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pdfAA-1 (Internet) Process and Screen Descriptions
The proposed AA-1 (Internet), Application for Employee Annuity, is not a form in the traditional
sense. Although it collects essentially the same information as the other approved versions of
the AA-1 application, it consists of a series of screens, which collects the necessary information.
It also provides the required notices and certifications, as well as help messages designed to
guide the applicant through the system and successfully complete the application. Depending
on the response to specific questions, the application automatically displays additional,
appropriate questions for the applicant to answer.
Process
1.
The applicant will access Form AA-1 (Internet) through the RRB’s website, RRB.Gov, and
complete the application without assistance by RRB personnel. However, before the AA-1
(Internet) can be accessed, the applicant’s identity will be authenticated by Login.gov,
which requires a two-factor authentication process. The applicant will be requested to
provide information for a Level of Assurance 3 (LOA3), including full name, date of birth,
home address, phone number, email address and password. A description of the process
was posted in the Federal Register under GSA dated January 19, 2017 (attached). The
RRB is updating its website to accommodate forms that will require authentication through
Login.gov (See Screens A-E).
2.
Upon logging onto RRB.gov, Benefit Online Services, the Introduction Screen (Screen 1)
will be displayed. The Introduction Screen contains a description of the process and the
RRB toll-free number to contact an RRB representative for additional information. The
screen also contains links to:
the Paperwork Reduction Act and Privacy Act Notices (Screen 2),
the Informational Booklet RB-1, “Age and Service Employee Annuity” (Screen 3),
and
a checklist of information needed for completing the application (Screen 4),
3.
The left side of each screen will show the Quick Access bar which contains the RRB’s
government seal along with a list of the different steps used in the application process
(Screen 5).
4.
Each step will have the option to:
continue to the next step by clicking “Next”
save the current step information and stay on the screen by clicking “Save,” or
return to the previous step by clicking “Previous.”
Applicants can also access a specific step using the Quick Access bar on the lefthand side of each screen.
NOTE: When the applicant clicks the “Next,” “Save,” or “Previous” buttons, the entered
information will be saved.
5.
Partially completed applications will be saved on a temporary database for 90 calendar
days. During that time the applicant can resume completion at any time; however; after 90
days, a partially completed application will be deleted. To apply for an annuity, the
applicant will need to start the application process again. This is all described on the
Introduction Screen (Screen 1).
6.
Pressing the “Start Application” button (Screen 1) accesses Step 1, the “Employee
Information” screen (Screen 6). The employee’s first and last names, email address, date
of birth, address, and telephone number are prefilled from Login.gov. The applicant
provides the additional identifying and contact information seen on Screens 6-6a.
Note: If the applicant is reentering a partially completed application, the “Start Application”
button will change to “Resume Application.”
7.
The first page of each subsequent step provides the items that the applicant must complete
with a selection of either a “Yes/No” response, dropdown list, or radio button. The screens
that follow each step show the input values for that step. Only input values that require a
response are shown. For example, if the response to a question is “No” but the applicant
must provide additional information, then those input screens are provided. However, if the
response to a question is “No” and the applicant does not have to provide additional
information, those screens are not shown.
8.
The application has a popup screen accessed by clicking “Add” to provide additional
information. For example, the popup is used when the applicant has to report employment
or describe family members. A table at the bottom of the screen will display the information
entered on the popup screen. For an example, see the bottom of Screen 8.
9.
When the applicant has completed all of the screens, they are given the opportunity to
review and edit their responses (Screens 21 and 21a). The applicant’s responses are
displayed in contracted steps. Clicking on a title expands and contracts the information in
each step to show the responses the applicant previously provided. Selecting the Edit key
on any step, returns the applicant to that step to show the responses previously supplied
and allows the applicant to make changes. Before submitting the application, the applicant
will have the option of printing the responses.
10. The last step is the Certification screen (Screen 22). The application is officially filed when
the Submit button is clicked and the application is successfully transmitted to the RRB. The
applicant will receive an application submission confirmation email (Screen 23).
11. After the application is submitted, the information will be moved from the holding database
to the currently existing APPLICATION EXPRESS (APPLE) system. Once the application
has been successfully submitted, it is frozen and cannot be modified by the applicant. The
applicant will receive an email (Screen 23) advising that the application has been
successfully submitted and providing reminders of events that must be reported.
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Screen Descriptions (Below is a brief description of each screen.)
Screen 1 – Introduction Screen
Screen 2 – Paperwork Reduction Act and Privacy Act Notices
Screen 3 – Informational Booklet RB-1, Age and Service Employee Annuity
Screen 4 – Checklist
Screen 5 – Quick Access Bar (appears on left of all screens)
Screens 6-6b, Step 1 – Employee Information
Screens 7-7b, Step 2 - Information About Type of Annuity - The applicant indicates the
type of annuity they wish to apply for.
Screens 8-8k, Step 3 – Employee’s Family Info – The applicant provides information
about current and past spouses and any children who may qualify the employee for
additional benefits. After responding to questions concerning the type and number of
spouses and children, the applicant will click on the “Add” button to access a popup
screen and provide additional information about each family member.
Screens 9-9a, Step 4 – Information About Your Railroad Work - This step requests
information about the applicant’s railroad employment. All applicants will have at least
one employer in the railroad industry. The applicant will click on the “Add” button to
access a popup screen to enter additional information. Multiple employers can be
entered. A table will display information entered for each employer. The applicant has
the ability to edit or delete the information provided.
Screens 10-10f, Step 5 – Information About Your Nonrailroad Work - This step requests
information about the applicant’s nonrailroad employers in the previous six months or
since the applicant stopped working in the railroad industry. A portion of the Tier 2 is not
payable if the applicant continues working for an employer or begins working for an
employer prior to the annuity beginning date. In addition, information about any selfemployment will be provided. A table will display information entered for each employer.
The applicant has the ability to edit or delete the information provided.
Screens 11-11d, Step 6 – Information About Your Earnings - This step requests
information about the applicant’s nonrailroad earnings which are over the annual earnings
exempt amount. The Tier I portion of an employee’s annuity is reduced for earnings over
the exempt amount. The Annual Earnings Exempt Amount is based on whether the
employee has reached Full Retirement Age (FRA). The annual and monthly exempt
amounts are automatically prefilled. When the applicant indicates they will have earnings
over the exempt amount, they will be asked for the amount of last year’s earnings, if the
annuity can begin before January of the current year. The applicant will also be asked for
an estimate of the current year’s earnings and next year’s earnings. Applicants who are
over FRA will not complete the questions for any full calendar year they are over FRA.
Screens 12-12b, Step 7 – Information About Your Pay for Time Lost and Sick Pay - This
step requests information about payments from the railroad for time lost, including
personal injury settlements, wage continuation plans, dismissal allowances. The
applicant also provides information about any lawsuit they have filed or expect to file.
Screens 13-13c, Step 8 – Information About Garnishment, Criminal Offense, and
Deemed Current Connection – This step requests information about legal process court
orders and incarceration due to a conviction for a criminal offense. The applicant will also
provide information to determine if entitled to a deemed current connection.
Screens 14-14a, Step 9 – Information About Your Military Service – This step requests
information about any active military service.
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Screens 15-15a, Step 10 – Information About Your Social Security Benefits - This step
requests the applicant provide information about receiving and filing for social security
benefits on the their own account or someone else’s account.
Screens 16-16i, Step 11 – Information About Your Noncovered Service Pension - This
step requests information about any pension or lump-sum payment the applicant received
or will receive from work after 1956 that is not covered by the Railroad Retirement Act or
the Social Security Act.
Screens 17-17a, Step 12 – Information About Other Railroad Retirement Annuity – This
step requests information about receiving and filing an RRA benefit under another
employee’s earnings record.
Screens 18-18f, Step 13 – Information About Private Pensions - This step requests
information about a private pension the employee receives from any of the employee’s
railroad employers.
Screens 19-19f, Step 14 – Information About Medicare - Through a series of questions,
the applicant advises if they currently have Part B Medicare, have recently filed for Part B
Medicare or would like to file for Part B Medicare. Information concerning Employer
Group Health Plans is also collected. These questions are only asked if the applicant has
met the 64 years and 5 months age requirement for Medicare enrollment. Otherwise, the
applicant is advised to go to the next step. (See Screen 19.)
Screens 20-20a, Step 15 - Receiving Your Payments - The applicant selects whether
their payments will be paid via direct deposit or by debit card. If direct deposit is selected,
information about the applicant’s financial institution is also secured.
Screens 21-21a, Step 16 – Summary
Screen 22, Certification
Screen 23, Confirmation, Printing, and Sample Email Messages
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Additional Items
The following questions have been added to the AA-1 (Internet) for clarity and/or to help us
produce the correct fields.
1. Screen 6 - Does your name match the name on your social security card?
Clarifying question to make sure the name on the applicant’s social security card matches
the name the RRB has. If the applicant answers “No,” the next question is “Name on SSA
card.”
2. Screens 6, 8d, 8f, 8g, 8i, and 12b - Do you currently live outside the United
States?/Currently reside outside of the United States?/Did this marriage begin outside the
United States?
Clarifying questions produce the appropriate fields to gather the address information. The
standard U.S. format appears if they reside in the United States (Screen 6) and the foreign
address format appears if they reside outside the United States (Screen 6a).
3. Screen 10d - Pay Period
Reworded current AA-1, Item 57 language, from “monthly salary” to “Pay Period” to give the
applicant multiple options for indicating salary (Weekly, Bi-weekly, Monthly, Yearly).
New Item (Screen 8) - Are you expecting a newborn?/Expected Delivery Date
This information will help determine if the applicant can potentially receive an additional benefit
amount.
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Screen A
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Screen B
Access Online Retirement Application
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Screen C
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Screen D
U.S. Railroad Retirement Board
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Screen E
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Screen 1
.
it for processing. A partially completed application will be saved for 90 calendar days. After 90 days, if the
application has not been submitted, it will be deleted and you will need to start the application process again.
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Paperwork Reduction Act and Privacy Act Notices
Screen 2
2
or not you are eligible to
government agencies. Information from these Matching programs can be used to establish or verify
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Informational Booklet RB-1, “Age and Service
Employee Annuity”
Screen 3
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Checklist
Screen 4
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Screen 5
Quick Access Bar (on all screens)
Private Pensions
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Screen 6
Step 1 – Employee Information
If your name was different at birth, enter that name
card?
See Screen 6a for "No" response
See Screen 6a for "Yes" response
See Screen 6b for dropdown choices
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Step 1 – Employee Information Input Values
Screen 6a
card?
card
Quebec
H3Z 2Y7
Canada
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Step 1 – Employee Information Input Values
Screen 6b
• States
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Step 2 – Information About Type of Annuity
Screen 7
See Screen 7a
See Screen 7b
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Step 2 – Type of Annuity Input Values
Screen 7a
• “Full 60/30” or “Full Age” selected
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Screen 7b
Step 2 – Type of Annuity Input Values
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Screen 8
Step 3 – Employee’s Family Info
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Step 3 – Employee’s Family Input Values
Screen 8a
• Current Marital Status = “Married or Other”
(Answer "No" if your only
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Step 3 – Employee’s Family Input Values
Screen 8b
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Step 3 – Add Family Member Input Values
Screen 8c
See Screens 8d and 8e
See Screens 8f and 8g
See Screen 8h
See Screen 8i. All "Child" screens except Screen 8j are the same.
child/Student
See Screen 8j.
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Step 3 – Female/Male Spouse
Screen 8d
See Screen 8e
See Screen 8e
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Step 3 – Male/Female Spouse Input Values
Screen 8e
Employee's Family Member Details
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Step 3 – Male/Female Spouse Input Values
Screen 8f
Employee's Family Member Details
State
Quebec
H3Z 2Y7
Canada
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Step 3 – Divorced Spouse
Screen 8g
See Screen 8h
See
en
Scre
8h
See Screen 8h
See Screen 8h
See Screen 8h
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Step 3 – Divorced Spouse Input Values
Screen 8h
Employee's Family Member Details
Marriage Began/Ended State
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Step 3 – Deceased Spouse
Screen 8i
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Step 3 – Child
Screen 8j
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Step 3 – Child
Screen 8k
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Step 4 – Information About Your Railroad Work
Screen 9
Row prefills once entire Screen
9a is completed.
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Step 4 – Railroad Employment Info Input
Screen 9a
this employer*
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Step 5 – Information About Your Nonrailroad Work
Screen 10
."
See Screen 10a
-
See Screen 10b
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Step 5 – Nonrailroad Work Input Values
Screen 10a
ABD month.
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Screen 10b
Step 5 – Nonrailroad Work Input Values
See Screen 10c
Complete and return to the RRB, Form AA-4, Self-Employment and
Substantial Service Questionnaire.
-
See Screen 10c
See Screen 10c
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Step 5 – Nonrailroad Work Input Value
Screen 10c
See Screen 10d-f for all types
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Screen 10d
Step 5 – Nonrailroad Work Input Values
ZIP Code
See Screen 10e
See Screen 10e
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Step 5 – Nonrailroad Work Input Values
Screen 10e
Information About Your Nonrailroad Work
xxxxxxxxxxxxxxxxxxxxxxxx
Weekly
Bi-Weekly
Monthly
Yearly
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Step 5 – Nonrailroad Work – Self-Employment
Screen 10f
Company's State
ZIP Code
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Step 6 – Information About Your Earnings
Screen 11
1, 2017?*
will be from only railroad employment before your date last worked, answer "No.") *
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Step 6 – Earnings for 2016 Input Values
Screen 11a
Information About Your Earnings
1, 2017?*
Prefills exempt amount.
that you did not earn more than the monthly earnings exempt amount from all
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Step 6 – Earnings for 2017 Input Values
Screen 11b
Information About Your Earnings
*
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Step 6 – Earnings for 2017 Input Values
Screen 11c
Information About Your Earnings
in 2017?
that you did not earn, or do not
expect to earn, more than the monthly earnings exempt amount.
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Step 6 – Earnings for 2018 Input Values
Screen 11d
Information About Your Earnings
will be from only
*
will be from only
*
that you expect to
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Step 7 – Information About Your Pay for Time Lost
and Sick Pay
*
Sick Pay
Screen 12
See Screen 12a
See Screen 12b
Did you receive or do you expect to receive sick pay under a railroad wage continuation plan (other
after the actual date you last worked for the
*
See Screen 12b
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Step 7 – Pay For Time Lost Input Values
Screen 12a
*
,"
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Step 7 Railroad Sick Pay Input Values
Screen 12b
Sick Pay
do you expect to receive sick pay under a railroad wage continuation plan (other
after the actual day you last worked for the
*
• Lawsuit Input Values
Sick Pay
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Step 8 Information About Garnishment, Criminal
Offense, and Deemed Current Connection
Screen 13
See Screen 13a
? (NOTE: Reference to pension rights may be
See Screen 13b
on this application nonrailroad employment that could break your current connection?*
See Screen 13c
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Step 8 – Garnishment or Property Settlement
Input Values
Screen 13a
? (NOTE: Reference to
applies?
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Step 8 – Criminal Offense Input Values
Screen 13b
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Step 8 Deemed Current Connection
Screen 13c
on this application nonrailroad employment that could break your current connection?*
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Step 9 – Information About Your Military Service
Screen 14
See Screen 14a
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Step 9 – Military Service Input Values
Screen 14a
,
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Step 10 – Information About Your Social Security
Benefits
Screen 15
See Screen 15a.
See Screen 15a.
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Step 10 –Social Security Benefits Input Values
benefits are based
Screen 15a
on whose earnings your social security
social security benefits are based
on whose earnings your
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Screen 16
Step 11 – Information About Your Noncovered Service
Pension
noncovered service pensions.
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Step 11 – Noncovered Service Pension Input Values
Screen 16a
Employer Infiormation About Your Noncovered Service Pension (NCSP)
Line prefills once all
questions in Step
11 are completed.
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Step 11 – Noncovered Service Pension Input Values
Screen 16b
See Screens 16c-e
See Screens 16f-g
See Screen 16h
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Step 11 – Lump-Sum Input
Screen 16c
See Screen 16d
-
-
lump-sum paid
See Screen 16e
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Step 11 – Lump-Sum Payment Input Values
Screen 16d
Employer Infiormation About Your Noncovered Service Pension (NCSP)
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Step 11 – Lump-Sum Payment Input Values
Screen 16e
Employer Infiormation About Your Noncovered Service Pension (NCSP)
lump sum paid
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Screen 16f
Step 11 – Recurring Payment Input
See Screen 16g1
See Screen 16g2
See Screen 16g3
See Screen 16g4 and 16g5 if "Yes" is selected
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Step 11 – Recurring Payment Input Values
Screen 16g
Employer Information About Your Noncovered Service Pension (NSCP
2
1
3
4
5
rate 1
rate 2
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Step 11 – Recurring and Lump-Sum Input
Screen 16h
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Step 11 – Recurring and Lump-Sum Input
Screen 16i
Employer Information About Your Noncovered Service Pension (NCSP)
Lump sum covers
period from
Lump sum covers
period to
lump sum
date the lump
sum
-
lump sum paid
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Step 12 – Information About Other Railroad
Retirement Annuity
Screen 17
See Screen 17a
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Step 12 – Other Railroad Retirement Annuity Input
Values
Screen 17a
Railroad Retirement Claim Number
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Step 13 – Information About Private Pensions
Screen 18
Private Pensions
Are you receiving or do you expect to receive a
recurring pension or lump-sum pension payment
from one or more railroad employers? *
*
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Step 13 – Private Pension Input Values
Screen 18a
Information About Private Pensions
Are you receiving or do you expect to receive a
recurring pension or lump-sum pension payment
from one or more railroad employers? *
See Screen 18b
private pension details
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Step 13 – Private Pension Input Values
Screen 18b
Private Pension Info
Select the correct option that
-
sum
-
See Screen 18c
See Screen 18d
See Screen 18e
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Step 13 – Private Pension Input Values
Screen 18c
Private Pension Info
Select the correct option that
-
Is this pension based on a collective
bargaining (union) agreement? *
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Step 13 – Private Pension Input Values
Screen 18d
Private Pension Info
Select the correct option that
-
Is this pension based on a collective
bargaining (union) agreement? *
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Step 13 – Private Pension Input Values
Screen 18e
Private Pension Info
Select the correct option that
-
See Screen 18f
See Screen 18f
See Screen 18f
Is this pension based on a
collective bargaining (union)
agreement?
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Step 13 – Private Pension Input Values
Screen 18f
Private Pension Info
Select the correct option that
-
Is this pension based on a
collective bargaining (union)
agreement?
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Step 14 – Information About Medicare – Under
Age 65
Screen 19
Based on your date of birth you have not met the 64 years and 5 months of age requirement.
You can skip this step and proceed to the next step.
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Step 14 – Information About Medicare – Age 65 or
Over
Screen 19a
Based on your date of birth you meet the 64 years and 5 months of age requirement.
Please read Part VI of the RB-1 booklet for an explanation of the Medicare program.
See Screen 19b
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Step 14 – Information About Medicare Input Values
Screen 19b
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Step 14 – Information About Medicare Input Values
Screen 19c
See Screen 19d for "Yes"
Note: You understand that by selecting "No" you are electing not to enroll in Part B and that the
premium rate may be higher if you do enroll later in Part B.
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Step 14 – Information About Medicare Input Values
Screen 19d
Note: You understand that by selecting "No" you are electing not to enroll in Part B and that the
premium rate may be higher if you do enroll later in Part B.
Note: You understand that by selecting "No" you are electing not to enroll in Part B and that the
premium rate may be higher if you do enroll later in Part B.
See Screen 19e for "Yes"
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Step 14 – Information About Medicare Input Values
Screen 19e
Information About Medicare
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
a Special Enrollment Period?
See Screen 19f
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Step 14 – Information About Medicare Input Values
Screen 19f
a Special Enrollment Period?
a Special Enrollment Period?
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Step 15 – Receiving your Payments
Screen 20
See Screen 20a
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Step 15 – Payments Input Values
Screen 20a
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Step 16 – Summary
Screen 21
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Screen 21a
Step 16 – Summary, continued
Private Pensions
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Screen 22
Certification
,"
See Attachment 22A
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Attachment 22A
I understand that my application will be signed electronically when I select the “Submit” box. I also understand that my electronic signature means that I intend to file for an annuity and
have provided accurate information. The information I provided will be used to process my application.
I certify that the information I have given to the Railroad Retirement Board (RRB) in relation to this application is true to the best of my knowledge. I know that if I make a false or
fraudulent statement or withhold information, in order to receive benefits from the RRB, I am committing a crime under Federal law, which may be punishable by fines, imprisonment,
or both.
I have reviewed the booklets RB-1, Age and Service Employee Annuity, and RB-9, Employee and Spouse Annuities - Events that Must be Reported. I understand that I am
responsible for reporting events that would affect my annuity as explained in the booklets. Failure to report any of the events listed below or other events that may affect my annuity
may result in a penalty deduction from my annuity, as well as criminal and/or civil prosecution.
I agree to immediately notify the RRB, if
Railroad Work – I return to work for a railroad or railroad labor organization or return to work in any capacity in the railroad industry.
Railroad Work – I change the date I will cease working for current railroad employer.
Social Security – I file for social security benefits based on any person’s earnings record.
Social Security – Benefits I receive directly from the Social Security Administration are adjusted for a reason other than normal cost-of-living increases.
Public Pension – I receive a lump-sum payment or begin to receive a pension based on earnings not covered by the Social Security Administration or the Railroad Retirement
Board.
Pension – I receive a lump-sum payment or begin to receive a monthly pension from my railroad employer.
Other Benefits – I begin to receive worker’s compensation or a public disability benefit.
Settlement – I receive a settlement with credit for railroad service as “pay-for-time-lost” for months after the last day I worked for a railroad employer.
Employment – There is a change in my status with my last nonrailroad employer.
Employment – I perform work, including self-employment, for a family owned, controlled or managed business, including a business operated, managed or owned by me, a
family member, friend or close associate, whether for pay or not, and without regard to how the business is organized (e.g., sole proprietorship, partnership, corporation, LLC,
etc.).
Employment – I become a corporate officer of, own or operate a corporation (including a corporation owned by a family member or friend), whether for pay or not.
Employment – I receive anything of value in lieu of salary or wages for any work that I performed.
Earnings – I work for any employer or perform any self-employment work.
Earnings – My earnings for this year change.
Address – My address changes, even if my payments are sent to a financial organization.
Bank Account – My financial organization or the account number at my financial organization changes.
Criminal Offense – I am confined in a jail, prison, penal institution, or correctional facility due to a conviction for a criminal offense.
Spouse – My spouse who is receiving a benefit dies or our marriage ends in divorce or annulment.
Child – A qualifying child marries or leaves my custody or residence.
If you are not FRA, in most cases, we calculate how much to reduce your annuity because of your earnings based on either the earnings estimate you gave us when you applied for
benefits, or on reports submitted by employers to the Social Security Administration. As a reminder, you should report your earnings (1) when we ask for a report of your earnings or
(2) if any of the following happens:
You stop working;
You start working and expect to earn more than the annual exempt amount;
Your employment is not covered under the Social Security Act (i.e., FICA taxes are not deducted from your pay);
You work for a railroad or railroad labor organization; or
You return to work for your last pre-retirement nonrailroad employer.
If you change your address, or if there is some other change that may affect your application, you or your representative should report the change at once. If you have any questions,
we will be glad to help you. You can report changes either by telephone, mail, or in person, whichever you prefer. You can contact our local office at 877-772-5772. Most Railroad
Retirement Board offices are open to the public from 9:00 AM to 3:30 PM, Monday, Tuesday, Thursday, Friday and 9:00 AM to 12:00 PM Wednesday.
When you select “Submit”, you will be sending this completed application electronically to the Railroad Retirement Board. Please make sure that everything is correct. You will not
be able to change the information once the application is submitted.
Screen 23
Confirmation and Printing
application?
application?
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| File Type | application/pdf |
| File Title | BOS Screens |
| Author | Falesch, Judy A. |
| File Modified | 2017-11-21 |
| File Created | 2017-07-21 |