed. For
example, a participant’s or beneficiary’s monthly benefit may not be reduced below
110% of the PBGC-guaranteed level. In addition, no reduction can apply to benefits
based on disability. Finally, an individual’s age affects the amount of the reduction that
may apply to the monthly benefit. No reduction applies to the benefits of an individual
who has reached age 80 as of the effective date of the reduction. For an individual who
is between ages 75 and 80 as of the effective date of the reduction, the maximum
amount of the reduction that can apply to his or her benefit is reduced. The closer the
individual is to age 80 as of the effective date of the reduction, the smaller the reduction
to the individual’s benefit can be. If the age-based limits on the amount of a reduction
apply for a participant, then the same limits will continue for any beneficiary of the
participant after the participant’s death, regardless of the beneficiary’s age.

Federal law requires that any reduction of benefits be distributed fairly among the
various categories or groups of participants and beneficiaries under the Plan. In
deciding whether the proposed reduction would be distributed fairly under the Plan, the
Board of Trustees took into account the following factors: [List the factors the Board of
Trustees took into account in designing the proposed suspension of benefits. This list
may include (but is not limited to) factors found in § 432(e)(9)(D)(vi).]

The Board of Trustees proposes the following reduction of benefits: [Describe the
proposed suspension of benefits and its effect. Describe each category or group of
individuals who would be affected differently by the suspension (including categories or
groups that would be unaffected) and how those categories or groups are defined;
describe the formula used to determine how the amount of the proposed suspension is
determined for individuals in each category or group; specify whether the proposed
suspension will remain in effect indefinitely or will expire by its own terms (and if so,
when it will expire); describe any proposed phase-in of the suspension; and describe
the effect of the proposed suspension on the plan’s projected insolvency.]

If you are a participant or beneficiary, the last part of this notice provides a dollar
estimate of how the proposed reduction applies to you.

AVAILABILITY OF THE APPLICATION AND HOW YOU CAN COMMENT ON IT

6
For more information about the amount of benefits guaranteed by PBGC, visit:
http://pbgc.gov/prac/multiemployer/multiemployer-benefit-guarantees.html
.

19

The application for approval of the proposed reduction of benefits will be made publicly
available within 30 days after the application has been received by the Treasury
Department. The application includes more information about the proposed reduction,
including details about: 1) the Plan actuary’s certification that the Plan is in critical and
declining status; 2) how the proposed reduction would satisfy the requirement that it be
large enough so that the Plan is projected to avoid insolvency, while not being larger
than needed to avoid insolvency; and 3) the sensitivity of the projection to the
assumptions used.

The application also includes a description of the measures the Board of Trustees has
already taken to try to avoid insolvency of the Plan, as well as why the Board of
Trustees believes that the proposed reduction is distributed fairly. Comments will be
accepted regarding the application from employees, deferred vested participants
(participants who are no longer earning benefits under the Plan but are not yet receiving
benefits from the Plan), retirees, beneficiaries, contributing employers, unions
representing participants, and other interested parties (such as the retiree
representative, if any).

See www.treasury.gov/mpra for a copy of the Plan’s application, for instructions on how
to send a comment on the application, and for how to contact the Treasury Department
for further information and assistance. The Treasury website will also provide updated
information on the application, such as whether the application has been modified or
withdrawn. If the application is withdrawn (or rejected), and the Board of Trustees
submits a new application, you may receive a notice for that new application that
supersedes this notice.

You may also contact the Treasury Department for further information and assistance at
the following address:

Department of the Treasury
Attn: MPRA, Room 1001
1500 Pennsylvania Ave., NW
Washington, D.C. 20220

RETIREE REPRESENTATIVE

The board of trustees of a multiemployer plan applying for approval to reduce benefits
may select a retiree representative to advocate for the interests of retirees,
beneficiaries, and deferred vested participants in connection with the approval process.
If the plan has 10,000 or more participants, the board of trustees is required by Federal
law to select a retiree representative.

[If the Board of Trustees has selected a retiree representative under § 432(e)(9)(B)(v)(I),
insert the following]

20

On [insert date], [insert name] was selected to act as the retiree representative. The
retiree representative, who is one of the retirees currently receiving benefits under the
Plan, [is/is not] a member of the Board of Trustees of the Plan. Participants and
beneficiaries may contact [insert name of retiree representative] at [insert phone
number, address, and e-mail address].

[If the Board of Trustees has not selected a retiree representative under
§ 432(e)(9)(B)(v)(I), insert the following]

The Board of Trustees has not chosen to select a retiree representative.

RIGHTS AND REMEDIES OF PLAN PARTICIPANTS AND BENEFICIARIES

Vote on Proposed Benefit Reduction

If the application for the proposed reduction of benefits is approved by the Treasury
Department, then participants and beneficiaries will be given the opportunity to vote to
approve or reject the proposed reduction. Unless a majority of all participants and
beneficiaries of the Plan vote to reject the reduction, the reduction will be permitted to
go into effect following the vote.

Final Authorization to Reduce Benefits

If a majority of all plan participants and beneficiaries do not vote to reject the proposed
reduction of benefits, then the Treasury Department is required to issue a final
authorization to permit the reduction of benefits to take effect.

[If the Board of Trustees believes that the PBGC will or may determine that the Plan is a
systemically important plan (a plan with a present value of projected PBGC financial
assistance payments that exceeds $1 billion), insert the following]

If the Plan is a systemically important plan (a plan with a present value of projected
PBGC financial assistance payments that exceeds $1 billion) and a majority of
participants and beneficiaries vote to reject the proposed reduction of benefits, then
Federal law requires the Treasury Department, notwithstanding the participants’ and
beneficiaries’ vote to reject, to issue a final authorization to permit either the proposed
reduction of benefits, or a modified version of the proposed reduction of benefits, to take
effect. Before this occurs, the PBGC’s Participant and Plan Sponsor Advocate may
submit recommendations to the Treasury Department regarding possible modifications
to the proposed reduction.

Claims Process for Incorrect Calculations

If you think the reduction to your benefits was calculated incorrectly, then you have the
right to submit a claim to the Plan to have the calculation corrected. Your Plan’s

21

summary plan description is required to include the Plan’s claims procedures, including
information on your right to have a court review the Plan’s final decision on your claim.

Access to Plan Documents

You, your contributing employer, the union representing you, and the retiree
representative (if any) also have the right to request the documents listed below from
the Plan. You may want to review these documents to help you understand your rights
and the proposed reduction to your benefits:
• The Plan document (including any amendments adopted to reflect an
authorized reduction of benefits), trust agreement, and other documents
governing the Plan (such as collective bargaining agreements),
• The most recent summary plan description (SPD or plan brochure) and any
summary of material modifications,
• The Plan’s Form 5500 annual reports, including audited financial statements,
filed with the U.S. Department of Labor during the last six years,
• The annual funding notices furnished by the Plan during the last six years,
• Actuarial reports, including reports prepared in anticipation of the benefit
reduction, furnished to the Plan within the last six years,
• The Plan’s current rehabilitation plan, including contribution schedules and
annual plan-sponsor determinations that all reasonable measures to avoid
insolvency continue to be taken and that the Plan is not projected to avoid
insolvency unless benefits are reduced, and
• Any quarterly, semi-annual or annual financial reports prepared for the Plan by
an investment manager, fiduciary or other advisor and furnished to the Plan
within the last six years.

The plan administrator must respond to your request for these documents within 30
days, and may charge you the cost per page to the Plan for the least expensive means
of reproducing documents, but cannot charge more than 25 cents per page. The Plan’s
Form 5500 Annual Return/Report of Employee Benefit Plan is also available free of
charge at www.dol.gov/ebsa/5500main.html
. Some of the documents also may be
available for examination, without charge, at the plan administrator’s office, your
worksite or union hall.

22

INDIVIDUAL ESTIMATE OF EFFECT OF PROPOSED REDUCTION IN BENEFITS

[Distribute this estimate to the affected individual]

[Affected Individual’s Name]
[Address]
[Town, State, Zip]

How the proposed reduction in benefits would affect you

The Plan’s actuary has calculated that if the proposed reductions are not implemented,
then the Plan is projected to be insolvent and unable to pay benefits when due in [insert
year of projected insolvency]. If the Plan becomes insolvent, your benefit would be
reduced to the monthly PBGC-guaranteed level. Your estimated monthly PBGC-
guaranteed level is [insert $xxxx.xx].

[Choose (a), (b), (c) or (d), as appropriate for an affected individual. Affected individuals
include a participant (including a retiree), a beneficiary of a deceased participant, or an
alternate payee. If (a), (b) or (c) is chosen, then insert a narrative description of the
effect of the suspension if it is not possible to estimate its effect quantitatively (on an
annual or monthly basis), such as in the case of a suspension that affects the payment
of any future cost of living adjustment.]

[(a) For an affected individual who is in pay status and who has a proposed suspension]

Effective [insert effective date of proposed suspension], your monthly benefit is
proposed to be reduced from [insert current monthly benefit] to [insert monthly benefit
reflecting proposed suspension].

[(b) For an affected individual who has a proposed suspension, is not yet in pay status,
and is below the participant’s normal retirement age]

Your future monthly benefit, based on the years of service you have (or, if you are a
beneficiary or alternate payee, the participant has) already worked as of [insert service
calculation date, i.e. no earlier than 1 year before date this notice is sent], if paid
beginning [insert participant’s normal retirement date] (your normal retirement date) in
the form of a [insert normal form of benefit] is proposed to be reduced from [insert
monthly benefits earned as of proposed effective date of suspension] to [insert monthly
benefits earned as of date of suspension reflecting proposed suspension].
7

7
The amount of your benefit before and after the proposed reduction will depend on when you decide to
begin receiving benefits and the form of benefit you choose as well as, if applicable, whether you continue
to work and earn years of service after the service calculation date. The amounts shown above are
based on an assumed commencement at age [insert the participant’s normal retirement age] (the plan’s
normal retirement age) without any additional years of service for future work. If you choose to begin
receiving benefits before your normal retirement age, or if you choose a form of benefit that includes
additional survivor benefits after your death, then any actuarial reduction for early commencement or

23

[(c) For an affected individual who has a proposed suspension, is not yet in pay status,
and is above the participant’s normal retirement age]

Your future monthly benefit, based on the years of service you have (or, if you are a
beneficiary or alternate payee, the participant has) already worked as of [insert service
calculation date, i.e. date no earlier than 1 year before date this notice is sent], payable
as of [insert date] in the form of a [insert normal form of benefit] is proposed to be
reduced from [insert monthly benefit as of proposed effective date of suspension]

to
[insert monthly benefit as of that date reflecting proposed suspension].
8

[(d) For an affected individual whose benefits are not proposed to be suspended]

Your monthly benefit would not change under the proposed reduction.

INFORMATION USED IN CALCULATING THE ESTIMATED BENEFIT REDUCTION

This is an estimate of your benefit under the proposed reduction. It is not a final benefit
calculation. This estimate of the proposed reduction is based on an assumed effective
date for the benefit reduction of [insert proposed effective date] (this date may be
subject to change, but in no event will the proposed reduction be effective earlier). If the
proposed reduction is effective at a later date, then the amount of the reduction to your
benefit might change.

This estimate is also based on the following information:

Years of Service

[If (a) or (d) above applies to the affected individual]

Plan records show that you have [insert total years and months of credited service]
under the Plan.

[If (b) or (c) above applies to the affected individual]

Plan records show that you have [insert total years and months of credited service as of
the service calculation date] under the Plan.

survivor benefits will be applied to your benefit after reflecting the effect of the separate reduction due to
the proposed amendment to the Plan described above. However, the combined reductions are not
allowed to result in a benefit that is less than 110 percent of the PBGC-guaranteed level.
8
This is the largest amount of proposed reduction that will apply and is based on commencement of
benefits in the specified form of benefit. If you choose a form of benefit that includes additional survivor
benefits after your death, then any actuarial reduction for those benefits will be applied to your benefit
after reflecting the effect of the separate reduction due to the proposed amendment to the Plan described
above. However, the combined reductions are not allowed to result in a benefit that is less than 110
percent of the PBGC-guaranteed level.

24

Age as of the Effective Date of the Proposed Reduction

Plan records show that you will be [insert age in years and months] as of the effective
date of the proposed reduction.

Disability Benefits

Plan records show that the portion of your benefit that is based on disability is [insert
amount].

PLAN OFFICE CONTACT INFORMATION

If you believe the information used to calculate your estimate is incorrect, please contact
the Plan office at [insert phone number, address, and e-mail address].

25

Appendix B

POWER OF ATTORNEY AND DECLARATION OF REPRESENTATIVE BEFORE THE
DEPARTMENT OF THE TREASURY

Applicant information [include name of plan, address, plan number, employer
identification number, name of contact, title of contact, telephone number, email
address, and fax number]:

Applicant hereby appoints the following representative(s) as attorney(s)-in-fact to
represent the taxpayer before the Department of the Treasury and perform acts related
to the attached application dated ______________ for suspension of benefits under
§ 432(e)(9) of the Internal Revenue Code of 1986, as amended.

Representative information: [include name, address, employer identification
number, telephone number, email address, and fax number]:

Send copies of notices and communications to representative [answer yes or no]

With the exception of the acts described below, I authorize my representative(s) to
receive and inspect my confidential tax information and to perform acts that I can
perform with respect to the attached application dated ______________ for suspension
of benefits under § 432(e)(9). For example, my representative(s) shall have the
authority to sign any agreements, consents, or similar documents.

Specific acts not authorized: [If the representative is not authorized to perform any act
described above, describe the act that the representative is not authorized to perform.]

Signature of Applicant and Date

Declaration of Representative

Under penalties of perjury, by my signature below I declare that:

• I am not currently suspended or disbarred from practice before the Internal Revenue
Service;

• I am authorized to represent the Applicant for the matter(s) specified in this Power of
Attorney and Declaration of Representative; and

26

• I am one of the following:

a Attorney—a member in good standing of the bar of the highest court of the
jurisdiction shown below.

b Certified Public Accountant—duly qualified to practice as a certified public
accountant in the jurisdiction shown below.

c Enrolled Agent

d Officer—a bona fide officer of the Applicant.

e Full-Time Employee—a full-time employee of the Applicant.

f Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment
of Actuaries under 29 U.S.C. 1242 (the authority to practice before the Internal Revenue
Service is limited by section 10.3(d) of Circular 230).

g Enrolled Retirement Plan Agent

Required information for Representative [include the appropriate designation of a
through g above. In addition, an officer or full-time employee of the Applicant must
include the title or position with the Applicant, and other Representatives must include
the licensing jurisdiction if applicable, and the bar, license, certification, registration, or
enrollment number as applicable.]:

Signature of Representative and date:

27

APPENDIX C
CHECKLIST - IS THE SUBMISSION COMPLETE?
Instructions The application must include a completed checklist placed on top of the
application. This will help ensure that the application is complete. Answer each
question in the checklist by circling Y for yes, N for no or N/A for not applicable, as
appropriate, in the blank next to the item. Also insert in the appropriate blank next to
each item the page number or numbers where the item appears in the application.
APPLICATION FOR APPROVAL OF BENEFIT SUSPENSION FOR [INSERT NAME
OF PLAN]
Response Item
number
Description of item Page number
in application
Yes
No
N/A
1. Does the application include an original signature of the plan sponsor or
an authorized representative of the plan sponsor. See section 2.01.

Yes
No
N/A
2. Does the application include a description of the proposed benefit
suspension - calculated as if no other limitations apply - that includes:
• the suspension’s effective date (and its expiration date, if
applicable),
• a description of the different categories or groups of individuals
affected, and
• how the suspension affects these individuals differently.
See section 2.02.

Yes
No
N/A
3. Does the application include a penalties-of-perjury statement signed by an
authorized trustee on behalf of the board of trustees. See Section 2.03.

Yes
No
N/A
4. Does the application include a statement, signed by an authorized trustee
on behalf of the board of trustees, acknowledging that the application and
the application’s supporting material will be publicly disclosed on the
Treasury Department’s website. See section 2.04.

Yes
No
N/A
5. Does the application include the plan actuary’s certification of critical and
declining status and the supporting illustrations, including:
• the year-by-year projections demonstrating projected insolvency
during the relevant period and
• separately identifying the available resources (and the market
value of assets and changes in cash flow) during each of those
years.
See section 3.01.

Yes
No
N/A
6. Does the application describe the assumptions used. See section 3.01.

28

Yes
No
N/A
7. Does the application include the plan actuary’s certification that the plan is
projected to avoid insolvency if the suspension takes effect and the
supporting illustrations, including:
• the year-by-year projections demonstrating projected solvency
during the relevant period and
• separately identifying the available resources (and the market
value of assets and changes in cash flow)during each of those
years.
See section 3.02.

Yes
No
N/A
8. Does the application include the plan sponsor’s determination of projected
insolvency that includes the documentation set forth in section 5 of the
revenue procedure. See section 3.03.

Yes
No
N/A
9. Does the application include a demonstration that the limitations on
individual suspensions are satisfied, including calculations regarding:
• the guarantee-based limitation,
• the disability-based limitation, and
• the age-based limitation.
See section 4.01.

Yes
No
N/A
10. Does the application include a demonstration that the proposed
suspension is reasonably estimated to achieve the level necessary to
avoid insolvency for the extended period, including illustrations regarding
the plan’s solvency ratio and available resources. See section 4.02(1).

Yes
No
N/A
11. Does the application include the required illustration utilizing stochastic
projections. (This illustration is not required if the plan is not required to
appoint a retiree representative under § 432(e)(9)(B)(v)(I) and stochastic
projections were not used in making the required determination.) See
section 4.02(2).

Yes
No
N/A
12. Does the application include a demonstration that the proposed
suspension is not projected to materially exceed the level necessary to
avoid insolvency, including illustrations regarding the plan’s solvency ratio
and available resources. See section 4.03.

Yes
No
N/A
13. Does the application include a demonstration that the proposed
suspension is equitably distributed, including
• a list of the factors taken into account,
• an explanation of why none of the factors listed in
§ 432(e)(9)(D)(vi) were taken into account (if applicable), and
• how any difference in treatment among categories or groups of
individuals results from a reasonable application of the relevant
factors.
See section 4.04.

Yes
No
N/A
14. Does the application include a copy of the actual notices (including
redacted sample calculations) that meet the requirements under
§ 432(e)(9)(F). See section 4.05(1).

Yes
No
N/A
15. Does the application include a description of the efforts that are being
taken to contact participants, beneficiaries in pay status, and alternate
payees. See section 4.05(2).

29

Yes
No
N/A
16. Does the application describe the steps the plan sponsor has taken to
ensure that notices delivered electronically are reasonably accessible to
the recipients. See section 4.05(3)

Yes
No
N/A
17. Does the application include a list of each employer who has an obligation
to contribute under the Plan and each employee organization representing
participants under the Plan. See section 4.05(4).

Yes
No
N/A
18. Does the application include information on past and current measures
taken to avoid insolvency. See section 5.01.

Yes
No
N/A
19. Does the application include the plan information required by section 5.02.

Yes
No
N/A
20. Does the application describe how the plan sponsor took into account – or
did not take into account – the factors listed in section 5.02 in the
determination that all reasonable measures were taken to avoid
insolvency. See section 5.03.

Yes
No
N/A
21. Does the application describe how the plan sponsor took into account - or
did not take into account - in the determination that all reasonable
measures have been taken to avoid insolvency the impact of
• benefit and contribution levels on retaining active participants
and bargaining groups under the plan, and
• past and anticipated contribution increases under the plan on
employer attrition and retention levels.
See section 5.03.

Yes
No
N/A
22. Does the application include a discussion of any other factors the plan
sponsor took into account including how and why those factors were taken
into account. See section 5.04.

Yes
No
N/A
23. Does the application include a copy of the proposed ballot. See section
6.01.

Yes
No
N/A
24. Does the application indicate whether the plan sponsor is requesting
approval from the PBGC of a proposed partition under section 4233 of
ERISA. See section 6.02.

Yes
No
N/A
25. If the answer to item 24 is yes, does the application specify the effective
date of the proposed partition and include a year-by-year projection of the
amount of the reduction in benefit payments attributable to the partition.
See section 6.02.

Yes
No
N/A
26. Does the application describe the plan’s experience with certain critical
assumptions, including a disclosure for each of the 10 plan years
immediately preceding the application that separately identifies
• total contributions,
• total contribution base units,
• average contribution rates,
• withdrawal liability payments, and
• the rate of return on plan assets.
See section 6.03.

30

Yes
No
N/A
27. Does the application include deterministic projections of the sensitivity of
the plan’s solvency ratio throughout the extended period by taking into
account more conservative assumptions of investment experience and
future contribution base units than assumed elsewhere in the application.
See section 6.04.

Yes
No
N/A
28. Does the plan include deterministic projections for each year in the
extended period of
• the value of plan assets,
• the plan’s accrued liability, and
• the plan’s funded percentage.
See section 6.05.

Yes
No
N/A
29. Does the application include the plan sponsor’s representation that, if it
receives the Treasury Department’s final authorization to suspend and
then chooses to implement the suspension, it will also amend the plan
• to indicate that the suspension will cease upon the plan
sponsor’s failure to determine that both all reasonable measures
continue to be taken to avoid insolvency and that the plan is
projected to become insolvent without a suspension,
• to require that any future benefit improvements must satisfy
§ 432(e)(9)(E), and
• to specify that the plan sponsor will not modify these
amendments, notwithstanding any other provision of the plan
document.
See section 6.06.

Yes
No
N/A
30. Does the application indicate whether the plan is a plan described in
§ 432(e)(9)(D)(vii)(III) and, if so, how is that fact reflected in the proposed
benefit suspension. See section 6.07.

Yes
No
N/A
31. Does the application include the required plan sponsor information,
including
• name
• address
• telephone number
• email address
• fax number
• employer identification number (EIN) and
• 3-digit plan number (PN).
See section 7.01.

Yes
No
N/A
32. Does the application include the required plan identification information.
See section 7.02.

Yes
No
N/A
33. Does the application include the required retiree representative
information (if applicable). See section 7.03.

Yes
No
N/A
34. Does the application include the required enrolled actuary information.
See section 7.04.

31

Yes
No
N/A
35. Does the application include a designation of power of attorney for each
authorized representative who will represent the plan sponsor in
connection with the application. See section 7.05 and Appendix B.

Yes
No
N/A
36. Does the application include
• the required plan documents,
• any recent amendments,
• the summary plan description (SPD),
• the summary of material modifications, and
• the most recent determination letter.
See section 7.06.

Yes
No
N/A
37. Does the application include the required excerpts from the relevant
collective bargaining agreements and side agreements. See section 7.07.

Yes
No
N/A
38. Does the application include the required excerpts from the most recently
filed Form 5500. See section 7.08.

Yes
No
N/A
39. Does the application include the most recently updated rehabilitation plan.
See section 7.09.

Yes
No
N/A
40. Does the application include this checklist, completed and placed on top
of the application. See section 7.10.

Signature Date

Title or Authority

Typed or printed name of person signing checklist