Notice of Failure to Make Required Contributions

Form 200 Instructions
Notice Of Failure To Make
Required Contributions

PAPERWORK REDUCTION ACT NOTICE
PBGC needs this information, which is required to be filed under ERISA §303(k)(4) and the Internal Revenue Code
§430(k)(4) and 29 CFR Part 4043, Subparts A and D, to make decisions regarding enforcement of a lien imposed by
ERISA §303(k)(1) and Code §430(k)(1). Information provided to PBGC is confidential to the extent provided in the
Freedom of Information Act and the Privacy Act.
PBGC estimates that it will take an average of 12 hours and $4,200 to comply with the requirements described in these
instructions. These figures are estimated averages that will vary depending on the nature and organizational structure of
persons liable for plan contributions (in particular, whether the plan's contributing sponsor is a member of a controlled
group and, if so, the size of that group) and on the funding history of the plan.
If you have any comments concerning the accuracy of these time estimates or suggestions for improving the form or these
instructions, please send your comments to the Pension Benefit Guaranty Corporation, Regulatory Affairs Group, Office of
the General Counsel, 1200 K Street, NW, Washington, DC 20005-4026.
This collection of information has been approved by the Office of Management and Budget (OMB) under control number
1212-0041. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number.

Table of Contents

Page

Introduction

2

General Instructions

3

Definitions

5

Specific Instructions

6

Part I. General Plan Information

6

Part II. Plan Funding Information

7

Part III. Contributing Sponsor and
Controlled Group Financial
Information
Part IV. Certifications

8
9

Appendix – Calculation Instructions
Concerning Failure to Make
Required Funding Payments

A-1

1

INTRODUCTION
ERISA §303(k) and Code §430(k) provide that a lien arises in certain cases where there is a failure to
make required contributions to a single-employer plan covered under ERISA §4021 whose funding
target attainment percentage (as defined in ERISA §303(d)(2) and Code §430(d)(2)) is less than 100
percent. The lien arises, in favor of the plan, upon all property and rights to property (whether real or
personal) belonging to the person or persons who are liable for required contributions (i.e., a contributing
sponsor and each member of the controlled group of which that contributing sponsor is a member) if:
(1) any person fails to make a required contribution payment when due, and
(2) the unpaid balance of the payment (including interest), when added to the aggregate unpaid
balance of all preceding such payments for which payment was not made when due (including
interest), exceeds $1 million.
Any lien imposed for failure to make required contributions may be perfected and enforced only by
PBGC or, at its direction, by the plan’s contributing sponsor or any member of the contributing
sponsor’s controlled group. ERISA §303(k)(4)(A) and Code §430(k)(4)(A) require that PBGC be
notified whenever there is a failure to make a required payment and the total of unpaid balances
(including interest) exceeds $1 million. Notice must be provided within 10 days of the due date for the
required payment.
To comply with this notification requirement, PBGC regulations (29 CFR 4043.81) require that a
contributing sponsor and, if that contributing sponsor is a member of a parent-subsidiary controlled
group, the “ultimate parent,” file Form 200 whenever such a failure occurs.
Note: PBGC’s decision not to require (at this time) controlled group members other than contributing
sponsors and ultimate parents to file Form 200 does not in any way limit the joint-and-several liability of
each controlled group member for required payments (whether the controlled group of which a
contributing sponsor is a member is a “parent-subsidiary,” “brother-sister,” or “combined” group), the
imposition of the lien on all assets of each controlled group member, or the ability of PBGC to take all
appropriate steps to perfect and enforce the lien.
PBGC has restricted Form 200 to information generally needed in its decision-making regarding
enforcement of a lien imposed by ERISA §303(k) and Code §430(k). If PBGC concludes that it needs
additional information in a particular case, it will notify (in writing) the person required to supplement
the Form 200 and specify the date by which the additional information must be submitted.
What’s New


The Appendix to these instructions describes how the aggregate outstanding balance of required
funding payments, including interest, must be computed.



All required information must now be filed electronically (see 29 CFR § 4003(b)(3)) by the due date
(see 29 CFR § 4043.81(a)(1)). The “partial electronic filing” method, whereby certain basic
information could be submitted on time electronically and followed up within 1 business day with
the remaining required information, may no longer be used. The current version of PBGC Form

200 is already available in “fillable” format; in connection with the change to electronic
filing, new versions of this form will be available in “fillable” format to facilitate electronic
filing.


In missed contribution cases, there is sometimes a credit balance that is available for application to a
contribution that is due. PBGC needs to be able to determine whether all or a portion of the credit
balance has been properly applied toward payment of the contribution. Accordingly, PBGC is
2

requiring filers to submit copies of election letters relating to application of the carryover balance
and prefunding balance to the contribution.

GENERAL INSTRUCTIONS
Who Must File
Form 200 must be filed by (1) a contributing sponsor and (2) if a contributing sponsor is a member of a
“parent-subsidiary” controlled group, the ultimate parent of such group. However, if a timely and
complete Form 200 is properly filed by either a contributing sponsor or the ultimate parent, PBGC will
deem the other to have so filed. (As noted in the “Introduction,” each other member of any controlled
group of which a contributing sponsor is a member also is jointly and severally liable for required
payments, and PBGC may enforce the statutory lien imposed on its assets.)
Special Rule for Terminating Plans: The fact that a plan is in the process of terminating does not mean
that a Form 200 notice need not be filed. However, a notice is waived if the deadline for filing the notice
is on or after the date on which (1) all of the plan’s assets (other than any excess assets) are distributed
pursuant to a termination or (2) a trustee is appointed for the plan under ERISA §4042(c).
What to File
A contributing sponsor must use the PBGC Form 200 to file a notice of a failure to make required
contributions. Certain individual items on the form call for additional information.
Attachments
If responding to an item requires the attachment of documentation or information, mark the attachment
to identify the item to which it responds.
Previously Submitted Information
Because ERISA §303(k)(4)(A) and Code §430(k)(4)(A) require that PBGC be notified each time there is
a failure to make a required payment and the total of unpaid balances of required payments (including
interest) exceeds $1 million, more than one filing may be required regarding the same plan, and at least
some of the information included in a previous Form 200 filing may continue to be accurate and
responsive at the time that a subsequent Form 200 must be filed. It also is possible that information
submitted to PBGC in another context (e.g., in a distress termination filing pursuant to ERISA §4041(c)
or in a notice of a reportable event required by 29 CFR Part 4043) is responsive. A filer may respond to
an item that calls for previously submitted documentation or other information by identifying the
previous submission in which the response was provided.
When to File
Form 200, including all required documentation and information, must be filed with PBGC no later than
10 days after the due date for the required payment.
Note: Form 200 must be filed each time there is a failure described in ERISA §303(k)(1) and Code
§430(k)(1) and the total of unpaid balances of required payments (including interest) exceeds $1 million.
Computation of time: In computing the 10-day period, the due date of the payment that resulted in the
requirement to notify PBGC is not included. Form 200 is due 10 days thereafter unless the tenth day is a
3

Saturday, Sunday, or Federal holiday, in which case the 10-day period runs until the next day that is not
a Saturday, Sunday, or Federal holiday. Information received on a weekend or Federal holiday or after
5 p.m. on a weekday is deemed to be filed on the next regular business day.
Note: There is no longer a special “partial electronic filing” provision whereby a filer could submit
certain required information within 1 business day after the filing deadline. Now, all required
information must be submitted by the filing deadline.
How to File
Form 200 must be filed with PBGC electronically using the form that is posted on PBGC’s web site.
29 CFR § 4043.5 requires that Form 200 information be submitted electronically, which can be done by
e-mail using [email protected]. You may not use a paper form to submit your filing unless you
request and receive an exemption from e-filing.
Attaching files
Filers may attach electronic files to their submission. Examples of files that may be attached include, but
are not limited to, actuarial valuation reports, financial statements, and organizational charts.
If the materials that you are filing are larger than 10 megabytes, please use LeapFILE. Enter
“pbgc.leapfile.com” in your Internet browser, click on “secure upload,” enter “[email protected]” in
the “Recipient Email” field, and attach the files.
Filing Date
The filing date for the Form 200 is the date it is received by PBGC at the electronic address listed under
“How to File.”
Information received on a weekend or Federal holiday or after 5:00 p.m. on a weekday is considered
filed on the next regular business day.
Effect of Failure to Timely File
If a Form 200 (or other required information) is not provided within the specified time limit, PBGC may
assess against each person required to provide the notice a separate penalty under ERISA §4071 of up to
$1,100 a day for each day for which the notice or other information is overdue. PBGC will generally
assess the full $1,100 a day penalty for failure to timely file a complete Form 200 (see 29 CFR Part 4071
and PBGC’s Statement of Policy on Assessment of Penalties for Failure to Provide Required
Information (60 FR 36837, July 18, 1995)). PBGC may pursue any other equitable or legal remedies
available to it under the law.
For Questions or Problems Regarding Form 200
If you have questions or problems regarding Form 200 or these instructions, contact:
Pension Benefit Guaranty Corporation
Corporate Finance and Restructuring Department
1200 K Street, NW
Washington DC 20005-4026
Telephone: 202-326-4070
Email: [email protected]
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TTY/TTD users may call the Federal Relay Service toll-free at 1-800-877-8339 and ask to be connected
to 202-326-4070.
Copies of Form 200 and instructions may be obtained from PBGC’s website at
http://www.pbgc.gov/prac/forms.html.
Reportable Event
A failure to make a required contribution may also be a reportable event under 29 CFR 4043.25(a). If
with respect to such failure, a Form 200 is completed and submitted in accordance with 29 CFR 4043.81,
the Form 200 filing is deemed to satisfy the reportable event requirement (see 29 CFR 4043.25(b)).

Note: If a contributing sponsor or controlled group member files a complete Form 200 with
PBGC within 10 days of the due date of the payment in accordance with 29 CFR §4043.81, the
Form 200 filing satisfies the notice requirement for purposes of 29 CFR 4043.25(a). However,
Form 10 may also be filed if desired. Choosing to rely on Form 200 to satisfy the Form 10
filing requirement does not make the Form 200 a reportable event filing under ERISA §4043
and does not give the Form 200 filing the benefit of the confidentiality protection for reportable
event notices under ERISA §4043(f).

DEFINITIONS
As used in PBGC Form 200 and these instructions:
Code means the Internal Revenue Code of 1986, as amended.
Contributing sponsor means a person that is a contributing sponsor as defined in ERISA §4001(a)(13).
Controlled group, for purposes of ERISA §303(k) and Code §430(k), means any group treated as a
single employer under subsection (b), (c), (m), or (o) of Code §414.
Due date means the date set forth in ERISA §303(j) and Code §430(j) for payment of a required installment and, in the case of a payment other than a required installment, the date such payment is required to
be made under ERISA §303 and Code §430.
EIN/PN means the nine-digit employer identification number assigned by the Internal Revenue Service
to a person and the three-digit plan number assigned to a plan. The EIN/PN should be the EIN/PN most
recently reported for a PBGC premium filing (if applicable).
ERISA means the Employee Retirement Income Security Act of 1974, as amended.
IRS means the Internal Revenue Service.
Person means an individual, partnership, joint venture, corporation, mutual company, joint-stock
company, trust, estate, unincorporated organization, association, or employee organization.
Required installment means any of the four quarterly contribution payments required for each plan year
by ERISA §303(j) and Code §430(j).
Required payment means a required installment or other payment required under ERISA §§ 302 and
303 and Code §§ 412 and 430 or as a result of a funding waiver.
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Single-employer plan means any defined benefit plan (as defined in ERISA §3(35)) that is not a
multiemployer plan (as defined in ERISA §4001(a)(3)) and that is covered by title IV of ERISA.
Ultimate Parent means the parent at the highest level in the chain of corporation and/or other
organizations constituting a parent-subsidiary controlled group. (For example, if Corporation A owns all
of the stock of Corporation B and Corporation C, and Corporation B owns all of the stock of Corporation
X, the contributing sponsor, then the “ultimate parent” of Corporation X is Corporation A.)

SPECIFIC INSTRUCTIONS
Part I. General Plan Information
1a Enter the complete name of the plan as it appears on the plan document.
b

Enter the first day of the plan year for which the payment described in item 7a was required.

2

Enter the name, address, telephone number, and email address of the individual or the board or other
entity, if any, specifically designated as plan administrator by the terms of the plan or trust
agreement. If none is so designated, enter the name, address, telephone number, and email address of
the contributing sponsor.

3a Enter the name, address, telephone number, and email address of (1) the contributing sponsor that is
filing this form or (2) if the ultimate parent is filing this form, the controlled group member that is
the contributing sponsor. (If the ultimate parent is filing and the plan covers the employees of more
than one controlled group member, provide information with respect to the controlled group member
with the greatest number of participants.)
b

The EIN/PN reported should be the EIN/PN most recently reported for a PBGC premium filing (if
applicable). If the plan has never made a PBGC premium filing, enter the EIN assigned to the
contributing sponsor in item 3a by the IRS for income tax purposes and the PN assigned by the
contributing sponsor.

c

If the EIN/PN in item 3b is different from that used in the earlier filings with PBGC (including
premium and reportable event filings), the DOL, or the IRS, enter the EIN/PN previously reported.
(If a different EIN or PN has not been used for this contributing sponsor/plan in previous filings,
enter “NA” (not applicable).)

4b If you checked “Yes” to item 4a, enter the name, address, telephone number, and EIN (or “none” if
there is no EIN) of the contributing sponsor’s ultimate parent. If the contributing sponsor has no
parent (e.g., the controlled group is a “brother-sister” group), enter “none.”
d

If you checked “Yes” to item 4c, attach a statement with (1) the name, address, telephone number,
and EIN (or state that there is no EIN) of each other controlled group member and (2) a description
of the structure of the controlled group. (The description must include the relationship of each
member of the parent-subsidiary, brother-sister, or combined group, as applicable, to the controlled
group. For example: “Corporation A, the ultimate parent of a parent-subsidiary group of trades or
businesses under common control, has three wholly-owned subsidiaries, Corporation B, Corporation
C, and Partnership D. Corporation B and Corporation C each own 50 percent of the stock of
Corporation X, the contributing sponsor. Partnership D owns all of the stock of Corporation Y.”)

6

5a Check “Yes” if the plan is maintained by two or more contributing sponsors and all plan assets are
available to pay benefits to all plan participants and beneficiaries.
b

If you checked “Yes” to item 5a, attach a statement listing, to the extent known, (1) the name of each
contributing sponsor and (2) the address, telephone number, and EIN (or state that there is no EIN)
of any contributing sponsor(s) for which this information is not provided in response to previous
items.

6

Enter the name, address, and telephone number of an individual who is an authorized representative
of the contributing sponsor or the ultimate parent filing this form if the individual is not the person
signing the certification in item 12.

Part II. Plan Funding Information
Note: An enrolled actuary must certify that the information in items 7 through 9 are true, correct, and
complete, and conforms to applicable regulatory requirements (see item 11).
7a Describe the required payment that was not made when due, resulting in the requirement to notify
PBGC (e.g., “the second quarterly installment for the plan year beginning on July 1, 2012”).
8a Enter the total amount, as of the due date in item 7b, of the unpaid balance of the required payment
described in item 7a and the aggregate unpaid balance of all preceding required payments for which
payment was not made when due (i.e., include in this amount the unpaid balances, including interest,
of all required payments for which payment was not made when due). Compute the total amount in
accordance with the instructions in the Appendix.
b

Describe how the amount in item 8a was determined. This description must include an attached
spreadsheet that shows the details of the calculation (see Appendix for the required information).

9a Provide the following actuarial information:
– Copy of the most recent Actuarial Valuation Report that includes or is supplemented with all of
the items described in 29 CFR §4010.8(a)(11) *
– If the amount described in item 7a is based on a determination of the minimum required
contribution for the plan year that is more recent than the determination reflected in the
Actuarial Valuation Report, all of the information described in 29 CFR §4010.8(a)(11)* on
which the more recent determination is based
– Statement of any material change in liabilities of the plan occurring after the date of the most
recent Actuarial Valuation Report
– Most recent month-end market value of plan assets
– Contact name, telephone number, and employer of the plan actuary if different from that listed
on the most recent Schedule SB filed
* The items described in 29 CFR §4010.8(a)(11) are:
o

o

The funding target calculated pursuant to ERISA section 303 without regard to subsection
303(i)(1), setting forth separately the value of the liabilities attributable to retirees and
beneficiaries receiving payment, terminated vested participants, and active participants (showing
vested and nonvested benefits separately;
A summary of the actuarial assumptions and methods used for purposes of ERISA section 303
and any changes in those assumptions and methods since the previous valuation and
justifications for any change; in the case of a plan that provides lump sums, other than de
7

o
o
o
o
o
o

o
o
o
o

minimis lump sums, the summary must include the assumptions on which participants are
assumed to elect a lump sum and how lump sums are valued;
The effective interest rate (as defined in ERISA section 303(h)(2)(A) and Code section
430(h)(2)(A));
The target normal cost calculated pursuant to ERISA section 303 without regard to subsection
303(i)(2) (and Code section 430 without regard to subsection 430(i)(2));
For the plan year and the four preceding plan years, a statement as to whether the plan was in atrisk status for that plan year;
In the case of a plan that is in at-risk status, the target normal cost calculated pursuant to ERISA
section 303 as if the plan has been in at-risk status for 5 consecutive years;
The value of the plan’s assets (reflecting any averaging method) as of the valuation date and the
fair market value of the plan’s assets as of the valuation date;
The funding standard carryover balance and the prefunding balance (maintained pursuant to
ERISA section 303(f)(1) and Code section 430(f)(1)) as of the beginning of the plan year and a
summary of any changes in such balances in the past year (e.g., amounts used to offset minimum
funding requirement, amounts reduced in accordance with any elections under ERISA section
303(f)(5) or Code section 430(f)(5), interest credited to such balances, and excess contributions
used to increase such balances);
A list of amortization bases (shortfall and waiver) under ERISA section 303 and Code section
430, including the year the base was established, the original amount, the installment amount,
and the remaining balance at the beginning of the plan year;
An age/service scatter for active participants including average compensation information for
pay-related plans and average account balance information for hybrid plans presented in a
format similar to that described in the instructions to Schedule SB of the Form 5500;
Expected disbursements (benefit payments and expenses) during the plan year; and
A summary of the principal eligibility and benefit provisions on which the valuation of the plan
was based (and any changes to those provisions since the previous valuation), along with
descriptions of any benefits not included in the valuation, any significant events that occurred
during the plan year, and the plan’s early retirement factors; in the case of a plan that provides
lump sums, other than de minimis lump sums, the summary must include information on how
annuity benefits are converted to lump sum amounts (for example, whether early retirement
subsidies are reflected).

c

Attach a copy of any IRS letter(s) granting or modifying a funding waiver, except a letter relating to
a waived funding deficiency that has been fully amortized.

d

Submit copies of election letters relating to the application of any carryover balance and/or
prefunding balance used to satisfy contribution requirements for any plan year in which
there are missed contributions.

Part III. Contributing Sponsor and Controlled Group Financial Information
10a Attach copies of audited financial statements (if available) or (if not) unaudited financial statements
that were prepared for the contributing sponsor and each other controlled group member
individually, including balance sheets, income statements, statements of cash flows, and notes to
financial statements and annual reports. However, if financial statements were only prepared on a
consolidated basis for more than one controlled group member, consolidated financial statements
and consolidating financial statements (if available) and (if not) consolidating trial balances that
identify each controlled group member individually may be attached instead.
c

Provide the address for the controlled group corporate head offices. Also, list and provide addresses
for each controlled group subsidiary and all real property owned by the controlled group.
8

Part IV. Certifications
11 This certification must be made by an enrolled actuary.
12 This certification must be made by an officer (or an individual of comparable authority in an
unincorporated organization) of the contributing sponsor or ultimate parent that is filing the Form
200.
Note: No additions or deletions may be made to the certifications.

9

Appendix
Calculation Instructions Concerning Failure to Make Required Funding
Payments
Calculation of the aggregate unpaid balance of required funding payments
The aggregate unpaid balance of all required payments for which payment was not made when due is
equal to the amount by which —


the aggregate amount of all statutorily required1 payments (including the current payment) that were
not made when due, accumulated with interest, exceeds



the aggregate amount of such payments that were actually made (after they were due), accumulated
with interest.

Adjusting for interest
For plan years beginning before 2008,2 missed contributions and actual contributions are accumulated at
the valuation funding interest rate for the plan year to which the contribution relates.
For plan years beginning after 2007,2 missed contributions and actual contributions are accumulated as
follows:


In the case of a required quarterly installment, the effective interest rate (as defined in ERISA
§ 303(h)(2)(A)) for the applicable plan year plus five percentage points (the adjustment for missed
quarterly contributions under ERISA §303(j)(3)(A)).



In all other cases, the effective interest rate for the applicable plan year.

If the effective interest rate for a plan year is not known at the time reporting is required, the lowest
24-month average segment rate for that plan year is used instead of the effective interest rate. The
lowest segment rate is determined based on the applicable month used for funding purposes for the plan
year without regard to whether an election has been made to use the yield curve for funding purposes.
Computations are done as of the date of each missed payment and are updated with each subsequent
missed payment. The following example shows how to determine the aggregate unpaid balance of
required payments, and in doing so, determine if/when the $1,000,000 threshold is crossed. The example
also illustrates the data to be submitted for the Form 200 (required if the aggregate unpaid balance,
including interest, exceeds $1,000,000).

1

2

Do not include payments (such as extra payments required solely as a condition of a funding waiver) that are not
required under ERISA sections 302 and 303.
For plans to which the new funding rules under the Pension Protection Act of 2006 (PPA 2006) did not become
applicable for 2008, use the valuation funding interest rate for years before the new funding rules apply and the
effective rate for years to which the new funding rules apply. (Such plans are described in PPA 2006 sections
104, 105, 106, and 402.)

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Example
Assume the plan sponsor of a calendar-year plan:
 missed a required 2009 quarterly installment of $600,000 on January 15, 2010
 made a contribution of $200,000 on March 1, 2010
 missed a 2010 required quarterly installment of $500,000 on April 15, 2010
 missed a 2010 required quarterly installment of $500,000 on July 15, 2010
 missed the final 2009 required contribution of $150,000 on September 15, 2010
In addition, assume the effective interest rate for plan year 2009 was 8% and for plan year 2010 was 6%.
Adding 5% (see ERISA §303(j)(3)(A)) to the effective interest rates for the periods of underpayment, the
applicable interest rates for the missed quarterlies for the 2009 and 2010 plan years are 13% and 11%,
respectively.
Aggregate Unpaid Balance of Required Contributions as of 7/15/2010
Applicable
Plan
Year

Applicable
Interest
Rate

Quarterly
Quarterly
Quarterly

2009
2010
2010

13.00%
11.00%
11.00%

Quarterly

2009

13.00%

Date

Days until
07/15/2010

Interest
Adjustment

$600,000
$500,000
$500,000

181
91
0

$37,488
$13,180
$0

$637,488
$513,180
$500,000

($200,000)

136

($9,318)

($209,318)

$41,350

$1,441,350

Amount

Total

Missed contribution

01/15/2010
04/15/2010
07/15/2010
Payment made

03/01/2010

$1,400,000

Total

Because the aggregate unpaid balance of required payments as of July 15, 2010 ($1,441,350) exceeds
$1,000,000, a Form 200 filing is due on July 25, 2010 (10 days after the missed contribution, with
weekend extension). The table shown above is an example of the data to be submitted with the Form 200
filing.
Aggregate Unpaid Balance of Required Contributions as of 9/15/2010
Applicable
Plan
Year

Applicable
Interest
Rate

Quarterly
Quarterly
Quarterly
Final

2009
2010
2010
2009

13.00%
11.00%
11.00%
8.00%

$600,000
$500,000
$500,000
$150,000

243
153
62
0

$50,861
$22,358
$8,942
$0

$650,861
$522,358
$508,942
$150,000

Quarterly

2009

13.00%

($200,000)

198

($13,709)

($213,709)

$68,452

$1,618,452

Date

Amount

Days until
09/15/2010

Interest
Adjustment

Total

Missed contribution

01/15/2010
04/15/2010
07/15/2010
09/15/2010
Payment made

03/01/2010

$1,400,000

Total

Because the aggregate unpaid balance of required payments as of September 15, 2010 ($1,618,452)
exceeds $1,000,000, an updated Form 200 filing is due on September 25, 2010 (10 days after the missed
A-2

contribution, with weekend extension). The table shown above is an example of the data to be submitted
with the Form 200 filing.

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