Form 1-C Comprehensive Premium Filing

Draft of Primary My PAA Screens for Plan Year 2015 Comprehensive Premium Filings (CPF)
The screen mockups are intended to show the expected placement of the 2015 data elements. Please
disregard any data reflected on the screens, e.g., inconsistent data and references to 2014 filings.
CONTENTS
Screen Prepared Single-Employer CPF with VRP and Overpayment
Screen Prepared Multiemployer CPF with Payment
Imported Single-Employer CPF with VRP and Payment
Uploaded Single-Employer CPF with VRP and Payment

PAGE
4 - 23
24 – 40
41 – 50
51 - 57

Notes:
1. The screens are organized based on the above four scenarios to describe how the screens are used
for the three premium e-filing options, note that the estimated flat-rate filing for large plans has
been eliminated.
2. The following screens (and page numbers) reflect the primary changes for 2015, which are also
described on the bottom of each of the modified screens:
- Page 8, Enter Plan Sponsor and Administrator Information Screen: The alternative phone number
and extension have been added
- Page 16, Report Miscellaneous Information Screen: The Risk Transfer Activity questions have been
added
- Page 19 – 20, Data Summary: The alternative phone number and extension, and Risk Transfer
Activity questions have been added
- Page 28, Enter Plan Sponsor and Administrator Information Screen: The alternative phone
number and extension have been added
- Page 30, Report Miscellaneous Information Screen: The Risk Transfer Activity questions have been
added
- Page 33, Data Summary: The alternative phone number and extension, and Risk Transfer Activity
questions have been added
3. The remainder of the screens do not have changes for plan year 2015; therefore, the screens are
those that are currently in effect.

1

Login Screen

2

Home Page

3

Screen Prepared Comprehensive Single Employer scenario
How to File screen

4

Identify Filing to be Made screen

5

Enter Plan Information

6

Enter Filing Information

7

Enter Plan Sponsor and Administrator Information screen

Added Alternative phone number and extension for Insured Plan List on pbgc.gov in the Plan
Administrator Information section.
8

Comprehensive Single Employer – Calculate Premium Due screen

9

Comprehensive Single Employer - Calculate Variable Rate Premium screen

10

Comprehensive Single Employer – Varaible rate Premium Due section
Single employer plans reporting eligibility for the small employer cap choosing to report the data in
items 7c – 7g.

11

Single employer plans eligible for the small employer cap choosing not to report the data in items 7c-7g
must omit items 7c “ Assumptions” through 7g ”Uncapped variable rate premium.”

12

All plans except multiemployer plans, single-employer plans exempt from the VRP, and single employer
plans reporting eligibility for the small employer cap.

13

Single Employer Calculate Total Premium Payment

14

Overpayment screen

15

Report Miscellaneous Information screen

Added Risk Transfer Activity questions.
16

Report Transfers From Other plans screen

17

Report Transfers To Other plans screen

18

Comprehensive Single Employer – Data Summary

Updated the Data Summary to include the new alternative phone number and risk transfer activity
questions for screen prepared and imported filings only.
19

Filing Manager screen

20

Filing Manager

21

22

23

Screen Prepared Comprehensive Multi Employer scenario
Identify Filing to be Made screen

24

Enter Plan Information

25

Enter Filing Information

26

Enter Plan Sponsor and Administrator Information screen

Added Alternative phone number and extension for Insured Plan List on pbgc.gov in the Plan
Administrator Information section.

27

Comprehensive Multi Employer – Calculate Total Premium Payment screen

28

Report Miscellaneous Information screen

Added Risk Transfer Activity questions.
29

Report Transfers From Other plans screen

30

Report Transfers To Other plans screen

31

Comprehensive Multi Employer – Data Summary

Updated the Data Summary to include the new alternative phone number and risk transfer activity
questions for screen prepared and imported filings only.
32

33

Payment Alternatives screen

34

35

36

Filing Manager screen

37

Filing Manager screen

38

39

40

Import Comprehensive Single Employer Scenario

41

42

Home Page

43

Filing Manager screen

44

Payment Alternatives

45

Pay online via My PAA

46

47

48

49

50

Upload Comprehensive Single Employer scenario

51

Filing Certification

52

Payment Alternatives

53

Selected Payment Method: Other

54

Confirmation screen

55

Home Page

56

Uploaded file details

57