RI 20-117 Cover Letter Giving Information About The Cost to Elect

United States
Office of Personnel Management
Retirement Operations Center
P. O. Box 45

Form approved
OMB Number: 3206-0174

Boyers, PA 16017-0045
Date

•

CSA No.

Important: Please Read This Entire Notice - As It Will Affect Your Annuity/Survivor Benefits.
You may elect a survivor annuity for a spouse you married after retirement. You must make your election within 2 years
of your marriage. Your election cannot be effective sooner than 9 months after your marriage. Since you were not
married at retirement, the election and reduction must be effective on the first day of the month after the 9-month period
beginning on the date of the marrieage.
If you make this election, your annuity will be reduced to reflect the benefit payable to your spouse upon your death.
There will be two reductions in your annuity.
The first reduction is the regular cost of providing a survivor benefit and may be eliminated should your marriage end.
The second reduction is permanent even if the marriage ends. This reduction is based on your age and on the amount that
your annuity would have been reduced to provide survivor benefits during any period(s) when it was not reduced for an
equal or greater survivor election, plus 6 percent interest compounded annually. Under the provisions of Public Law
103-66, the only way to pay this amount is through an "actuarial" reduction in your annuity. This is called an "actuarial"
reduction because it is designed to spread the repayment out over the average life expectancy of a person your age. There
is no unpaid balance due after your death.
You were married on ________________ (mm/dd/yyyy); therefore, your election for a survivor benefit and the reduction
to provide this benefit is effective ________________ (mm/dd/yyyy). The current maximum survivor benefit is
$_________________.
As of the effective date, your gross monthy annuity is $_________________. The first reduction is
$_________________. The cost for any period(s) when your annuity was not reduced is $_________________, and the
actuarial reduction to pay it back is $_________________. Taken together the two reductions reduce your gross monthly
annuity to $_________________.
If your annuity is not reduced by _________________ (mm/dd/yyyy), the excess annuity paid will result in an
overpayment. Therefore, it is to your advantage to return the enclosed election form ( RI 20-63) as soon as possible.

RI 20-117
Revised August 2010
Page 1

We computed the above costs assuming you want to elect the maximum possible benefit. You do have the option of
electing a smaller survivor annuity benefit, which would proportionately reduce the cost figures provided in this letter. If
you want to know the exact cost of a smaller benefit, enter the amount you would want your spouse to receive each month
on the enclosed request form. Return the request form to the following address: Office of Personnel Management,
Retirement Operations Center, Attn: PRM - STOP, PO Box 45, Boyers, PA 16017.
If you are requesting information on the cost for a smaller benefit, be sure to use the enclosed request form. An election
cannot be revoked or changed once we receive a valid survivor annuity election form (RI 20-63).
If you decide not to provide a survivor benefit for your spouse, you must complete the bottom portion of the enclosed
RI 20-63 and return it to our office before the second anniversary of your marriage.
If we have not received your completed election form by the second anniversary of your marriage, your request for
survivor benefits will be dismissed.
If we can be of further assistance, please let us know.

Sincerely,

Benefits Specialist
Retirement Operations
(724) 794-2005, Ext.___________

Enclosure: RI 20-63 - Survivor Annuity Election for a Spouse

RI 20-117
August 2010
Reverse of Page 1

Request Form
(Use this form to request cost information on electing less than the maximum survivor benefit.)

CSA No.

I am requesting cost information for a gross monthly survivor benefit of $____________________.
(Please specify a whole doller amount [i.e. $25, $50, $75, $100] and sign and date below.)

Print your full name

Signature

Date

RI 20-117
August 2010
Page 2