rp-16-27.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 2016-27

This revenue procedure contains revised procedures for applications for a
suspension of benefits under a multiemployer defined benefit pension plan that is in
critical and declining status under § 432(e)(9). These procedures replace the
procedures set forth in Rev. Proc. 2015-34, 2015-27 I.R.B. 1218. The procedures set
forth in this revenue procedure must be followed for applications submitted on or after
April 26, 2016.

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 June 19, 2015, the Treasury Department and the IRS published temporary
regulations (TD 9723) and proposed regulations (REG-102648-15) under § 432(e)(9)
(the June 2015 regulations) in the Federal Register at 80 FR 35207 and 80 FR 35262,
respectively. The IRS issued Rev. Proc. 2015-34 contemporaneously with the June
2015 regulations. Rev. Proc. 2015-34 prescribed the application process for approval of
a proposed benefit suspension in accordance with § 432(e)(9)(G) and provided a model
notice that a plan sponsor proposing a benefit suspension could use to satisfy the

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Section 201 of MPRA made amendments to section 305 of ERISA that are parallel to § 432(e)(9), and
the Department of the Treasury has interpretive jurisdiction over the subject matter of these provisions
under ERISA as well as under the Code. See also section 101 of Reorganization Plan No. 4 of 1978 (43
FR 47713). 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. Furthermore, 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.

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content and readability requirements of § 432(e)(9)(F)(ii) and (iii)(II).

On September 2, 2015, the Treasury Department and IRS published temporary
regulations (TD 9735) and proposed regulations (REG-123640-15) on the voting
provisions under § 432(e)(9)(H) in the Federal Register at 80 FR 52972 and 80 FR
53068, respectively. On February 11, 2016, the Treasury Department and the IRS
published proposed regulations (REG-101701-16) on the application of
§ 432(e)(9)(D)(vii) in the Federal Register at 81 FR 7253.

On April 28, 2016, the Treasury Department and IRS published final regulations
under § 432(e)(9) in the Federal Register. Those final regulations finalize the two
proposed regulations under § 432(e)(9) that were proposed during 2015 and reserve a
paragraph for the proposed regulations published in February of 2016.

This revenue procedure supersedes Rev. Proc. 2015-34 and applies to
submissions made on or after April 26, 2016. Therefore, plan sponsors should follow
the application process prescribed in this revenue procedure for approval of a proposed
benefit suspension submitted on or after that date. The model notice in Appendix A of
this revenue procedure replaces the model notice attached to Rev. Proc. 2015-34 for
notices with respect to applications submitted under this revenue procedure.
Applications submitted under Rev. Proc. 2015-34 were required to comply with the
applicable provisions of the June 2015 regulations. As noted in Rev. Proc. 2015-34,
plan sponsors that submit an application under that revenue procedure may need to
revise the proposed suspension or supplement the application to take into account the
final regulations and this revenue procedure.

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 an 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 trustees or by an authorized
representative of the plan sponsor who is described in section 7.01(13) of Rev.

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Proc. 2016-1, 2016-1 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) If the proposed suspension does not provide for different treatment of
participants and beneficiaries (other than as a result of application of the individual
limitations of § 432(e)(9)(D)(i), (ii) and (iii) (the “individual limitations”), a statement to
that effect.

(4) If the proposed suspension provides for different treatment of participants and
beneficiaries (other than as a result of application of the individual limitations), the
categories or groups of individuals for which the proposed suspension provides for
different treatment (other than as a result of application of the individual limitations) and
how those categories or groups are defined. The description must describe the
differences in treatment, 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 individual limitations on a benefit
suspension, 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 individual limitations 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

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Section 7.01(13) of Rev. Proc. 2016-1 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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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.

.05 Where to submit an 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.

.08 Resubmission review. If the application for a suspension is submitted under
the resubmission review process pursuant to § 1.432(e)(9)-1(g)(3), see section 8 for
special procedures that apply.

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)(A) 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 plan-year-by-plan-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 period described in § 432(b)(6) that applies to
the plan. The documentation must include a description of each of the assumptions
used, including the new entrant profile, the total contribution base units, and the
average contribution rates. The plan-year-by-plan-year projection must separately
identify the market value of assets as of the beginning and end of each plan year in the
relevant period and the following cash-flow items for each of those years:

(1) Contributions.

(2) Withdrawal liability payments.

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(3) Benefit payments, separately identifying benefit payments with respect to
current retirees and beneficiaries, terminated vested participants who are not currently
receiving benefits, currently active participants, and future new entrants.

(4) Administrative expenses.

(5) Investment returns.

.02 Plan actuary’s certification that the plan is projected to avoid insolvency. The
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 plan-year-by-plan-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 extended period
described in § 1.432(e)(9)-1(d)(5)(ii)(C). The documentation must include a description
of each of the assumptions used, including the new entrant profile, the total contribution
base units and average contribution rates. The plan-year-by-plan-year projection must
separately identify the market value of assets as of the beginning and end of the initial
period and each subsequent plan year in the extended period and the following cash-
flow items for the initial period and each of those plan years:

(1) Contributions.

(2) Withdrawal liability payments.

(3) Benefit payments, separately identifying benefit payments with respect to
current retirees and beneficiaries, terminated vested participants who are not currently
receiving benefits, currently active participants, and future new entrants.

(4) Administrative expenses.

(5) Investment returns.

For this purpose, the initial period begins on the first day of the calendar quarter
in which the application is submitted and ends with the last day of the plan year that
includes that first day.

.03 Plan sponsor’s determination of projected insolvency. The plan sponsor’s
determination under § 432(e)(9)(C)(ii) that the plan would not be projected to avoid

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insolvency if no suspension of benefits were applied under the plan, 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 individual limitations.
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The
demonstration must include:

(1) A sample calculation applying the guarantee-based limitation under
§ 432(e)(9)(D)(i) for an individual in each category or group identified in accordance with
section 2.02(4) 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

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

(2) If the plan provides for benefits based on disability (as defined under the
plan):

(a) A description of each benefit based on disability, as defined under the plan,
that is paid to an individual under the plan (including disability benefits that are not
available to newly disabled participants), and

(b) A sample calculation applying the disability-based limitation under
§ 432(e)(9)(D)(iii) for an individual in each category or group identified in accordance
with section 2.02(4) 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 applying the age-based limitation under
§ 432(e)(9)(D)(ii) for an individual in each category or group identified in accordance
with section 2.02(4) of this revenue procedure. Each sample calculation must show
how the proposed suspension satisfies the age-based limitations taking into account the
guarantee-based limitation. If the plan provides for benefits based on disability, then
each 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:

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

(a) For each plan year during the extended period described in § 1.432(e)(9)-
1(d)(5)(ii)(C), the plan’s solvency ratio – the ratio of the plan’s available resources (as
defined in § 418E(b)(3)) to the scheduled benefit payments under the plan for the plan
year – is projected on a deterministic basis 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 required to appoint a retiree representative is not required to provide
this illustration, unless the plan sponsor chooses to use stochastic projections to
demonstrate that the plan will avoid insolvency.)

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

(a) If an actuarial assumption used for the deterministic projections under section
4.02(1) of this revenue procedure differs from that used under section 3.01 of this
revenue procedure, an explanation of the information and analysis that led to the
selection of that assumption.

(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 an actuarial assumption used for stochastic projections described in section
4.02(2) of this revenue procedure differs from that used for deterministic projections
described in section 4.02(1) of this revenue procedure, an explanation of the information
and analysis that led to the selection of that assumption.

.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 must be the same as those used

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for purposes of 4.02 of this revenue procedure. The demonstration must include an
illustration, prepared on a deterministic basis, of the plan’s available resources and
solvency ratio as described in section 4.02(1) of this revenue procedure (and, if
applicable to the plan, an illustration of the probability that the plan will avoid insolvency
prepared using stochastic projections, as described in section 4.02(2) of this revenue
procedure) showing that the proposed suspension would not reasonably be estimated
to enable the plan to avoid insolvency if the dollar amount of the proposed suspension
for each participant and beneficiary were reduced (but not below zero) by the greater
of—

(1) Five percent of the reduction in the periodic payment proposed for that
participant or beneficiary; or

(2) Two percent of the participant’s or beneficiary’s periodic payment determined
without regard to the reduction proposed in the application.

.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) For the plan in the aggregate, the application must include the following:

(a) A statement of the number of participants, beneficiaries, and alternate
payees; the average monthly benefit before the suspension; the average monthly
benefit after the suspension (determined taking into account the individual limitations);
and the aggregate present value of the reduction in benefits for all individuals.

(b) A demonstration of the distribution of the benefit suspension. This
demonstration may be expressed as a count of individuals whose benefits are not
reduced, and a count of individuals whose benefits are reduced by a percentage that
falls within a series of ranges that do not exceed 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.

(2) If, as described in section 2.02(4) of this revenue procedure, the proposed
suspension provides for different treatment for different categories or groups (other than
as a result of application of the individual limitations), the application must include the
following:

(A) The information described in section 4.04(1)(A) and (B) of this revenue
procedure for each such category or group.

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(B) With respect to the demonstration that the proposed benefit suspension is
distributed in an equitable manner across the participant and beneficiary population, 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.

(C) 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 none of them were taken into
account in designing the proposed suspension.

(D) For each factor identified under paragraph 4.04(2)(B) of this revenue
procedure that is not one of the factors listed in § 432(e)(9)(D)(vi)(I) through (XI), an
explanation of why the factor is relevant.

(E) An explanation of how the differences in treatment under the proposed
suspension among the categories or groups identified result from a reasonable
application of the relevant factors.

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

(1) A copy of each type of actual notice
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that has been or will be given to
participants, beneficiaries, employers that have an obligation to contribute within the
meaning of section 4212(a) of ERISA, and each employee organization representing
participants under the plan. If there is more than one category or group of individuals
described in section 2.02(4) of this revenue procedure, a copy of each type of actual
notice that has been given or will be given to an individual in each 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

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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) 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.

(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

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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 took into account any other
factors in its determination that all reasonable measures have been taken to avoid
insolvency, then the application must discuss why those factors were relevant and how
they were taken into account.

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). However, the proposed ballot should not include the information
described in § 1.432(e)(9)-1(h)(3)(i)(E), (L) or (M) (regarding the statement in opposition
to the proposed benefit suspension described, the individualized estimate that was
provided as part of the notice, and the voting procedures (including the deadline for
voting)).

.02 Partition. Whether the plan sponsor is requesting approval from the Pension
Benefit Guaranty Corporation (PBGC) of 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 plan-year-by-plan-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.

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.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.

The projections described in (3) and (4) may be made without reflecting any
adjustments to the projected benefit payments that result from the alternative
assumptions regarding future contribution base units.

.05 Projection of funded percentage. The plan sponsor must include an
illustration, prepared on a deterministic basis, of the projected value of plan 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 maintain a written record of its determination that
both:

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

(b) The plan would not be projected to avoid insolvency if no suspension of

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benefits were applied under the plan.

(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). Whether the plan is a plan
described in § 432(e)(9)(D)(vii) and, if so, how the provisions of § 432(e)(9)(D)(vii) are
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.

.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

5
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

15

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 is 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.
(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 Valuation reports. The two most recent actuarial valuation reports for the
plan.

.11 Completed checklist. A completed checklist of information required to be

a favorable determination under §§ 401 and 501(a), see Rev. Proc. 2016-6, 2016-1 I.R.B. 200, and Rev.
Proc. 2007-44, 2007-2 C.B. 54, as modified.

16

included in the application. See Appendix C.

SECTION 8. RESUBMISSION REVIEW

If the application for a suspension is submitted for resubmission review
procedure pursuant to § 1.432(e)(9)-1(g)(3), the application must include:

.01 All of the information required under this revenue procedure for an original
application, except that, with respect to information that has not changed, the
application should cross-reference that information in the prior application rather than
provide the information again.

.02 A statement that the application is being submitted for resubmission review
and the date on which the Treasury Department gave approval to submit an application
for resubmission review.

SECTION 9. EFFECT ON OTHER REVENUE PROCEDURES

Rev. Proc. 2015-34 is modified and superseded.

SECTION 10. 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.

17

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

18

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)
and the related regulations. The notice, including any inserts and additional material,
must be written in a manner so as to be understood by the average plan participant.]

[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.]

NOTICE OF A PROPOSED REDUCTION OF YOUR PENSION BENEFITS

On [insert date], the Board of Trustees of the [insert Plan name] (“Plan”) [insert
submitted/will submit] an application to the U.S. Treasury Department for approval to
reduce benefits under the Plan. This type of benefit reduction is allowed by the Federal
law called the Multiemployer Pension Reform Act of 2014.

You are getting this notice because you have a pension benefit under the Plan. The
end of this notice describes the proposed reduction of your monthly payments.
6

This notice will also answer the following questions for you—

1. Why is the Board of Trustees proposing to reduce benefits?
2. What will happen if the Plan runs out of money?
3. How did the Board of Trustees decide whose benefits to reduce and by how much?
4. What are the proposed reductions in benefits?
5. What comes next?

1. Why is the Board of Trustees proposing to reduce benefits?

The Plan’s actuary estimated that, unless benefits are reduced, the Plan will not have
enough money to pay benefits in the year [insert year]. This estimate is based on how
much money the actuary expects the Plan to receive and to pay out each year. The
Plan’s actuary estimated that, with the reduction of benefits that the Board of Trustees
has proposed, the plan should not run out of money.

2. What will happen if the Plan runs out of money?

If the Plan does not have enough money to pay benefits, then only the amount
guaranteed by the Pension Benefit Guaranty Corporation (“PBGC”) will be paid. You
can find the amount of your benefit that is guaranteed by PBGC at the end of this
notice.

6
A version of this notice that does not include the estimate of the effect on your benefit is being sent to
unions that represent Plan participants and to all contributing employers.

19

3. How did the Board of Trustees decide whose benefits to reduce and by how
much?

Under Federal law, the Board of Trustees must apply the following rules to the proposed
reduction—

• The total reduction in everybody’s benefits must be estimated to be large enough
to keep the plan from running out of money but not larger than needed to do that.

• Your monthly benefit and the benefit of your beneficiary cannot be reduced below
110% of the amount guaranteed by PBGC.

• Disability benefits (as defined under the Plan) cannot be reduced.

• The benefits of people who are at least 80 years old on [insert date that is the
last day of the month during which the suspension is proposed to take effect] and
their beneficiaries cannot be reduced.

• The benefits of people who are at least 75 years old on [insert date that is the
last day of the month during which the suspension is proposed to take effect] and
their beneficiaries are partially protected, and the closer the person is to age 80
the less the benefits can be reduced.

• The reduction of benefits must be spread fairly among the people who have a
pension benefit under the plan.

In deciding whether the proposed reduction is spread fairly, the Board of Trustees took
into account the following: [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).]

4. What are the proposed reductions in benefits?

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 for which the proposed suspension provides for different treatment (other
than as a result of application of the individual limitations) 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.]

20

5. What comes next?

Approval or denial of the application by the Treasury Department

The Treasury Department will review the application to see whether it meets all
of the legal requirements under Federal law. If the application meets all of those
requirements, the Treasury Department is required to approve the application. If
the application does not meet the legal requirements, the Treasury Department
will deny the application. The Treasury Department will have until [insert date
225 days after the application is submitted] to make a decision.

You can get information from the Treasury Department

More information about the proposed benefit reductions and a copy of the
application is available at www.treasury.gov/mpra.

The application will be available on that website within 30 days after the Treasury
Department receives it. The application includes more information about the
proposed reduction, including details about: 1) the Plan actuary’s certification that
the Plan will run out of money (that is, 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 estimated not to run out of money, while not
being larger than needed; and 3) the sensitivity of these estimates to the
assumptions used.

The application describes the steps the Board of Trustees has already taken to
keep the Plan from running out of money and why the Board of Trustees believes
that a benefit reduction is the only remaining option to keep the plan from running
out of money. In addition, the application explains why the Board of Trustees
believes that the proposed reduction is spread fairly among the people who have
a pension benefit under the plan.

The Treasury Department website will also provide updated information on the
application, such as whether the application has been updated or withdrawn.

For further information and assistance you can also write to the Treasury
Department at the following address:

Department of the Treasury
Attn: MPRA Office, Room 1001
1500 Pennsylvania Avenue, NW
Washington, DC 20220

You can comment on the application to reduce benefits

21

You can submit a comment on the application by going to
www.treasury.gov/mpra. Comments may also be mailed to the Department of
the Treasury, at the address listed above. All interested parties can make
comments, and the comments will be publicly available.

Retiree Representative

If a plan has 10,000 or more participants, the Board of Trustees must select a
retiree representative to advocate for the interests of retirees, beneficiaries, and
deferred vested participants as part of this process. A plan is required to pay the
reasonable expenses of the retiree representative.

[If the selection of the retiree representative was required under § 432(e)(9)(B)(v)(I),
insert the following]

On [insert date], the Board of Trustees selected [insert name] to be the retiree
representative. [He/She] is a retiree currently receiving benefits under the Plan
and [is also/is not] a member of the Board of Trustees. 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 selected a retiree representative under § 432(e)(9)(B)(v)(I),
even though it was not required, insert the following]

Even though the Plan has fewer than 10,000 participants, the Board of Trustees
selected [insert name] to be the retiree representative on [insert date]. [He/She]
is a retiree currently receiving benefits under the Plan and [is also/is not] a
member of the Board of Trustees. 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, insert the following]

The Board of Trustees is not required to select a retiree representative, because
the Plan has fewer than 10,000 participants. The Board of Trustees has not
chosen to select a retiree representative.

Vote on the proposed benefit reduction

If the application for the proposed reduction of benefits is approved by the
Treasury Department, then you will have the opportunity to vote on the proposed
reduction. Unless a majority of all participants and beneficiaries of the Plan vote
to reject the reduction, the Treasury Department must allow the reduction of
benefits to take effect. This means that not voting counts the same as a vote to
approve the reduction.

22

[If the Board of Trustees believes that 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]

Even if a majority votes to reject the proposed reduction of benefits, Federal law
requires the Treasury Department to allow the proposed benefit reduction (or a
modified version) to take effect if the cost to PBGC to provide guaranteed
benefits is particularly large. This rule applies if the value of payments from
PBGC if the plan runs out of money is expected to be more than $1 billion.
Before the Treasury Department permits a reduction in this circumstance,
PBGC’s Participant and Plan Sponsor Advocate may recommend possible
modifications to the proposed reduction.

You may contact PBGC’s Participant and Plan Sponsor Advocate by mail at
Pension Benefit Guaranty Corporation, Attn: Participant and Plan Sponsor
Advocate, 1200 K St., NW, Washington DC 20005; by telephone at (202) 326-
4448; or by e-mail at advocate@PBGC.gov.

Your right to see Plan documents

You may want to review Plan documents to help you understand your rights and the
proposed reduction to your benefits. The Plan administrator must respond to your
request for the following documents within 30 days:

• 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 Plan’s 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
running out of money continue to be taken and that the Plan would run out of
money if there were no benefit reductions.
• 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 may charge you the cost per page to the Plan for the cheapest
way of copying 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

23

available for examination, without charge, at the Plan administrator’s office, your
worksite or union hall.

Your right to challenge incorrect calculations

If you think the Plan miscalculated the reduction to your benefits, then you have the
right to submit a claim to the Plan to have the calculation corrected. The Plan’s
summary plan description (“SPD”) tells you how to submit a claim. The SPD also
describes your right to have a court review the Plan’s final decision on your claim.

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

[The following may be on a separate page at the end of the notice.]

HOW YOUR MONTHLY PAYMENTS WILL BE AFFECTED

[Distribute this estimate to the affected individual]

This estimate of the effect of the proposed reduction of benefits has been prepared for:

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

[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]

Your current monthly benefit is [insert current monthly benefit]. Under the proposed
reduction your monthly benefit will be reduced to [insert monthly benefit reflecting
proposed suspension] beginning on [insert effective date of the 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]

If you start receiving your benefit on [insert participant’s normal retirement date] in the
form of a [insert normal form of benefit], your monthly benefit without the proposed
reduction would be [insert monthly benefits earned as of proposed effective date of

24

suspension]. Under the proposed reduction your monthly benefit in the same form
would be reduced to [insert monthly benefit reflecting proposed suspension].
7

[(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 benefit without the proposed reduction as of [insert date] in the form of a [insert
normal form of benefit] is [insert monthly benefit as of proposed effective date of
suspension].

Under the proposed reduction your monthly benefit in the same form will
be reduced to [insert monthly benefit 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.

[If the proposed suspension is permanent, insert the following for all affected individuals
who have a benefit suspension]

The proposed reduction is permanent.

[If the proposed suspension is temporary, insert the following for all affected individuals
who have a benefit suspension]

The proposed reduction in your payments will last until [insert date]. Under the
proposed reduction, after that date your monthly benefit will increase to the unreduced
amount.

[The following text is for all individuals.]

This is an estimate of the effect of the proposed reduction on your benefit under the
Plan. It is not a final benefit calculation. This was done assuming that the proposed
benefit reduction starts on [insert proposed effective date]. If the benefit reduction starts
later, the effect of the proposed reduction on your benefit might be different.

This estimate is based on the following information from Plan records:

• You have [insert total years and months of credited service or total years and
months of credited service as of the service calculation date, as applicable] of
credited service under the Plan.

7
These numbers are just estimates. The actual amount you receive will depend on things like how long
you work and when you begin receiving payments. For more information, see [insert cross-reference].
8
These amounts will be different if you take your benefit in a different form. For example, if you elect
[insert other form of benefit available under the plan], your reduced monthly benefit will be [insert monthly
benefit reflecting proposed suspension].

25

• You will be [insert age in years and months] as of [insert last day of the month of
that includes the effective date of proposed suspension].

• The portion of your benefit that is based on disability is [insert amount].

[Add additional bullets for other data that is used to estimate the effect of proposed
suspension on the individual’s benefit.]

PBGC Guaranteed Benefits

If the Plan does not have enough money to pay benefits, your monthly benefit would be
no larger than the amount guaranteed by PBGC. The amount of your monthly benefit
guaranteed by PBGC is estimated to be [insert $xxxx.xx].

26

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

This power of attorney must be signed and dated by an authorized trustee who is a
current member of the board of trustees.

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;

27

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

• 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:

28

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),
• whether the suspension provides for different treatment of
participants and beneficiaries,
• 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 plan-year-by-plan-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, including the new
entrant profile, the total contribution base units, and the average
contribution rates? See section 3.01.

29

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 plan-year-by-plan-year projections demonstrating projected
solvency during the relevant period,
• a description of the assumptions used, including the new entrant
profile, the total contribution base units, and the average
contribution rates, 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:
• information on the effect of the suspension on the plan in the
aggregate,
• information on the effect of the suspension for different
categories or groups,
• 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),
• for each factor taken into account that is not one of the factors
listed in § 432(e)(9)(D)(vi), an explanation why the factor is
relevant, 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.

30

Yes
No
N/A
14. Does the application include a copy of the notices (excluding personally
identifiable information) 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).

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, excluding the
information regarding the statement in opposition, the individualized
estimate, and the voting procedures? See section 6.01.

Yes
No
N/A
24. Does the application indicate whether the plan sponsor is requesting
approval from 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 plan-year-by-plan-year
projection of the amount of the reduction in benefit payments attributable
to the partition? See section 6.02.

31

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.

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 the 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 would
not be projected to avoid insolvency 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) 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.

32

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.

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.

Yes
No
N/A
41. If the application is being submitted for resubmission review, does the
application include:
• a statement that the application is being submitted for
resubmission review, and
• the date on which the Treasury Department gave approval to
submit an application for resubmission review?
See section 8.

Signature Date

Title or Authority

Typed or printed name of person signing checklist