Qualified Domestic Relations Orders submitted to PBGC

PBGC QDRO BOOKLET 2018 ogc-oba draft v.11

Qualified Domestic Relations Orders submitted to PBGC

OMB: 1212-0054

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2021-12-16 - Revision of a currently approved collection

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Pension Benefit
Guaranty Corporation

Qualified
Domestic
Relations
Orders & PBGC

This booklet provides general information to attorneys and other pension professionals on submitting
domestic relations orders to the Pension Benefit Guaranty Corporation (PBGC) after PBGC becomes trustee of a
terminated pension plan. It also provides general information on the procedures PBGC follows to determine whether
an order is a qualified domestic relations order (QDRO) for purposes of paying benefits under title IV of the Employee
Retirement Security Act of 1974, as amended (ERISA). Under ERISA §206(d)(3)(G)(ii), each plan must establish
reasonable procedures for determining whether an order is a QDRO, but plans may differ in the procedures they
establish. The procedures described in this booklet are PBGC's procedures and may differ from procedures for
plans that have not been trusteed by PBGC.
The information summarizes PBGC's rules at the time that the booklet was published. It is not intended to
give legal advice or to replace the advice of an attorney. None of this information takes precedence over legislation,
regulations, or specific interpretations or rulings. The model orders and model language are provided solely to assist
individuals in preparing orders for submission to PBGC, and they cover only the most common situations that may
need to be addressed in a domestic relations order. PBGC will not condition its determination of whether an order
is a QDRO on the use of any particular form or language.
The information does not represent the government's interpretation of the rules governing QDROs.
Interpretation of those rules is within the jurisdiction of the U.S. Department of Labor (DOL) and the Internal
Revenue Service (IRS).
This booklet may be obtained from PBGC's website at www.pbgc.gov or by calling PBGC at 1-800-400PBGC (7242). (TTY/ASCII users may call the Federal Relay Service toll-free at 1-800-877-8339 and ask to be
connected to this number.)
For additional information, DOL's publication The Division of Retirement Benefits through Qualified
Domestic Relations Orders is available at https://www.dol.gov/sites/default/files/ebsa/about-ebsa/ouractivities/resource-center/publications/qdros.pdf, or by calling the Employee Benefits Security Administration Hotline
at 1-866-444-EBSA (3272). IRS Notice 97-11 ("Providing Sample Language for a Qualified Domestic Relations
Order") was published January 13, 1997, at 1997-2 I.R.B. 49 and appears in its entirety in Appendix C of DOL's
QDRO publication.
This edition of PBGC’s booklet Qualified Domestic Relations Orders & PBGC includes the following
changes from the guidance published in December 2015:
•
•
•
•
•
•
•

Deleting former Appendix G and slightly revising and moving language regarding an early retirement subsidy
from the appendix to Section 3 of the Model Separate Interest QDRO (page 6).
Adding additional early retirement subsidy language to Section 3 of the PBGC Model QDRO Instructions (page
15).
Adding language in Section 9 of the PBGC Model QDRO Instructions (page 21), clarifying that the alternate
payee's benefit commences on the annuity starting date.
Clarifying Example 11 (page 24), Section 10 of the PBGC Model QDRO Instructions, that the participant in the
example may elect any form of annuity for his remaining benefit.
Deleting in Appendix F (page 47) the sentence that PBGC may apply an actuarial charge against the participant's
benefit when a contingent alternate payee is identified in a QDRO. (PBGC does not apply an actuarial charge.)
Removing the notarization requirement from Appendix G (formerly Appendix H) (page 49).
Adding definitions of the terms “early retirement benefit” and “early retirement subsidy” to the Glossary and
modifying the definition of “subsidized early retirement benefit” (page 50).

Required Paperwork Reduction Act Notice
Under ERISA, no part of an individual's benefit under a plan trusteed by PBGC may be assigned to another person
involved in a domestic relations proceeding, such as a separation or divorce, unless PBGC receives a domestic
relations order and determines it to be a qualified domestic relations order, or "QDRO." The model QDROs and
accompanying guidance in PBGC's booklet, Qualified Domestic Relations Orders & PBGC, are intended to assist
parties by making it easier to comply with statutory requirements. Under the Paperwork Reduction Act, 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. This collection of information has been approved by the Office of Management
and Budget (OMB) under control number 1212-0054 (expires 12/31/2018). The information provided to PBGC may be
disclosable under the Freedom of Information Act and the Privacy Act.
PBGC estimates that the average burden of preparing a QDRO with the assistance of PBGC's booklet will be 3/4
hour of the participant's or alternate payee's time and $1,500 in professional fees if the participant or alternate payee
hires an attorney or other professional to prepare the QDRO. Comments concerning the accuracy of this estimate or
suggestions for further reducing this burden may be sent to Pension Benefit Guaranty Corporation, Office of General
Counsel, 1200 K Street NW, Washington, DC 20005-4026.

Contents
Page
I

Qualified Domestic Relations Orders and PBGC

PBGC Model QDROs:

PBGC Model Separate Interest QDRO [PDF]

PBGC Model Shared Payment QDRO [PDF]

PBGC Model QDRO Instructions

Section 1. Identification of Plan

Section 2. Identification of Participant and Alternate Payee

Section 3. Amount of Benefit to Be Paid to the Alternate Payee

Section 4. PBGC Benefit Adjustments

Section 5. Benefits Start

Section 6. Form of Benefit

Section 7. Benefits Stop

Section 8. Death of Participant

Section 9. Death of Alternate Payee

Section 10. Surviving Spouse Rights of Alternate Payee

Section 11. Other Requirements

Section 12. Reservation of Jurisdiction

III

Procedures and Checklist

Appendix A

Defined Benefit Pension Plans and PBGC Benefit Rules

Appendix B

Domestic Relations Orders Qualified Before PBGC Becomes Trustee

Appendix C

QDRO Tax Rules

Appendix D

PBGC Model Child Support Shared Payment QDRO

Appendix E

PBGC Model Treat-As-Spouse QDRO

Appendix F

Language for Including a Contingent Alternate Payee

Appendix G

How to Obtain Certain Participant Information from PBGC

Glossary

I. Qualified Domestic Relations Orders and PBGC
The
Pension
Benefit
Guaranty
Corporation (PBGC) is a federal agency that
insures the benefits of workers, retirees, and
beneficiaries participating in qualified,
private-sector defined benefit pension plans.
A defined benefit pension plan that does not
have enough money to pay benefits may be
terminated if the employer responsible for the
plan faces severe financial difficulty, such as
bankruptcy, and is unable to maintain the
plan. In such an event, PBGC becomes
trustee of the plan and pays pension benefits,
subject to legal limits, to plan participants
and beneficiaries. PBGC's rules on benefit
amounts and benefit forms payable by PBGC
are summarized in Defined Benefit Pension
Plans and PBGC Benefit Rules – Appendix
A.

PBGC reviews a domestic relations order
that has been submitted to PBGC and must
determine that the order is qualified before
being able to pay benefits to an alternate
payee.

PBGC QDRO Requirements
Identity of the plan participant, each
alternate payee, and each pension plan. A
QDRO must specify the name, last known
mailing address, and Social Security Number
of the plan participant and each alternate
payee covered by the order. A QDRO also
must identify the name of each plan to which
the order applies; this should be each plan's
formal name.
Amount to be paid and when payments
start. A QDRO must state how much of the
plan participant's benefit is to be paid to the
alternate payee, such as a dollar amount or
percentage of the benefit, or make clear the
manner in which the amount is to be
determined. A QDRO also must specify or
allow the alternate payee to choose when
payments to the alternate payee will start.

The benefits of a pension plan participant
generally may not be assigned or alienated.
The law provides an exception for domestic
relations orders that relate to child support,
alimony payments, or marital property rights
of an alternate payee (a spouse, former
spouse, child, or other dependent of a plan
participant). The exception applies only if the
domestic relations order meets specific legal
requirements and the plan administrator
determines that it is qualified, that is, a
qualified domestic relations order, or
"QDRO." See section 206(d) of ERISA and
related regulations, and section 414(p) of the
Internal Revenue Code of 1986, as amended
(Code).

What happens on the death of the plan
participant and the alternate payee. A
QDRO should specify whether the alternate
payee will be treated as the participant's
spouse for purposes of any survivor benefits.
A QDRO also should specify what happens
to benefits when the participant or alternate
payee dies.

What a QDRO Must Not Require
A QDRO must not require PBGC to:
•

pay any benefits not permitted under
ERISA or the Code;

•

provide any type or form of benefit, or
any option, not otherwise provided under
the plan or paid by PBGC;

•

pay benefits to the participant and
alternate payee with a total value that
exceeds the value of benefits that the
participant would otherwise receive
under title IV of ERISA;

•

pay benefits to the alternate payee when
those benefits are required to be paid to
another alternate payee under a QDRO
that is in effect prior to the order;

•

pay benefits to the alternate payee for any
period before PBGC receives the order;

•

pay benefits as a separate interest to the
alternate payee if the participant is
already receiving benefit payments; or

•

change the benefit form or beneficiary of
a joint-life annuity if the participant is
already receiving benefit payments.

II. PBGC Model QDROs
PBGC has developed two model QDROs
for general use after a defined benefit plan
has terminated and PBGC has become trustee
of the plan: a PBGC Model Separate Interest
QDRO and a PBGC Model Shared Payment
QDRO. (Two additional model QDROs that
may be used specifically for child support or
for providing only a surviving spouse benefit
are located in Appendices D and E,
respectively.) A QDRO should be clear as to
whether the alternate payee is to receive a
portion of the actual benefit payments made
to the participant (a shared payment order) or
the value of a separate portion of the participant's retirement benefit, where the
benefit may be paid at a time and in a form
different from that chosen by the participant
(a separate interest order). PBGC's Model
QDROs make this distinction clear.

(2) receive pension benefits over his or her
lifetime rather than the participant's lifetime,
and (3) choose a straight life annuity or
certain-and-continuous (C&C) annuity that
may provide benefits to the alternate payee's
beneficiary for a limited period. The QDRO
may also assign survivor benefits to the
alternate payee, but this assignment is not
needed to ensure that the alternate payee
receives benefits for life (see page 21).
The PBGC Model Shared Payment
QDRO may be used where the plan
participant and the alternate payee will
"share" each benefit payment. The model
may be used regardless of whether the
participant has started receiving benefits or
not. However, the alternate payee cannot
begin receiving benefits before the
participant does. The PBGC Model Shared
Payment QDRO must specify the amount or
percentage of the participant's benefit
payment that is assigned to the alternate
payee and the number or duration of
payments to the alternate payee. Payments to
the alternate payee stop, at the latest, when
the participant dies or stops receiving
payments. However, the QDRO may also
assign the alternate payee a right to survivor
benefits or other benefits under the plan.

The PBGC Model Separate Interest
QDRO may be used only if the
participant's benefit payments have not
started when the domestic relations order
is submitted to PBGC for qualification.
The participant's benefit is divided into two
separate parts, with each part providing the
participant and the alternate payee with his or
her separate interest in a lifetime annuity.
Unlike the PBGC Model Shared Payment
QDRO (see below), the PBGC Model
Separate Interest QDRO gives the alternate
payee control over the timing and form of his
or her benefit payments. The alternate payee
may (1) start his or her payments before the
participant (subject to certain restrictions),

•

PBGC Model
QDRO [PDF]

Separate

Interest

•

PBGC Model
QDRO [PDF]

Shared

Payment

PBGC Model Separate Interest QDRO
(You may use this model when a defined benefit pension plan has terminated, PBGC
has become trustee of the plan, and the parties want PBGC to divide the value of the
participant’s benefit between the participant and the alternate payee. You may use this
model only if the participant’s benefit payments have not started when the order is
submitted to PBGC for qualification. Please read PBGC Model QDRO Instructions
(page 13) for important information.)

IN THE ___________ COURT OF ____________
DIVISION ___________ COUNTY ____________
---------------------------------------------------------------X
IN RE MARRIAGE/SUPPORT OF
:
____________
PETITIONER,

:
:

V.
__________________________
PARTICIPANT, RESPONDENT.

:
:

:
:
:

CASE NO.____________

---------------------------------------------------------------X

QUALIFIED DOMESTIC RELATIONS ORDER
This Order is intended to be a qualified domestic relations order (“QDRO”), as that term is
defined in section 206(d) of the Employee Retirement Income Security Act of 1974, as
amended (“ERISA”) and section 414(p) of the Internal Revenue Code of 1986, as amended
(“Code”). This Order is granted in accordance with [applicable state domestic relations
law citations], which relate to marital property rights, child support, and/or spousal support
between spouses or between a spouse and a former spouse in
matrimonial actions. The Participant is not currently receiving benefit payments from PBGC
with respect to the plan identified below.
SECTION 1. IDENTIFICATION OF PLAN
This Order applies to benefits under the [formal name of plan] (“Plan”). The Pension
Benefit Guaranty Corporation (“PBGC”) is trustee of the Plan.

SECTION 2. IDENTIFICATION OF PARTICIPANT AND ALTERNATE PAYEE
a. [Name of the Participant] is eligible to receive a benefit from the Plan and is hereafter
referred to as the “Participant.” The Participant’s mailing address is [address]. The
Participant’s Social Security Number is [Social Security Number].
b. [Name of the Alternate Payee] is hereafter referred to as the “Alternate Payee.” The
Alternate Payee’s mailing address is [address]. The Alternate Payee’s Social Security Number
is [Social Security Number]. The Alternate Payee is the [spouse/former spouse/child/other
dependent] of the Participant.
SECTION 3. AMOUNT OF BENEFIT TO BE PAID TO ALTERNATE PAYEE
Starting at the time specified in section 5, PBGC shall pay to the Alternate Payee as a
separate interest an amount actuarially equivalent to [all/x%] of the Participant’s benefit
under the Plan. The Participant’s benefit shall be determined as of [date of separation/date
of divorce/date of plan termination/some other date]. The Alternate Payee’s separate
interest shall be determined as a benefit payable over the lifetime of the Alternate Payee.
[If the alternate payee is to receive a pro rata portion of the participant's early
retirement subsidy, insert the paragraph below. "Pro rata" means a
proportionate allocation to two or more parts based on each part’s share of
the whole. The paragraph below should NOT be included unless the Plan
provides a subsidized early retirement benefit. See p. 15 below for an
explanation of early retirement subsidy and subsidized early retirement
benefit.]
The Alternate Payee shall be entitled to a pro rata share of any early retirement subsidy
provided to the Participant. The portion of the early retirement subsidy payable to the
Alternate Payee shall become payable on the date the Participant commences benefits, but not
before. If the Alternate Payee commences receiving benefits on an unsubsidized basis before
the Participant retires with an early retirement subsidy, then the amount payable to the
Alternate Payee shall be increased, in accordance with PBGC's practices and actuarial principles,
to provide the Alternate Payee with a pro rata share of the early retirement subsidy payable as
of the Participant's annuity starting date. The pro rata share of the early retirement subsidy
payable to the Alternate Payee shall be calculated in the same manner as the Alternate Payee's
share of the Participant's retirement benefits is calculated pursuant to the terms of this Order.
SECTION 4. PBGC BENEFIT ADJUSTMENTS
If PBGC adjusts the Participant’s benefit from the benefit payable under the Plan, any
reduction shall be applied by decreasing [pro rata the value of the Participant’s and the
Alternate Payee’s benefits/the value of the Participant’s remaining benefit first/the
value of the Alternate Payee’s separate interest first], and any increase shall be applied
by increasing [pro rata the value of the Participant’s and the Alternate Payee’s
benefits/the value of the Participant’s remaining accrued benefit/the value of the
6

Alternate Payee’s separate interest]. “Pro rata” means a proportionate allocation to two
or more parts based on each part’s share of the whole.
SECTION 5. BENEFITS START
The Alternate Payee’s annuity starting date shall be [such future date as the Alternate
Payee elects/a future specified date]. (This date must be the first day of a month and
cannot be before the Participant’s “earliest PBGC retirement date,” which is defined in 29 C.F.R.
§4022.10.) Payment shall not be made until PBGC qualifies this domestic relations order and
receives a PBGC benefit application from the Alternate Payee.
SECTION 6. FORM OF BENEFIT
PBGC shall pay the Alternate Payee’s benefit in the form elected by the Alternate Payee on
the PBGC benefit application.
SECTION 7. BENEFITS STOP
PBGC shall stop payments of the Alternate Payee’s separate interest in accordance with the
form of benefit elected by the Alternate Payee (or in accordance with the automatic form, if
applicable).
SECTION 8. DEATH OF PARTICIPANT
The Participant’s death shall not affect payments of the Alternate Payee’s assigned separate
interest. Additional benefits may be payable if the Alternate Payee is designated as the
Participant’s spouse in Section 10.
SECTION 9. DEATH OF ALTERNATE PAYEE
If the Alternate Payee dies before commencing benefits, the Alternate Payee’s separate
interest shall [revert to the Participant/be paid to the Contingent Alternate Payee
(see Language for Including a Contingent Alternate Payee – Appendix F)]. If the
Alternate Payee dies after commencing benefits, see Section 7, the Alternate Payee’s death will
have no effect on the benefits paid to the Participant.
SECTION 10. SURVIVING SPOUSE RIGHTS OF ALTERNATE PAYEE
[NOTE: Section 10 applies only if the Alternate Payee is the spouse or former spouse of the
Participant; it does not apply if the Alternate Payee is a child or other dependent of the
Participant.]

a. PBGC shall treat the Alternate Payee as the Participant’s spouse for purposes of the
Participant’s qualified joint-and survivor annuity (QJSA) for [none/all/x%] of the
benefit in which the Participant retains a separate interest.
7

b. PBGC shall treat the Alternate Payee as the Participant’s spouse for purposes of the
Participant’s qualified preretirement survivor annuity (QPSA) for [none/all/x%] of the
benefit in which the Participant retains a separate interest.
[NOTE: Once a separate interest is qualified, the Alternate Payee’s rights to benefits for life are
guaranteed. In light of this, survivor benefits need not be provided in a separate interest order to
ensure that the Alternate Payee continues to receive benefits after the Participant’s death. See
page 22 for additional information on surviving spouse rights in separate interest orders.
However, if the parties desire that an additional amount be payable to the Alternate Payee at
the Participant’s death, one or both of the following provisions may be included. The survivor
benefit in this case will be based on the benefit in which the Participant retains a separate
interest, not on the entire Participant benefit before it was divided into two separate parts.]
[NOTE: When “X%” is used above, it refers to the portion of the survivor benefit awarded to
the Alternate Payee – not the automatic survivor percentage of the plan's QJSA or QPSA
(which is typically 50%). Thus, if the Alternate Payee is awarded 40% of the QPSA benefit and
the plan's automatic survivor percentage for the QPSA is 50%, then the Alternate Payee will
receive 20% of the Participant's benefit as his/her survivor benefit.]

SECTION 11. OTHER REQUIREMENTS
Nothing in this Order shall require PBGC:
a. To pay any benefits not permitted under ERISA or the Code;
b. To provide any type or form of benefit or any option not otherwise provided under the
Plan or paid by PBGC;
c. To pay benefits to the Participant and Alternate Payee with a total value that exceeds
the value of the benefits the Participant otherwise would receive under title IV of ERISA;
d. To pay benefits to the Alternate Payee that are required to be paid to another alternate
payee under a QDRO that is in effect prior to this Order;
e. To pay benefits to the Alternate Payee for any period before PBGC receives this Order;
f. To pay benefits as a separate interest to the Alternate Payee if the Participant is already
receiving benefit payments; or
g. To change the benefit form or the beneficiary of a joint-life annuity if the Participant is
already receiving benefit payments.
SECTION 12. RESERVATION OF JURISDICTION
The Court reserves jurisdiction to amend this Order to establish or maintain its status as a
QDRO under ERISA and the Code.
8

PBGC Model Shared Payment QDRO
(You may use this model when a defined benefit pension plan has terminated, PBGC has
become trustee of the plan, and PBGC is to pay the alternate payee a portion of the
participant’s monthly benefit payments. You may use this model either before or after
the participant’s benefit payments have started; however, benefit payments to the
alternate payee cannot start until the participant’s benefit payments have started.
Please read PBGC Model QDRO Instructions (page 13) for important information.)

IN THE ___________ COURT OF ____________
DIVISION ___________ COUNTY ____________
---------------------------------------------------------------X
IN RE MARRIAGE/SUPPORT OF
:
____________
PETITIONER,

:
:

V.
__________________________
PARTICIPANT, RESPONDENT.

:
:

:
:
:

CASE NO.____________

---------------------------------------------------------------X

QUALIFIED DOMESTIC RELATIONS ORDER
This Order is intended to be a qualified domestic relations order (“QDRO”), as that term
is defined in section 206(d) of the Employee Retirement Income Security Act of 1974, as
amended (“ERISA”) and section 414(p) of the Internal Revenue Code of 1986, as amended
(“Code”). This Order is granted in accordance with [applicable state domestic relations law
citations], which relate to marital property rights, child support, and/or spousal support
between spouses or between a spouse and a former spouse in matrimonial actions.
SECTION 1. IDENTIFICATION OF PLAN
This Order applies to benefits under the [formal name of plan] (“Plan”). The Pension
Benefit Guaranty Corporation (“PBGC”) is trustee of the Plan.

SECTION 2. IDENTIFICATION OF PARTICIPANT AND ALTERNATE PAYEE
a. [Name of the Participant] is eligible to receive a benefit from the Plan and is hereafter
referred to as the “Participant.”
b. The Participant’s mailing address is [address]. The Participant’s Social Security Number
is [Social Security Number].
c. [Name of the Alternate Payee] is hereafter referred to as the “Alternate Payee.” The
Alternate Payee’s mailing address is [address]. The Alternate Payee’s Social Security Number is
[Social Security Number]. The Alternate Payee is the [spouse/former spouse/child/other
dependent] of the Participant.
SECTION 3. AMOUNT OF BENEFIT TO BE PAID TO ALTERNATE PAYEE
a. Starting at the time specified in section 5, PBGC shall pay to the Alternate Payee [$x/x%]
of each of the Participant’s monthly benefit payments.
b. OPTIONAL: When [insert future event] occurs and PBGC is notified in writing, PBGC shall
[increase/decrease] the amount paid to the Alternate Payee from each of the Participant’s
monthly benefit payments to [$x/x%].
SECTION 4. PBGC BENEFIT ADJUSTMENTS
If PBGC adjusts the Participant’s benefit from the benefit payable under the Plan, any
reduction shall be applied by decreasing [pro rata the Participant’s and the Alternate
Payee’s benefits/the Participant’s benefit first/the Alternate Payee’s benefit first], and any
increase shall be applied by increasing [pro rata the Participant’s and the Alternate Payee’s
benefits/the Participant’s benefit/the Alternate Payee’s benefit]. “Pro rata” means a
proportionate allocation to two or more parts based on each part’s share of the whole.
SECTION 5. BENEFITS START
The Alternate Payee’s commencement of benefits shall be [such future date as the
alternate payee elects/the date when PBGC will start payments to the Participant/another
future date. This date must be the first day of a month], but not earlier than the later of the
date PBGC receives this domestic relations order and the Participant’s annuity starting date.
Payment shall not be made until PBGC qualifies this domestic relations order and receives a
PBGC benefit application from the Alternate Payee.

SECTION 6. FORM OF BENEFIT
The Alternate Payee shall not have the right to elect a form of benefit. The amount paid to
the Alternate Payee will be determined by the benefit form elected by the Participant.
SECTION 7. BENEFITS STOP
Except for any survivor benefits described in section 10, PBGC shall make payments to the
Alternate Payee until the [earlier of the Participant’s or Alternate Payee’s death/earlier of:
the Participant’s or Alternate Payee’s death, a specific date, or the date PBGC is notified
in writing of the occurrence of [insert specific event]].

SECTION 8. DEATH OF PARTICIPANT
Except for any survivor benefits described in section 10, if the Participant dies before the
Alternate Payee, the Alternate Payee is not entitled to any payments as of the first of the
month following the Participant’s death.
SECTION 9. DEATH OF ALTERNATE PAYEE
If the Alternate Payee dies before the Participant, the shared payment shall [revert to the
Participant/be paid to the Contingent Alternate Payee (see Language for Including a
Contingent Alternate Payee—Appendix F)].
SECTION 10. SURVIVING SPOUSE RIGHTS OF ALTERNATE PAYEE
[NOTE: Section 10 applies only if the Alternate Payee is the spouse or former spouse of the
Participant; it does not apply if the Alternate Payee is a child or other dependent of the
Participant.]
[NOTE: Survivor benefit may be assigned to the Alternate Payee only if the Participant is not
already receiving benefits or if when the Participant began receiving benefits the benefit was
being paid as a joint and survivor benefit with the Alternate Payee as survivor.]

a. PBGC shall treat the Alternate Payee as the Participant’s spouse [[for purposes of
[none/all/X%] of any qualified joint-and-survivor annuity (QJSA) that becomes payable
under the Plan with respect to the Participant] OR [to the extent of Participant’s benefit
assigned to the Alternate Payee under Section 3 above.]]

b. PBGC shall treat the Alternate Payee as the Participant’s spouse [[for purposes of
[none/all/X%] of any qualified preretirement survivor annuity (QPSA) that becomes
payable under the Plan] OR [to the extent of Participant’s benefit assigned to the
Alternate Payee under Section 3 above.]
[NOTE: When “X%” is used above, it refers to the portion of the survivor benefit awarded to
the Alternate Payee – not the automatic survivor percentage of the plan's QJSA or QPSA
(which is typically 50%). Thus, if the Alternate Payee is awarded 40% of the QPSA benefit and
the plan's automatic survivor percentage for the QPSA is 50%, then the Alternate Payee will
receive 20% of the Participant's benefit as his/her survivor benefit.]

SECTION 11. OTHER REQUIREMENTS
Nothing in this Order shall require PBGC:
a. To pay any benefits not permitted under ERISA or the Code;
b. To provide any type or form of benefit or any option not otherwise provided under the
Plan or paid by PBGC;
c. To pay benefits to the Participant and Alternate Payee with a total value that exceeds
the value of the benefits the Participant otherwise would receive under title IV of ERISA;
d. To pay benefits to the Alternate Payee that are required to be paid to another alternate
payee under a QDRO that is in effect prior to this Order;
e. To pay benefits to the Alternate Payee for any period before PBGC receives this Order;
or
f. To change the benefit form or the beneficiary of a joint-life annuity if the Participant is
already receiving benefit payments.
SECTION 12. RESERVATION OF JURISDICTION
The Court reserves jurisdiction to amend this Order to establish or maintain its status as a
QDRO under ERISA and the Code.

PBGC Model QDRO Instructions
The following information on completing the PBGC Model Separate Interest QDRO and
Model Shared Payment QDRO discusses each provision separately, but all of the provisions work
together. The time that benefit payments start and stop can affect the amount of benefits the
participant and the alternate payee will receive. Similarly, the form of benefit payments – whether
benefits are paid as a straight life annuity or an annuity with survivor benefits – can affect the
amount of benefits the parties will receive.
The models are drafted assuming one plan and one alternate payee. If the domestic relations
order (Order) is intended to cover more than one PBGC-trusteed plan or more than one alternate
payee, the Order should be clear as to which plan and alternate payee each provision is addressing.
The preferred way of doing this is to repeat sections 1 through 10 as necessary for each plan.

Introductory Paragraph

the privacy of the parties, the participant’s
and alternate payee’s Social Security
Numbers may be provided to PBGC in a
separate document that has not been
submitted to the court. If you choose to
provide the information to PBGC in this way,
note on the Order that this information is in a
separate document. The Order should be
clear on the identity of the participant and the
alternate payee. PBGC uses Social Security
Numbers provided to identify the
participant’s and alternate payee’s records
within PBGC, to report income for tax
purposes, and to respond to lawful requests
for information from other individuals and
entities. If an alternate payee is a minor or
legally incompetent, the Order must include
the name and address of the guardian, other
legal representative, or state agency to whom
PBGC will send payments on behalf of the
minor or legally incompetent person (see
language in section 2.b. of the PBGC Model
Child Support Shared Payment QDRO—
Appendix D).

Insert the applicable state domestic
relations law citations.

Section 1. Identification of Plan
Insert the formal name of the plan
covered by this Order (i.e., the full name as
stated in plan documents). PBGC will
determine whether an order is qualified only
for plans specifically named and for which
PBGC is the trustee. If the participant
participated in more than one pension plan,
the parties are responsible for ensuring that
each plan subject to the order is properly
identified.

Section 2. Identification of
Participant and Alternate Payee
(a) Insert the name, mailing address and
Social Security Number of the participant.
(b) Insert the name, mailing address and
Social Security Number of the alternate
payee.
Specify
the
relationship
(spouse/former
spouse/child/other
dependent) of the alternate payee to the
participant.

Section 3. Amount of Benefit to Be
Paid to Alternate Payee
Insert the flat dollar amount or
percentage of the participant's benefit that
the alternate payee is to receive. Also insert
the date as of which the benefit is to be
determined, if applicable.

Note, documents filed in state courts may
be made available to the public. To protect
13

The Order must specify how much of the
participant's benefit the alternate payee will
receive. Because the participant often does
not know the specific amount that will be
paid at retirement, this can be difficult for the
Order to address and for PBGC to interpret.
The assistance of an actuary may be helpful
in making these complex determinations.
Information about the participant's benefit
under a plan trusteed by PBGC may be
obtained by a prospective alternate payee (or
his or her guardian) by requesting this
information from PBGC (see How to Obtain
Certain Participant Information from
PBGC—Appendix G).

NOTE: The dollar amount or percentage

can be based on the participant's entire
benefit or payment, or just on the part of the
benefit or payment earned during the
marriage and/or up to a specified date.
The PBGC Model Separate Interest
QDRO provides that the alternate payee will
receive a benefit that is the actuarial
equivalent of a specified portion of the
benefit that the participant has earned as of a
given date (see below), typically as a
percentage of the participant’s benefit (for
example, 50% of the participant’s benefit).
An order may also assign a specific dollar
amount payable to the alternate payee.

PBGC has found there is less confusion
with an Order that states a specific percentage
of the benefit (for Separate Interest QDROs)
or specific percentage or dollar amount of the
monthly benefit (for Shared Payment
QDROs), and the models are drafted with
that approach. If, instead, the parties choose
to include a formula, PBGC will treat the
domestic relations order as qualified only if
it can determine the benefit under the formula
based on the information in the Order. The
Order must include any information that
would be necessary to determine the benefit
assigned and, where applicable, the period
during which it is to be paid (for example, a
child's birth date if the benefit stops when the
child attains a certain age).

However, when a separate interest order
assigns a specified dollar amount to an
alternate payee and benefit adjustments are
subsequently necessary, the effect of the
benefit adjustment on the amounts
apportioned to each party may result in the
parties receiving benefits that were
unintended by the parties. The number of
factors that go into the calculation of the
participant’s and alternate payee’s benefits
under a separate interest order (including the
plan's early retirement factors (if applicable),
the ages of the participant and alternate payee
at the time the alternate payee's benefit
payments begin; and the form elected by the
alternate payee) may make it difficult to
know what each party will receive if a
specified dollar amount is assigned and needs
to be adjusted. (See Section 4 – PBGC
Benefit Adjustments on page 17.)

Neither type of Order can provide for
payments to the alternate payee to be payable
as of a date before PBGC receives the
domestic relations order, but the Shared
Payment QDRO can increase the monthly
payment amount to the alternate payee (and
decrease the monthly payment to the
participant by the same amount) for a
specified period.

NOTE: In a Separate Interest QDRO, the

sum of the values of the participant’s portion
and the alternate payee’s portion cannot
exceed the total value of the benefit PBGC
would have paid the participant assuming
there was no Order.

There are many ways an Order can
specify the portion or value of a benefit or
pension payment that the alternate payee is to
receive under the Order.

The PBGC Model Shared Payment
QDRO provides that the alternate payee will
receive a portion of each of the participant's
benefit payments on or after the date the
14

participant starts benefit payments. It allows
the alternate payee's portion to increase or
decrease at a specified time or upon a
specified event. The Order must specify the
amount and timing of any change.

depend on his age when he starts benefit
payments, actuarial factors, and the benefit
form he elects.
Most pension plans provide for "normal
retirement" at age 65 (or, if later, the fifth
anniversary of the date the participant
commenced participation under the plan).
Many plans allow "early retirement" at some
younger age, often in combination with a
specified amount of service with the
employer-for example, at age 60 with at least
20 years of service. Some plans actuarially
reduce the early retirement benefit to reflect
the longer payout-for example, if the benefit
would be $1,000 per month starting at age 65,
it might be reduced to $650 per month
starting at age 60.

NOTE: In a Shared Payment QDRO, the
sum of the portions paid to the participant
and to the alternate payee cannot exceed the
total payment that PBGC would have paid
the participant assuming there was no Order.

A Separate Interest QDRO must specify
the date as of which the alternate payee's
portion of the participant's benefit is to be
determined. Typically, for domestic relations
orders issued after PBGC trustees a plan, the
division of benefits is based on the
participant's benefit as of the date: of marital
separation, of divorce, or of plan termination
(in plans trusteed by PBGC, all benefit
accruals will have ceased no later than the
date the plan terminated). The choice of the
determination date (for example, at the date
of marital separation or divorce) can have a
significant effect on the benefit amount
assigned to the alternate payee and the benefit
amount retained by the participant.

Other plans may not reduce the benefit at
all-for example, paying the same $1,000 per
month starting at age 60 as the participant
would receive starting at age 65. This kind of
early retirement benefit is referred to as a
"fully-subsidized" early retirement benefit,
because the participant's benefit is not
reduced even though it will cost the plan
more due to the earlier starting date. (The
benefit would be considered "partially
subsidized" if the benefit were reduced, but
not as much as would be necessary to make it
equal in value to the benefit that would be
paid starting at age 65.)

Example 1 – Separate Interest QDRO.
Carol is the plan participant and is age 40;
Mark is age 35. Their QDRO provides that
Mark will receive a separate interest that is
actuarially equivalent to 50% of Carol's
pension benefit at date of divorce. Carol's
benefit in the form of a straight life annuity
with payments beginning at her age 65 is
$600 per month. Mark's 50% interest in
Carol's benefit has a value that is actuarially
equivalent to a life annuity of $300 ($600 x
50%) per month to Carol beginning at her
age 65.

A Separate Interest QDRO may be
written so as to provide (or not provide) the
alternate payee with all or part of the value of
an early retirement subsidy payable under the
plan upon the participant’s commencement
of benefits before the participant’s normal
retirement age. It may specify that PBGC will
provide a “pro rata” share of the early
retirement subsidy (here "pro rata" means a
proportionate allocation to two or more parts
based on each part’s share of the whole) or a
different portion of the early retirement
subsidy to the alternate payee.

Mark is younger than Carol, so a benefit of
$300 per month to Carol at age 65 generally
will provide a different monthly benefit for
Mark depending upon when he starts. Mark's
actual monthly life annuity payments will
15

NOTE: If the Separate Interest QDRO is
silent with respect to whether the alternate
payee is to receive any portion of the
participant’s early retirement subsidy, PBGC
will pay the entire subsidy to the participant.
Moreover, if the participant has not yet
commenced benefits at the time the alternate
payee elects to commence benefits under a
Separate Interest QDRO and if the alternate
payee commences benefits before the
participant’s normal retirement age, then the
alternate payee cannot receive any portion of
the early retirement subsidy unless and until
the participant commences benefits before
the participant’s normal retirement age.
Thus, if the participant retires on or after the
participant’s normal retirement age, no
portion of an early retirement subsidy is
payable at all from the plan, either to the
participant or the alternate payee, regardless
of whether the alternate payee commenced
benefits before the participant’s normal
retirement age or whether all or a portion of
the early retirement subsidy was awarded to
the alternate payee.

A QDRO provides Dick's former spouse,
Jane with 25% of each of his monthly pension
payments once his payments start. Dick
begins receiving his benefits at age 65, and
his monthly payments are $900 per month in
the form of a straight life annuity. Jane's
portion of Dick's payment will be $225 per
month ($900 x 25% = $225). Under the
QDRO, Jane will receive $225 per month for
Dick's lifetime and Dick will receive $675 per
month ($900 - $225).
In calculating the amount or percentage
to be given to the alternate payee under a
QDRO, the parties frequently will take into
account the portion of the participant's
benefit that was earned during the time the
alternate payee and the participant were
married. Under this method, the alternate
payee's portion of the participant's benefit
(for example, 50%) would be multiplied by a
fraction, the numerator of which is the
number of months that the participant earned
benefits under the plan during the parties'
marriage, and the denominator of which is
the total number of months that the
participant earned benefits under the plan.
This method of allocating the benefit is
sometimes referred to as the marital portion
or marital fraction method, and it can be used
for both shared payment and separate interest
QDROs.

Under the PBGC Model Shared Payment
QDRO, if the alternate payee receives a
percentage share of the participant's benefit,
the
alternate
payee's
benefit
will
automatically include a portion of the early
retirement subsidy if the participant retires
early.

NOTE: if this method is used, the parties
should carefully check the formula for
accuracy and confirm that it provides the
benefits they intend, especially if the order
states the number of months. For example, if
PBGC’s records indicate that the participant
earned benefits under the plan for 126
months and the order uses 100 months,
PBGC may disqualify the order or seek
clarification from the parties.

The PBGC Model Shared Payment
QDRO provides that a specific amount or a
percentage of each of the participant's
monthly benefit payments is paid directly to
the alternate payee (for example, $400 per
month, or 25% of each monthly benefit
payment). The combined benefit payments to
the participant and the alternate payee under
a Shared Payment QDRO equal the benefit
that would be paid to the participant
assuming there was no QDRO.

Example 3 – Marital Fraction Method
(Separate Interest QDRO).

Example 2 – Shared Payment QDRO.
Continuing with the facts provided in
Example 1, assume Carol earned benefits
16

under the plan for 10 years and was married
to Mark for 5 of those years. If their QDRO
applied the marital fraction method to Mark's
50% separate interest, Mark's 50% interest
would be multiplied by the marital fraction of
5/10. Thus, Mark's pension would be
actuarially equivalent to the value of a
straight life annuity of $150 ($600 x 50% x
5/10) per month payable to Carol beginning
at her age 65. (If Mark and Carol had been
married 12 years, and Carol had earned
benefits for 10 of those years, the marriage
fraction would have been 10/10, or 1. Mark
would receive a benefit actuarially
equivalent to 50% of Carol's benefit.)

For example, assume a plan benefit of
$2,000 per month. An alternate payee is
awarded 40% ($800 per month) of the
participant’s benefit. The participant’s
remaining benefit is 60% of the original plan
benefit ($1,200 per month). Absent a QDRO,
assume that PBGC must reduce the original
plan benefit by $200 per month as a result of
the maximum insurance limitation, the
phase-in limitation, and other legal
limitations. PBGC generally reduces plan
benefits on an actuarially equivalent basis.
Thus, if the QDRO specified that the
reduction would be applied pro rata, then
PBGC would pay the participant 60% of the
reduced benefit (actuarially adjusted for the
participant’s benefit) and would pay the
alternate payee 40% of the reduced benefit
(actuarially adjusted for the alternate payee’s
benefit). Therefore, the alternate payee’s
original awarded benefit would be reduced
by $80 (40% of $200) per month to reflect
PBGC’s legal limitations. Similarly, the
benefit remaining to the participant would be
reduced by $120 (60% of $200) per month.
Note that with separate interest orders the
alternate payee’s and participant’s benefits
will actuarially reflect the benefit
commencement date, duration of the benefit
payments, the elected benefit form, etc.

Section 4. PBGC Benefit Adjustments
Insert the method for apportioning any
adjustments PBGC makes in benefits.
Because the parties may wish to handle
benefit increases and decreases differently,
the models include separate sentences for
each.
After trusteeing a plan, PBGC may
reduce benefits as necessary to meet the
limitations established by ERISA (see
Defined Benefit Pension Plans and PBGC
Benefit Rules—Appendix A). PBGC pays
estimated benefits until it has completed its
work on the plan and determined final
benefits. In some cases-especially in plans
with benefits that exceed PBGC guarantee
limits or that have complex benefit
structures-final benefit amounts will differ
from the estimated payment amounts paid by
PBGC.

If a QDRO awards a fixed-dollar amount
of the participant's benefit to the alternate
payee with no additional guidance, PBGC
will first increase or decrease the participant's
benefit to reflect PBGC's adjustment. PBGC
will not adjust the fixed-dollar amount
awarded to the alternate payee for an increase
and will reduce the alternate payee's fixeddollar amount only if the total decrease to be
made exceeds the participant's benefit.
Because any adjustments where fixed-dollar
amounts have been awarded will first be
applied to the participant’s benefit,
adjustments may affect the participant’s
benefit in ways that were not intended by the
parties.

In general, if a QDRO awards a fixed
percentage of the participant's benefit
payment to the alternate payee and provides
no guidance on apportioning any benefit
adjustments made by PBGC between the
participant and alternate payee, PBGC will
actuarially adjust their benefits pro rata. "Pro
rata" means a proportionate allocation to two
or more parts based on each part’s share of
the whole.
17

Section 5. Benefits Start

terms, the participant cannot receive a benefit
until a later age, or (2) PBGC determines
under a facts-and-circumstances test that the
participant could retire earlier than 55. PBGC
tells each participant what his or her EPRD is
in a benefit determination.

Indicate the date as of which the alternate
payee's benefit payments should begin. The
models allow for benefits to begin as of a
specific future date, or a future date elected
by the alternate payee. The alternate payee's
benefit start date will depend in part on the
participant's "earliest PBGC retirement
date" (benefits cannot begin before the
participant’s earliest PBGC retirement date)
and whether the participant has begun
receiving benefits at the time the order is
submitted to PBGC for qualification. The
PBGC Model Separate Interest QDRO may
not be used if the participant already is
receiving benefit payments. The PBGC
Model Shared Payment QDRO does not
allow the alternate payee's payments to begin
until the participant starts receiving benefits.

Example 4.
Continuing with Example 1, the Separate
Interest QDRO allows Mark to start his
benefit payments without regard to when
Carol's benefit payments actually start. For
example, Mark may want to begin receiving
benefit payments as early as age 50, which is
when Carol would be 55 years old. (Assume
Carol's "earliest PBGC retirement date" is
55. If Carol's EPRD were instead 60, Mark
couldn't start receiving benefits until he was
55.) If Mark and Carol had used a Shared
Payment QDRO and Carol did not begin
receiving benefits until age 65 (normal
retirement age under the plan), Mark would
not be able to begin receiving benefit
payments until Carol did.

The PBGC Model Separate Interest
QDRO permits the alternate payee to specify
a future date that his or her benefit payments
will start or to choose a starting date at some
later time. The Order can be written to allow
the alternate payee to begin receiving
payments independently of when the
participant begins receiving benefits, but
payments to the alternate payee may not
begin before the participant's "earliest PBGC
retirement date." Payments to the alternate
payee must begin no later than the date the
participant is required to begin payments
under section 401(a)(9) of the Code
(typically, April 1 of the year after the year
the participant turns age 70 ½) (see QDRO
Tax Rules—Appendix C). The alternate
payee's benefit will be actuarially adjusted to
reflect the alternate payee's age at
commencement and also for form of benefit
(see page 17).

The PBGC Model Shared Payment
QDRO provides the alternate payee with a
portion of the participant's benefit payments
during the period that the participant receives
benefits. If the participant is already
receiving benefit payments, the alternate
payee under the QDRO may begin receiving
benefits once PBGC qualifies the order and
the alternate payee submits a benefit
application. (In general, benefits would be
payable retroactive to the date the original
signed order or a certified or authenticated
copy was received by PBGC unless a later
date was provided for in the QDRO.) If the
participant has not begun receiving benefit
payments, the alternate payee may not begin
receiving payments until the participant does.

The "earliest PBGC retirement date" has
a specific meaning for PBGC purposes and is
defined in PBGC regulation 29 C.F.R.
§4022.10. Typically, a participant's age as of
his or her "earliest PBGC retirement date"
(EPRD) will be 55 unless (1) under the plan's

Example 5.
Continuing with Example 2, PBGC will not
begin paying benefits to Jane of $225 per
month under the Shared Payment QDRO
18

until the time that Dick begins receiving his
benefit payments of $675 a month.

Continuing with Example 1, the Separate
Interest QDRO will allow Mark to apply to
PBGC to receive benefits as a straight-life
annuity or a C&C annuity. As explained
above, the amount of Mark's monthly benefit
is actuarially adjusted to reflect his life
expectancy at the date payments begin. In
addition, the amount of his monthly benefit is
affected by the benefit form he selects. No
matter what benefit form he selects, his
benefit must have the same value as a $300per-month benefit payable to Carol over her
lifetime beginning at her age 65. If Mark
chooses a straight-life annuity, no further
payments will be made after Mark dies. If he
chooses to receive a C&C annuity, an
annuity that guarantees benefits for the
longer of his life or the period certain, his
monthly benefit will be less. If Mark chooses
a 10-year C&C annuity and dies after 7
years, his designated beneficiary will receive
3 years of payments in the same amount Mark
had been receiving.

Section 6. Form of Benefit
Generally, if an Order is issued after
PBGC becomes trustee of a plan, the forms
that PBGC will allow the alternate payee to
choose pursuant to the PBGC Model
Separate Interest QDRO are a straight-life
annuity for the life of the alternate payee or a
certain-and-continuous (C&C) annuity with a
5-year, 10-year, or 15-year period certain.
A straight-life annuity pays benefits only
for the lifetime of the alternate payee; no
payments are made after the alternate payee
dies. A C&C annuity guarantees payments
for the longer of the alternate payee's life or
the period certain that is selected. If the
alternate payee dies before the end of the
period certain, payments are made to his or
her beneficiary for the rest of the period
certain. If the alternate payee dies after the
end of the period certain, no further payments
are made.

In the PBGC Model Shared Payment
QDRO, if the participant is receiving benefit
payments, the Order cannot change the form
of benefit payments elected by the
participant. However, if the participant is not
yet receiving payments, the Shared Payment
QDRO (like the Separate Interest QDRO)
can provide surviving spouse benefits and
thus affect the form of benefit payment that
the participant can elect. For example,
section 10 of either model QDRO can
provide that the participant's former spouse,
as the alternate payee, will be treated as the
participant's surviving spouse based on all or
a portion of the participant's benefit. If the
Order so provides for the portion of the
benefit for which the alternate payee is
treated as the spouse, the participant cannot
choose a form of benefit other than a
qualified joint-and-survivor annuity with the
alternate payee as the beneficiary without the
alternate payee's consent at the time the
pension is to begin. If under the Shared
Payment QDRO the participant is receiving a

NOTE: Because benefits under a C&C
annuity are guaranteed to be paid for at least
the period certain, monthly payments under a
C&C annuity will be less than they would be
if the alternate payee had selected a straight
life annuity.
The alternate payee selects his or her
form of benefit when applying to PBGC for
benefits. If the alternate payee selects a C&C
annuity, the alternate payee must designate a
beneficiary who will receive the remaining
payments if the alternate payee dies while
receiving payments, but prior to the end of
the period certain. Parties or their
representatives should contact PBGC
before providing for any other benefit
form in an Order to make certain it is a
form that PBGC pays.
Example 6.
19

govern whether the beneficiary will be paid
and for how long.

C&C annuity and the participant dies during
the certain period, payments to the alternate
payee end unless the alternate payee is the
named beneficiary to receive benefits under
the certain period.

Section 8. Death of Participant
Indicate what happens to payments when
the participant dies.

Example 7.

The PBGC Model Separate Interest
QDRO provides that PBGC will pay the
separate interest to the alternate payee
regardless of when the participant dies. (The
alternate payee will receive additional
monthly payment amounts to the extent the
alternate payee is to be treated as the
surviving spouse under section 10.)

Continuing with the Shared Payment QDRO
in Example 2, PBGC will begin paying Jane's
portion of Dick's benefit no earlier than the
time that Dick begins receiving his benefit
payments. If the QDRO gives Jane surviving
spouse rights, Dick must elect a qualified
joint-and-survivor annuity with Jane as
beneficiary, unless Jane consents to Dick's
waiver of the qualified joint-and-survivor
annuity. If the QDRO does not give Jane
surviving spouse rights, Dick can elect any
form of payment provided to participants by
PBGC.

The PBGC Model Shared Payment
QDRO provides that payment of a benefit, if
any, to an alternate payee stops no later than
the death of the participant (except to the
extent that the alternate payee is to be treated
as the surviving spouse under section 10 or
the alternate payee is a named beneficiary
under a C&C annuity).

Section 7. Benefits Stop
The time when benefits stop for the
alternate payee generally is governed by the
form elected in the PBGC benefit application.

Example 8.
Continuing with the Shared Payment QDRO
in Example 2, suppose that Dick retires and
begins receiving his pension benefits as a 10year certain-and-continuous (C&C) annuity
rather than a straight-life annuity. Dick and
Jane's child is the designated beneficiary of
Dick's C&C annuity. Jane receives a 25%
share of Dick's benefit payments. Two years
after commencing benefit payments, Dick
dies. Dick's benefit payments to Jane stop
upon Dick's death. However, payments to
their child, the designated beneficiary, would
then commence equal to 100% of Dick's
benefit payment and continue for 8 more
years until the end of the 10-year period
certain.

Once benefit payments to the participant
or the alternate payee have started, the form
of benefit will govern when benefits stop.
Under the PBGC Model Shared Payment
QDRO, payments to an alternate payee will
stop on the earliest of the (1) death of the
participant, (2) the death of the alternate
payee, or (3) the occurrence of a specified
date or event, such as the remarriage of the
alternate payee or the date a child attains a
certain age. Parties must notify PBGC in
writing when an event occurs that affects
the benefit.
Under the PBGC Model Separate Interest
QDRO, payments to an alternate payee
generally stop upon the death of the alternate
payee. But if the alternate payee elected a
benefit form under which a designated
beneficiary could be paid (for example, a
C&C annuity), the form of benefit will

Section 9. Death of Alternate Payee
Indicate what happens when the alternate
payee dies.
20

In the PBGC Model Separate Interest
QDRO, the QDRO may provide that if the
alternate payee dies before commencing
benefits, the alternate payee’s benefit may be
paid to a contingent alternate payee.

certain. PBGC will not qualify or enforce a
separate interest Order that provides for the
alternate payee’s benefit to revert to the
participant if the alternate payee dies after
commencing benefits.

A contingent alternate payee must satisfy
the definition of an alternate payee under
ERISA. Therefore, the Order must identify
that the contingent alternate payee is the
participant’s spouse, former spouse, child or
other dependent. (See Language for
Including a Contingent Alternate Payee—
Appendix F). If the alternate payee’s separate
interest is paid to a contingent alternate
payee, the separate interest benefit will be
actuarially adjusted to reflect the contingent
alternate payee’s age. Alternatively, the
QDRO may provide that if the alternate
payee dies before commencing benefits, the
alternate payee’s separate interest reverts to
the participant. If the QDRO is silent on what
happens if the alternate payee dies before
commencing benefits, PBGC will treat the
separate interest as reverting to the
participant. If the alternate payee’s separate
interest would revert to the participant but the
participant is not alive at the time of the
alternate payee's death, the benefit will revert
to PBGC because the order cannot provide
for any further assignment.

The PBGC Model Shared Payment
QDRO addresses what happens to the
alternate payee's benefit if the alternate payee
dies before the participant dies (whether or
not benefit payments have started to the
alternate payee). If the alternate payee dies
before the participant, unless the QDRO
states otherwise, the participant's monthly
benefit payments will be returned to the
amount that the participant would have
received assuming there was no QDRO. The
alternate payee cannot pass payments on to
another beneficiary upon death unless the
beneficiary is designated in the Order as a
Contingent Alternate Payee. However, as
with the Separate Interest QDRO, the Shared
Payment QDRO could be drafted to cover
multiple or contingent alternate payees, such
as payments to the participant's former
spouse and then, upon the former spouse's
death, to the participant's dependent children
as contingent alternate payees. See Language
for Including a Contingent Alternate
Payee—Appendix F.
Example 9.

A benefit "commences" for purposes of
this Section on the alternate payee's annuity
starting date. The annuity starting date is a
date selected by the alternate payee when
applying for benefits, or another date on
which benefits must commence under the
QDRO, under the Plan, or by law.

Continuing with the Shared Payment QDRO
in Example 2, Dick retires and begins
receiving his pension benefits as a joint-andsurvivor annuity. Jane receives a 25% share
of Dick's benefit payments. Two years after
commencing benefit payments, Jane dies.
Because their QDRO did not name a
contingent alternate payee, Jane's portion of
Dick's benefit payments reverts to Dick at
Jane's death.

If the alternate payee dies after benefits
commence, the benefit form elected in the
alternate payee’s benefit application (or the
automatic form, if applicable) will govern.
For example, under a straight life annuity,
payments end; under a period certain and
continuous annuity, payments continue to
the alternate payee's designated beneficiary
for the remainder, if any, of the period

Section 10. Surviving Spouse Rights
of Alternate Payee

PBGC generally will qualify an Order
assigning the alternate payee a survivor
benefit based on the participant’s benefit as
of specific date or to the extent of
participant’s benefit assigned to the alternate
payee under Section 3. Under the shared
payment model QDRO, the participant's
former spouse, as the alternate payee, can be
treated as the surviving spouse (even if the
participant has remarried) based on the
participant’s benefit or to the extent of
participant’s benefit assigned to the alternate
payee under Section 3.

This section applies only if the alternate
payee is the spouse or former spouse of the
participant.
Indicate whether the alternate payee will
be treated as the spouse of the participant for
purposes of part or all of the qualified
preretirement survivor annuity and/or the
qualified joint-and-survivor annuity, and, if
so, indicate the part (all or some portion) of
the participant’s benefit on which the
survivor annuity is to be based.
(Survivor rights may be assigned in a
shared payment QDRO only if the
participant’s benefit payments have not
started when the order is submitted to PBGC
for qualification or if when the participant
began receiving benefits the benefit was
being paid as a joint and survivor benefit
with the alternate payee as survivor. A
separate interest QDRO may be used only if
the participant’s benefit payments have not
started when the order is submitted to PBGC
for qualification.)

NOTE: Where an order assigns to the
alternate payee any part of the survivor
portion of the QJSA, the participant cannot
elect a form of benefit other than the plan’s
QJSA with the alternate payee as beneficiary
unless the alternate payee consents to a
different benefit form at the time the pension
is to begin.

The portion stated in Section 10 of the
model is not the plan’s automatic survivor
percentage of a joint-and-survivor annuity
benefit (e.g., a joint-and-50% survivor
annuity benefit). It is the portion of the
participant’s benefit on which the survivor
benefit will be based.

If the alternate payee is to receive a
surviving spouse benefit only under a
qualified preretirement survivor annuity
and/or qualified joint-and-survivor annuity
(that is, the alternate payee will not receive a
separate interest or shared payment benefit),
see the PBGC Model Treat-As-Spouse
QDRO—Appendix E.

For the PBGC Model Shared Payment
QDRO, the survivor benefit may be based on
all or a portion of the participant’s accrued
benefit. If 35% is entered in section 10 of the
shared payment QDRO, the alternate payee
will get a survivor benefit based on 35% of
the participant’s benefit.
The survivor
benefit will then be 50% (unless the plan’s
QJSA provides for a greater percent) of the
participant’s benefit, times 35%.

In general, if a participant dies before
starting benefit payments, PBGC pays the
participant's surviving spouse a qualified
preretirement survivor annuity (QPSA). The
surviving spouse can elect to take the QPSA
in the form of a straight life annuity or a
certain-and-continuous annuity. If a
participant dies after starting benefit
payments in the form of a qualified joint-andsurvivor annuity (QJSA), PBGC pays the
participant's surviving spouse the survivor
portion of the QJSA.

Typically, separate interest orders do not
need to award post-retirement survivor rights
to an alternate payee. This is because the
alternate payee’s benefit is actuarially based
on the alternate payee’s lifetime so the
alternate payee will receive lifetime benefits
22

Survivor benefits are in addition to a
separate interest or shared payment the
alternate payee also has a right to receive.
Generally, PBGC will pay survivor benefits
in accordance with the terms of the QDRO
even if the participant has designated a
different beneficiary or has remarried, as long
as the order was submitted before the
participant’s annuity starting date. An order
assigning pre-retirement survivor benefits
that is submitted before the participant’s
retirement date, but after his or her death, will
only
be
qualified
under
limited
circumstances. You may wish to contact
PBGC for more information before
attempting to obtain an order.

regardless of whether survivor benefits are
awarded. Nor does it matter if the participant
dies before the alternate payee begins to
receive benefits because of the way PBGC
administers separate interest orders.
When PBGC administers a separate
interest order, it uses a totally severed
approach. The participant's benefit is divided
into two separate parts – one for the
participant and one for the alternate payee.
Once the order is qualified, the participant’s
death before or after the alternate payee’s
benefits commence will not affect the
alternate payee's rights to a lifetime benefits.
Thus, assignment of either pre- or postsurvivor annuities are not needed to ensure
that the alternate payee will receive lifetime
benefits.

NOTE: If a participant is married as of
his or her annuity starting date, and the
participant did not waive the QJSA (with
spousal consent), that spouse retains the right
to the survivor annuity even if the participant
and spouse later divorce. The spouse retains
this right to the survivor annuity even if no
domestic relations order is submitted to
PBGC. Moreover, PBGC will not qualify an
order which would require a surviving spouse
benefit to be relinquished after the joint-andsurvivor annuity is in pay status. PBGC will
generally not enforce such an order, even if
qualified by the prior plan administrator,
unless the survivor benefits had been
relinquished before PBGC trusteed the plan.

However, some alternate payees and
participants may choose to include survivor
annuity provisions in their orders. Since such
assignments are permissible, PBGC will
qualify a separate interest order that includes
an assignment of survivor rights to an
alternate payee. For the PBGC Model
Separate Interest QDRO, where the
participant retains a separate interest in only
part of his or her benefit, the survivor benefit
will be based on only that portion of the
benefit retained as a separate interest by the
participant. Thus, if 35% is entered in section
10 of a separate interest QDRO, and the
separate interest retained by the participant is
40%, the alternate payee will get a survivor
benefit based on 35% of the participant’s
separate interest, or 35% of the 40% separate
interest retained by the participant.
Assuming the survivor benefit under the plan
is 50% of the participant’s accrued benefit,
the survivor benefit payable to the alternate
payee will be 35% (the amount specified in
section 10) times 40% (the participant’s
retained separate interest benefit) times 50%
(the plan’s survivor percentage for the QJSA)
of the participant’s monthly plan benefit.

Example 10.
Continuing with the Separate Interest QDRO
in Example 1, Carol dies at age 41. Mark's
separate interest in Carol's pension benefit is
unaffected by her death, but PBGC will not
pay benefits to him before Carol would have
reached her "earliest PBGC retirement
date." Also, if the QDRO is silent as to
survivor benefits, because Carol and Mark
were not married at the time of Carol's death,
Mark is not treated as Carol's spouse and will
not receive a QPSA.
23

Section 11. Other Requirements

Example 11.

The provisions in this section should be
in all Orders submitted to PBGC, and the
parties' attorneys or representatives should
ensure that the provisions are met.

Continuing with the Shared Payment QDRO
in Example 2, assume the QDRO provides
that Jane will be treated as Dick's surviving
spouse for purposes of survivor benefits
payable under the plan as of the date of
marital separation based on 35% of his
benefit. Dick can elect any form of annuity
for the remaining 65% of his benefit. Assume
also that Dick’s monthly benefit payable as of
the date of separation was $900 per month.
When Dick retires, he elects a qualified jointand-50%-survivor annuity for his benefit as
of the date of separation, which reduces the
monthly benefit payable as of the date of
separation from $900 to $820. Based on the
terms of their Shared Payment QDRO, Jane
is to receive 25% of the monthly benefit
payable during Dick's life, or $205. Three
years after starting benefit payments, Dick
dies. Under the terms of their QDRO, Jane's
25% portion of Dick's benefit payments stops
at Dick's death. However, Jane will receive a
survivor annuity (that is, a monthly benefit
for her lifetime) based on 35% of Dick’s
benefit payable under the plan as of the date
of separation, or $287 (35% of $820). Jane’s
joint-and-50% survivor annuity benefit
based on the $287 will be $143.50 (50% of
$287).

Section 12. Reservation of
Jurisdiction
Include the necessary language for the
court issuing the domestic relations order to
retain jurisdiction over the Order.

In rare cases, a pension plan provides
for survivor benefits in addition to those
required by ERISA. For example, certain
plans, typically steel plans, provide "Free
Surviving Spouse Benefits" – survivor
benefits that impose no cost on a participant’s
benefit, i.e., the participant’s benefit is not
reduced to provide a survivor annuity. In
order for part or all of such benefits to be paid
to an alternate payee (rather than to the
person who otherwise would be entitled to
receive such death benefits under the plan, for
example, a second spouse), the QDRO must
specifically provide for payment of such
benefits to the alternate payee.
24

III. Procedures and Checklist
Planning for a QDRO

extension of time to appeal, must be filed
within 45 days after the date of PBGC's
determination. While PBGC is reviewing the
order to determine whether the order is
qualified, PBGC will suspend payment to the
participant of any amounts that the domestic
relations order would give to the alternate
payee.

Plan ahead and allow enough time at each
stage of the process. Failure to do so may
preclude certain benefit options for the
alternate payee. For example, if PBGC does
not receive an original signed domestic
relations order (or a copy certified or
otherwise authenticated under state domestic
relations procedures) until after the
participant is in pay status, the alternate payee
will not be able to have a separate interest
order or an order providing for a survivor
benefit for the alternate payee approved as a
QDRO by PBGC.

If PBGC determines that the order is
qualified, PBGC will begin making payments
(including any suspended payments) to the
alternate payee under the QDRO after the 45day period for filing an appeal has elapsed
and the alternate payee has submitted a
benefit application. If an appeal is filed, or a
suit is filed in court, PBGC will continue to
suspend payment of the benefits in
controversy until the appeal or suit is
resolved.

Submission to PBGC
To submit an original signed order or a
certified or authenticated copy to PBGC,
send it to the PBGC QDRO Coordinator,
P.O. Box 151750, Alexandria, VA 223151750. Because PBGC needs an original
signed order or a certified or authenticated
copy, the order cannot be submitted
electronically to PBGC.

If PBGC determines that the order is not
qualified, PBGC will lift the suspension and
make any back payments to the participant as
soon as the 45-day period for filing an appeal
has elapsed. However, the suspension of
payments will continue if, within 45 days of
PBGC's determination: (1) an appeal is filed
or (2) either party notifies PBGC in writing
that they are making the necessary changes in
the domestic relations order and they submit
a revised original signed order or a certified
or authenticated copy within 60 days of
notifying PBGC. If an appeal is filed and
PBGC determines on appeal that the order is
not qualified, PBGC will grant both parties
60 days to submit a revised original signed
order or a certified or authenticated copy. If
the participant or alternate payee provides a
copy of a court scheduling order, or a written
statement by the participant or alternate
payee (or the participant's or alternate payee's
attorney or representative), to the effect that
the court will not review the proposed

PBGC Review of Orders and the
Suspension of Benefits During Its
Review
PBGC will review an original signed
order or a certified or authenticated copy to
determine whether the order is qualified, and
will inform the interested parties in writing of
its determination. Interested parties include
all parties named in the order, their attorneys
(if identified), and any representative
designated in writing by the parties.
If PBGC determines the order is not a
QDRO, PBGC will explain the reason(s)
along with its procedures for appealing the
determination. An appeal, or a request for an
25

domestic relations order until after the 60-day
period has ended, PBGC will grant an
extension of the 60-day period based on the
facts and circumstances.

establish an alternate payee’s annuity starting
date based on the date on which PBGC
receives a draft order.
If an original signed order or a certified or
authenticated copy is received by PBGC
within the 60-day period, PBGC will review
the order and suspend benefits in accordance
with the procedures described in "PBGC
Review of Orders and the Suspension of
Benefits During Its Review," which appears
earlier in this section. If an original signed
order or a certified or authenticated copy is
not received by PBGC within the 60-day
period, PBGC will put the participant in pay
status if he or she applied for benefits before
the draft order was received or while it was
being reviewed unless by the end of the 60day period PBGC receives a copy of a court
scheduling order, or a written statement by
the participant or alternate payee (or the
participant's or alternate payee's attorney or
representative), to the effect that the court
will not review the proposed domestic
relations order until after the 60-day period
has ended. In that case, PBGC will grant an
extension of the 60-day period based on the
facts and circumstances.

PBGC will not suspend a participant’s
payments for more than 18 months from the
date the first payment to the alternate payee
would have been due under the order. PBGC
will pay suspended benefits to the participant
with interest.

Draft Domestic Relations Orders
At the request of a participant or an alternate
payee (or an attorney or a representative of
either), PBGC will informally review a
domestic relations order in draft form to
determine if it would satisfy qualification
requirements if submitted as an original
signed order or a certified or authenticated
copy. For instructions on how to submit a
draft order for a preliminary, informal
review electronically, contact PBGC's
Customer Contact Center at 1-800-4007242. To submit a draft order for a
preliminary, informal review by mail, send it
to the PBGC QDRO Coordinator, P.O. Box
151750, Alexandria, VA 22315-1750.

If PBGC puts the participant in pay
status, the alternate payee will not be able to
have a separate interest order or an order
providing for a survivor benefit for the
alternate payee approved as a QDRO by
PBGC.

PBGC will acknowledge receipt of a draft
domestic relations order in writing. For a
participant who is not yet in pay status but is
eligible to receive benefits and has applied
for benefits, PBGC will delay the
commencement of any benefits for a period
of up to 60 days from the date that PBGC
notifies the parties of the results of its
informal review. For a participant who is in
pay status, PBGC will not suspend any
portion of the participant’s benefit based on
receipt of a draft domestic relations order.

Multiple Orders
After PBGC has qualified an order, a
second order sometimes will be submitted
attempting to modify the first order. When
this occurs, PBGC will suspend benefit
payments that would be affected by the new
order. If PBGC qualifies the second order,
changes in benefit payments will be made
prospectively only from the date of
submission of the second order; the terms of
the second order that differ from the first
order will not be applied retroactively to the

An alternate payee’s annuity starting date
cannot be before the date on which PBGC
receives an original signed order or a certified
or authenticated copy. PBGC will not
26

date the first order was submitted. If PBGC
does not qualify the second order, see "PBGC
Review of Orders and the Suspension of
Benefits During Its Review," above, for
appeal rights and/or resubmitting a revised
order to PBGC.

PBGC suggests using the following
checklist when drafting a domestic relations
order that will be sent to PBGC:
Does the order clearly specify the
PBGC-trusteed pension plan to which it
applies?

Other Pleadings Related to Domestic
Relations Actions

Does the order clearly identify the
defined benefit pension plan (for
example, formal plan name)? If the
participant has earned benefits in
more than one plan, are all the plans
clearly identified?

Upon receipt of any pleading intended to
add PBGC as a party to a domestic relations
action (including a request for joinder),
PBGC will acknowledge receipt of the
documents and will temporarily delay
commencement of benefits for 60 days, in the
same manner that PBGC does when
reviewing a draft domestic relations order
(see above). PBGC will not appear in any of
these actions and will pay benefits only
according to the terms of any domestic
relations order it determines is a QDRO.

Is the plan trusteed by PBGC?
Does the order include the names of
the persons to whom it applies?
Does the order clearly identify the
participant by providing full name,
last known mailing address, and
Social Security Number?

NOTE: if the participant is receiving benefits

at the time that PBGC receives a request
described in this section, PBGC will not
suspend any portion of the participant’s
benefits until a domestic relations order is
received by PBGC.

Does the order clearly identify each
alternate payee (and, if applicable,
each contingent alternate payee) by
providing full name, last known
mailing address, and Social Security
Number?

Change of Address or Entitlement Status

Does the order clearly identify each
alternate payee (and, if applicable,
contingent alternate payee) as a
spouse, former spouse, child, or other
dependent of the participant?

PBGC should be notified promptly of any
change in address. The parties also should
notify PBGC immediately if an event occurs
that affects benefits PBGC is paying or will
pay. For example, if payments to the alternate
payee would end on a future event, such as
remarriage or a child's reaching a certain age,
or an event that would affect benefits under
the QDRO, the parties should immediately
notify PBGC in writing when the event
occurs.

Does the order provide the name and
address of the guardian, legal
representative, or state agency to
whom PBGC will send payments on
behalf of an alternate payee (and, if
applicable, a contingent alternate
payee) who is a minor or legally
incompetent?

Checklist

Does the order specify the amount to
be paid to each alternate payee and the
27

length of time such payments will be
made?

Does the order specify what happens
when the alternate payee dies?

Does the order clearly specify the
amount or percentage (or state how to
determine the amount or percentage)
of the participant's monthly benefit
payment to be paid to each alternate
payee?

Does the order clearly specify what
happens to the alternate payee's
separate interest, if any, when the
alternate
payee
dies
before
commencing benefits?

Does the order clearly specify (or
allow a future election that would
specify) when payments will start for
each alternate payee?

Does the order clearly specify what
happens to the participant's benefit
when the alternate payee predeceases
the participant in the case of a shared
payment QDRO?

Does the order clearly require
payment to the alternate payee from
PBGC (rather than, for example, to
the participant for payment to the
alternate payee)?

Was the order issued under a State's
domestic relations law?
Is the order a judgment, decree, or
order (including the approval of a
property settlement
agreement)
issued pursuant to a State's domestic
relations law (including a community
property law)?

Does the order specify what happens
when the participant dies?
Does the order specify that shared
payments to the alternate payee stop
no later than the participant's death
(or never start if the participant dies
before entering pay status)?

Was the order an order issued by a
state unit, typically a court or agency,
with authority to issue such
judgments, decrees, or orders under a
State's domestic relations law?

Does the order specify that payments
continue to be made to the alternate
payee regardless of the participant's
death in the case of a separate
interest QDRO?

Does the order relate to the provision
of child support, alimony payments,
or marital property rights to a spouse,
former spouse, child, or other
dependent of a participant?

Does the order specify whether the
participant's former spouse, as the
alternate payee, is to be treated as the
participant's spouse (regardless of
whether the participant remarries) for
all or part of the participant's
remaining separate interest (in the
case of a separate interest QDRO) or
all or part of the participant's monthly
benefit (in the case of a shared
payment QDRO) for purposes of the
qualified preretirement survivor
annuity and/or the qualified jointand-survivor annuity?

Does the order state assignments?
Assignments must be specifically
stated in the order to be enforceable by
PBGC. For example, assignments of –
Early retirement subsidy
Assignment of any survivor benefits
(including the QJSA and/or QPSA)
Free Surviving Spouse Benefits (see
explanation in PBGC Model QDRO
Instructions, Section 10, above)
28

Does the order comply with other
requirements?
Is it clear that the order does not
require PBGC to pay benefits that
have a value in excess of the value of
benefits to which the participant
would otherwise be entitled from
PBGC?
Is it clear that the order does not
require PBGC to pay any type or form
of benefit, or provide any option, that
either PBGC or the plan would not
otherwise pay or provide to
participants and alternate payees?
Is it clear that the order does not
require PBGC to pay benefits to an
alternate payee that are required to be
paid to another alternate payee under
a previous QDRO?
Is it clear that the order does not
require PBGC to pay benefits to an
alternate payee in an amount or form
that is not permitted under ERISA or
the Code?
Is it clear that the order does not
require PBGC to pay benefits to the
alternate payee for any period before
PBGC receives the order?
Is it clear that the order does not
require PBGC to pay benefits as a
separate interest to the alternate
payee if the participant already is
receiving benefit payments?
Is it clear that the order does not
require PBGC to change the benefit
form if the participant already is
receiving benefit payments?

Appendix A—Defined Benefit Pension Plans and PBGC
Benefit Rules
Defined Benefit Pension Plans

unless the participant had waived the QJSA
with spousal consent. If the QJSA is not
waived with spousal consent, the person who
was the participant's spouse at retirement
ordinarily will receive the survivor portion of
the QJSA when the participant dies even if
the parties are divorced at the participant's
death. If a married participant dies before
starting to receive retirement benefits, the
participant's spouse will receive a qualified
preretirement survivor annuity (QPSA),
unless the participant had waived the QPSA
with spousal consent.

There are two basic types of pension
plans: defined benefit plans and defined
contribution plans. PBGC insures benefits of
workers,
retirees
and
beneficiaries
participating in most private-sector defined
benefit plans. PBGC does not insure benefits
in defined contribution plans, such as 401(k)
plans.
A defined benefit plan promises each
participant a specified benefit at retirement.
The benefit usually is based on a formula
such as the number of years a participant has
worked for a company and/or the
participant's average salary for the last few
years of work or over the participant's career.

Many defined benefit plans offer
participants a choice of times at which they
may retire - early, normal, or late retirement.
The date a participant chooses to retire and
start payments usually will affect the monthly
amount of pension benefits the participant
receives. In most plans, the longer a
participant waits to start receiving benefits,
the larger the monthly benefit payments will
be.

Defined benefit plans may pay retirement
benefits in a variety of ways. The most
common form of benefit payment is an
annuity. Normally, annuity payments are
paid over the participant's life, over the lives
of the participant and a beneficiary, or over
the longer of the participant's life or a
specified period.

PBGC Benefit Rules
PBGC guarantees most, but not all,
pension benefits in plans that it insures.
PBGC does not guarantee non-pension
benefits, such as most death benefits (but
PBGC does pay the plan's QPSA benefit even
if QPSA coverage previously was waived
before plan termination). PBGC does not
guarantee benefits over a certain amount. For
example, for single-employer pension plans
terminating in 2019, the maximum amount
that PBGC guarantees is $5,607.92 per
month ($67,295 per year) for a participant
who starts receiving benefits at age 65 with a
straight life annuity. The maximum amount
is reduced if benefits will be paid in a form

A participant will automatically receive
his or her benefit in the form of an annuity
unless the participant chooses (with spousal
consent, if married) a different form of
payment. An unmarried participant usually
will receive an annuity for his or her life. A
married participant usually will receive a
qualified joint-and-survivor annuity (QJSA),
unless the participant has waived it with
spousal consent.
If a married participant dies after starting
to receive retirement benefits, the
participant's spouse at retirement ordinarily
will receive the survivor portion of the QJSA,
30

other than a straight life annuity. This
maximum amount also is reduced for a retiree
who is younger than age 65 when the plan
terminates and for participants and
beneficiaries who begin receiving benefit
payments after the plan terminates but before
reaching age 65. (However, the maximum
guaranteed amount generally is not reduced
on account of the age of a participant where
the participant retired early (or could have
retired early) under the plan due to a
disability that is determined by the Social
Security Administration to meet its definition
of disability.) In addition to the maximum
insurance limitation, PBGC's guarantee may
also be limited for supplemental benefits and
benefit increases resulting from plan
amendments within five years before the plan
terminates. PBGC may pay more than the
guaranteed amounts if the plan has enough
assets or as a result of PBGC's recoveries
from employers.

reduced plan benefit (determined on an
actuarial basis) to the alternate payee.
However, if the QDRO (shared payment or
separate interest) awards a fixed dollar
amount (e.g., $500) of the participant’s
benefit to the alternate payee, then the
participant’s benefit payable by PBGC would
be reduced by the fixed dollar amount (or
actuarial equivalent thereof). In this case,
PBGC would reduce the alternate payee’s
benefit only if the fixed dollar amount
awarded to the alternate payee exceeds the
total benefit payable by PBGC to the
participant.
For participants who have started
receiving benefit payments or have properly
chosen annuity benefit forms before their
plans are trusteed, PBGC generally will pay
benefits in the forms chosen. For participants
who have not started to receive benefits or
have not chosen benefit forms at the time
their plans are trusteed, PBGC will pay
benefits in the form that participants elect.
The election choices are the plan's automatic
forms – generally a straight life annuity for
an unmarried participant and a QJSA for a
married participant-and the optional forms
provided under PBGC regulations (see 29
C.F.R. §4022.8(c)). The optional forms
provided currently by PBGC for an
unmarried participant or a married participant
who has obtained spousal consent are a: (1)
straight life annuity, (2) five-year certainand-continuous annuity, (3) ten-year certainand-continuous annuity, (4) fifteen-year
certain-and-continuous annuity, (5) jointand-50%, -75%, or -100% survivor annuity,
and (6) joint-and-50%-survivor "pop-up"
annuity.

If a QDRO awarded a fixed percentage of
the participant's plan benefit to the alternate
payee, the benefits payable to both the
participant and the alternate payee would be
reduced typically by the same percentage to
reflect PBGC's guarantee limitations (as well
as any additional benefits funded by plan
assets and/or PBGC recoveries). For
example, if a QDRO awarded an alternate
payee 50% of a participant's $1,000 monthly
plan benefit and if the plan benefit is reduced
by 10% as a result of PBGC's legal
limitations (as well as plan funding and
PBGC recoveries), then the participant and
alternate payee will each receive 10% less of
their share of the $1,000 monthly plan
benefit. After the 10% reduction to the
benefit (from $1,000 to $900), the $900
benefit is allocated 50% to the participant and
the alternate payee, or $450 per month.

The annuity benefit form available to an
alternate payee who is not yet in pay status
depends on the type of QDRO. With a
separate interest QDRO, an alternate payee
may choose from among optional annuity
benefit forms (1) through (4), above, offered
by PBGC, regardless of what benefit form the
participant chooses. With a shared payment

If a QDRO awarding a fixed percentage
of the participant's benefit to an alternate
payee is a separate interest order, PBGC will
reduce the plan benefit by the applicable title
IV limits and pay a fixed percentage of the
31

QDRO, the alternate payee will receive a
portion of each payment that is being paid to
the participant in an amount designated by
the QDRO; the alternate payee does not
choose the annuity benefit form.
Under both types of QDROs, if benefit
payments to the participant have not started,
the QDRO may provide that the alternate
payee will be treated as the participant's
spouse for all or part of the QPSA and/or the
QJSA with respect to either the participant's
benefit (in the case of a shared payment
QDRO) or the portion of the benefit in which
the participant retains a separate interest (in
the case of a separate interest QDRO). In
such case, the alternate payee would have the
right to consent to a waiver by the participant
of the QJSA.
PBGC will provide specific information
about the choices of annuity benefit forms at
the time a participant or alternate payee
applies for benefits. With regard to a separate
interest, PBGC will pay a lump sum if the
value of the benefit (determined separately
for the participant and alternate payee) is
$5,000 or less at plan termination.

Appendix B—Domestic Relations Orders Qualified
Before PBGC Becomes Trustee
While this booklet deals with domestic
relations orders issued after PBGC becomes
trustee of a plan, PBGC receives and
administers domestic relations orders in two
other situations: (1) where PBGC becomes
trustee of a plan that is already paying
benefits pursuant to a QDRO and (2) where
PBGC becomes trustee of a plan where the
plan administrator already has approved a
QDRO but payments under the QDRO have
not started yet.

applied differently, an amended order
indicating how any reduction should be
addressed would need to be submitted to
PBGC for review.
PBGC guarantee limitations apply to
domestic relations orders qualified before or
after PBGC becomes trustee. In addition,
PBGC benefit form limitations, options and
benefit start date provisions apply to the
alternate payee's benefit payments or
elections under pre-trusteeship domestic
relations orders if the alternate payee's
benefit form election is made after PBGC
trusteeship.

When PBGC becomes trustee of a plan
under which the plan administrator already
has approved orders as QDROs, PBGC
generally reviews the QDROs to see if there
is anything in the QDROs that would call
their qualification into question under
PBGC's rules. If any issues arise, PBGC
communicates with the parties to the QDRO.
If the Order was qualified in error by the prior
plan administrator, the parties may be
required to obtain a corrected order before
payments to the alternate payee can continue
or begin.
Because PBGC guarantees may not cover
a participant's full pension benefit, a
participant's benefit may be reduced after
PBGC takes over a plan. This can reduce
benefits payable to one or both parties under
the QDRO. PBGC will not treat the order as
not qualified solely because benefits paid by
PBGC require reduction of the participant's
and/or the alternate payee's benefit. PBGC
will apply the reduction rules to domestic
relations orders qualified before PBGC
becomes trustee (assuming the QDRO is
silent) in the same manner as it applies the
reduction rules to orders that are qualified
after PBGC becomes trustee. (See Appendix
A above.) If the participant or alternate payee
desires that the guarantee limitation be
33

Appendix C—QDRO Tax Rules
The following information is not intended to be tax advice. Any questions on tax matters
should be directed to a tax advisor or the IRS.
Pension benefits are taxable when they
are paid to the participant or, in some cases,
to the alternate payee. Internal Revenue
Service Publication 575, Pension and
Annuity Income, explains these rules. A local
IRS office will be able to provide this
publication, or it may be obtained from the
IRS's website at www.irs.gov or by calling 1800-TAX FORM.

Section 401(a)(9) of the Code specifies
the date by which distributions must start.
Question and Answer 6 of the Treasury
regulation §1.401(a)(9)-8 addresses how the
required minimum distribution rules of
section 401(a)(9) of the Code apply to an
alternate payee under a QDRO. Payments to
the alternate payee must begin no later than
the date the participant is required to begin
payments under section 401(a)(9) of the
Code. The regulation limits the period over
which benefits may be paid with respect to
the alternate payee's separate interest, thereby
limiting what survivor benefits may be paid,
including the length of the period certain in a
certain-and-continuous annuity.

Benefit payments are taxable to the plan
participant, except for payments made under
a QDRO directly to an alternate payee who is
a spouse or former spouse (the spouse or
former spouse is taxed under these
circumstances). This means, for example,
that the participant is taxed on payments
made under a QDRO to his or her children as
alternate payees during the lifetime of the
participant.
In some cases participants have made
their own contributions to their plan. When
pension benefits are paid, a portion of each
benefit payment is a return of some of these
contributions. Because these contributions
were already taxed before they were
contributed to the plan, they will not be taxed
again when they are paid out from the plan.
The tax law provides detailed rules for
determining what portion of each payment is
a tax-free return of the participant's
contributions.
There is generally an additional 10
percent tax on non-annuity payments that are
made before age 59 1/2. However, this 10
percent tax does not apply to payments made
to an alternate payee under a QDRO. There
are special rules regarding rollovers of
amounts paid to alternate payees.
34

Appendix D—PBGC Model Child Support Shared
Payment QDRO
(You may use this model when a defined benefit pension plan has terminated, PBGC
has become trustee of the plan, and PBGC is to pay a portion of the participant’s
monthly benefit payments as child support. If the participant’s benefit payments
have not started, you may submit a shared payment or a separate interest
child support order to PBGC (e.g., a temporary life annuity for the child). After a
participant’s benefits have started, only a shared payment order may be submitted.
Only a shared payment order model is shown because, in PBGC’s experience, it is
more commonly used.
NOTE: Child support payments under a shared payment order cannot start
until the participant’s benefit payments have started. Please read PBGC Model
Child Support QDRO Instructions (page 39) for important information.

IN THE ___________ COURT OF ____________
DIVISION ___________ COUNTY ____________
---------------------------------------------------------------X
IN RE MARRIAGE/SUPPORT OF
:
____________
PETITIONER,

:
:

V.
__________________________
PARTICIPANT, RESPONDENT.

:
:

:
:
:

CASE NO.____________

---------------------------------------------------------------X

SECTION 1. IDENTIFICATION OF PLAN
This Order applies to benefits under the [formal name of plan] (“Plan”). The Pension
Benefit Guaranty Corporation (“PBGC”) is trustee of the Plan.
SECTION 2. IDENTIFICATION OF PARTICIPANT AND ALTERNATE PAYEE(S)
a. [Name of the Participant] is eligible to receive a benefit from the Plan and is hereafter
referred to as the “Participant.” The Participant’s mailing address is [address]. The
Participant’s Social Security Number is [Social Security Number].
b. [Name of the Alternate Payee] is hereafter referred to as the “Alternate Payee.” The
Alternate Payee’s mailing address is [address]. The Alternate Payee’s Social Security Number
is [Social Security Number]. The Alternate Payee is the child or other dependent of the
Participant.
[If the alternate payee has a guardian, add:]
The Alternate Payee’s legal guardian is [name of guardian], whose mailing address is
[address].
[If the payments are required to be sent to a state agency, add:]
Payments under this Order are to be mailed to [name of agency and its full mailing
address]. Questions concerning these payments should be addressed to [specify contact at
the state agency] at [telephone number].
SECTION 3. AMOUNT OF BENEFIT TO BE PAID TO ALTERNATE PAYEE
a. Starting at the time specified in section 5, PBGC shall pay to the Alternate Payee [$x/x%]
of each of the Participant’s monthly benefit payments.
b. OPTIONAL: When [insert future event] occurs and PBGC is notified in writing, PBGC
shall [increase/decrease] the amount paid to the Alternate Payee from each of the
Participant’s monthly benefit payments to [$x/x%].

SECTION 4. PBGC BENEFIT ADJUSTMENTS
If PBGC adjusts the Participant’s benefit, any reduction shall be applied by decreasing [pro
rata the Participant’s and the Alternate Payee’s benefits/the Participant’s benefit
first/the Alternate Payee’s benefit first], and any increase shall be applied by increasing
[pro rata the Participant’s and the Alternate Payee’s benefits/the Participant’s
benefit/the Alternate Payee’s benefit]. “Pro rata” means a proportionate allocation to two
or more parts based on each part’s share of the whole.”
SECTION 5. BENEFITS START
The Alternate Payee’s commencement of benefits shall be [such future date as the
alternate payee elects/the date when PBGC will start payments to the
Participant/another future date. This date must be the first day of a month], but not
earlier than the later of the date PBGC receives this domestic relations order and the
Participant’s annuity starting date. Payment shall not be made until PBGC qualifies this
domestic relations order and receives a PBGC benefit application from the Alternate Payee.
SECTION 6. FORM OF BENEFIT
The Alternate Payee shall not have the right to elect a form of benefit. The amount paid to
the Alternate Payee will be determined by the benefit form elected by the Participant.
SECTION 7. BENEFITS STOP
PBGC shall make payments to the Alternate Payee until the [earlier of the Participant’s
or Alternate Payee’s death/earlier of: the Participant’s or Alternate Payee’s death,
[a specific date], or the date PBGC is notified of the occurrence of [insert specific
event]].
SECTION 8. DEATH OF PARTICIPANT
If the Participant dies before the Alternate Payee, the Alternate Payee is not entitled to any
payments as of the first of the month following the Participant’s death.
SECTION 9. DEATH OF ALTERNATE PAYEE
If the Alternate Payee dies before the Participant, PBGC shall return the Participant’s
monthly benefit payments to the amount that the Participant would be receiving had there
been no Order.

SECTION 10. OTHER REQUIREMENTS
Nothing in this Order shall require PBGC:
a. To pay any benefits not permitted under ERISA or the Code;
b. To provide any type or form of benefit or any option not paid by PBGC with respect to the
Plan;
c. To pay benefits to the Participant and Alternate Payee with a total value that exceeds the
value of the benefits the Participant otherwise would receive under title IV of ERISA;
d. To pay benefits to the Alternate Payee that are required to be paid to another alternate
payee under a QDRO that is in effect prior to this Order;
e. To pay benefits to the Alternate Payee for any period before PBGC receives this Order; or
f. To change the benefit form if the Participant is already receiving benefit payments.
SECTION 11. RESERVATION OF JURISDICTION
The Court reserves jurisdiction to amend this Order to establish or maintain its status as a
QDRO under ERISA and the Code.

PBGC Model Child Support QDRO Instructions

This model is a simplified shared
payment QDRO that is designed to provide
child support only. As this PBGC model is a
shared payment QDRO, payments to the
alternate payee cannot start until the
participant’s benefit payments have started.
The participant’s benefit payments cannot
start earlier than the participant’s “earliest
PBGC retirement date” (defined in PBGC
regulation 29 C.F.R. §4022.10).
Section 10 of the PBGC Model Shared
Payment QDRO, which addresses treating
the alternate payee as the participant’s spouse
for surviving spouse benefits, has been
omitted because only spouses and former
spouses qualify for those benefits. See the
instructions beginning on page 17 for
information on all other aspects of this
model. If more than one child or other
dependent is to be covered by this order, list
each child or dependent (and guardian, if
applicable) in section 2.b., and specify the
amount of the benefit to be paid to each child
or dependent in section 3.

Appendix E—PBGC Model Treat-As-Spouse QDRO
(You may use this model when a defined benefit pension plan has terminated, PBGC
has become trustee of the plan, and PBGC is to treat a spouse or former spouse as
the participant’s spouse for purposes of a Qualified Preretirement Survivor Annuity or
a Qualified Joint-and-Survivor Annuity, or both. To also provide an alternate payee
with part of the participant's benefit, use the PBGC Model Separate Interest QDRO or
the PBGC Model Shared Payment QDRO instead of this model.
You may use this model only if it is submitted to PBGC for qualification before the
participant’s benefit payments have started or if when the participant began receiving
benefits the benefit was being paid as a joint and survivor benefit with the alternate
payee as survivor. Please read the PBGC Model Treat-as-Spouse QDRO Instructions
(page 45) for important information.)

IN THE ___________ COURT OF ____________
DIVISION ___________ COUNTY ____________
---------------------------------------------------------------X
IN RE MARRIAGE/SUPPORT OF
:
____________
PETITIONER,

:
:

V.
__________________________
PARTICIPANT, RESPONDENT.

:
:

:
:
:

CASE NO.____________

---------------------------------------------------------------X

SECTION 1. IDENTIFICATION OF PLAN
This Order applies to benefits under the [formal name of plan](“Plan”). The Pension
Benefit Guaranty Corporation (“PBGC”) is trustee of the Plan.
SECTION 2. IDENTIFICATION OF PARTICIPANT AND ALTERNATE PAYEE(S)
a. [Name of the Participant] is eligible to receive a benefit from the Plan and is hereafter
referred to as the “Participant.” The Participant’s mailing address is [address]. The
Participant’s Social Security Number is [Social Security Number].
b. [Name of the Alternate Payee] is hereafter referred to as the “Alternate Payee.” The
Alternate Payee’s mailing address is [address]. The Alternate Payee’s Social Security Number
is [Social Security Number]. The Alternate Payee is the [spouse/former spouse] of the
Participant.
SECTION 3. SURVIVING SPOUSE RIGHTS OF ALTERNATE PAYEE
[Include either a., b., or both, as appropriate:]
a. PBGC shall treat the Alternate Payee as the Participant’s spouse for [none/all/X%] of any
qualified joint-and-survivor annuity (QJSA) that becomes payable under the Plan with respect to
the Participant.
b. PBGC shall treat the Alternate Payee as the Participant’s spouse for [none/all/X%] of
any qualified preretirement survivor annuity (QPSA) that becomes payable to the Participant
under the Plan.
[NOTE: When “X%” is used above, it refers to the portion of the survivor benefit awarded to
the Alternate Payee – not the automatic survivor percentage of the plan's QJSA or QPSA
(which is typically 50%). Thus, if the Alternate Payee is awarded 40% of the QPSA benefit and
the plan's automatic survivor percentage for the QPSA is 50%, then the Alternate Payee will
receive 20% of the Participant's benefit as his/her survivor benefit.]

SECTION 4. AMOUNT OF BENEFIT TO BE PAID TO ALTERNATE PAYEE
The amount of benefit paid to the Alternate Payee shall be based on the surviving spouse
benefits provided to the Alternate Payee under sections 3 and 7.

SECTION 5. PBGC BENEFIT ADJUSTMENTS
If PBGC adjusts the Participant’s benefit from the benefit payable under the Plan, the
Alternate Payee’s survivor annuity shall be based on the Participant’s adjusted benefit.
SECTION 6. BENEFITS START
PBGC shall start payments to the Alternate Payee after the death of the Participant. In the
case of a qualified joint-and-survivor annuity, the Alternate Payee’s benefit shall start on the
first of the month following the month in which the Participant dies. In the case of a qualified
preretirement survivor annuity, the Alternate Payee’s benefit shall start not earlier than the
first of the month following: the Participant’s death or, if later, the Participant’s “earliest PBGC
retirement date,” which is defined in 29 C.F.R. §4022.10. The Alternate Payee may defer
commencement of the qualified preretirement survivor annuity to a date not later than the
date specified by Section 401(a)(9) of the Internal Revenue Code. Payment shall not be made
until the Alternate Payee submits a PBGC benefit application to PBGC.
SECTION 7. FORM OF BENEFIT
a. If the Alternate Payee is treated as the Participant’s spouse for purposes of the
Participant’s qualified joint-and-survivor annuity under Section 3.a., above, the participant must
elect the plan’s automatic joint-and-survivor annuity (unless the alternate payee consents to
the election of a different form of benefit). If the Participant dies while receiving payments,
PBGC shall pay to the Alternate Payee a survivor benefit as a straight-life annuity for the
Alternate Payee’s life unless the Alternate Payee consented in writing to the Participant’s
waiver of the qualified joint-and-survivor annuity at the participant’s retirement.
b. If the Alternate Payee is treated as the Participant’s spouse for purposes of the
Participant’s qualified preretirement survivor annuity under Section 3.b., above, and the
Participant dies prior to receiving benefit payments, the Alternate Payee may elect a straightlife annuity or a certain-and-continuous annuity form offered by PBGC.

SECTION 8. BENEFITS STOP
PBGC shall make payments to the Alternate Payee until the death of the Alternate Payee. If
the Alternate Payee elects a certain-and-continuous annuity in the PBGC benefit application for
a qualified preretirement survivor annuity, and the Alternate Payee dies before the end of the
period certain, any remaining payments shall be made to the Alternate Payee’s designated
beneficiary.
SECTION 9. DEATH OF PARTICIPANT
[Include either a., b., or both, as appropriate:]
a. If the Participant dies before the Alternate Payee and before the Participant’s benefit
payments have started, the Alternate Payee shall be eligible for a qualified preretirement
survivor annuity whose annuity starting date shall be determined in accordance with section 6.
b. If the Participant dies before the Alternate Payee, but after the Participant’s benefit
payments have started, the Alternate Payee is eligible to begin receiving survivor benefit
payments in accordance with the form of the Participant’s benefit and section 3.
SECTION 10. DEATH OF ALTERNATE PAYEE
Under this Order, no benefit will be paid with respect to an Alternate Payee who dies before
the Participant. If the Participant’s benefit is being paid at the Alternate Payee’s
death, the Participant’s benefit will continue to be paid in the form in which it is being paid.
SECTION 11. OTHER REQUIREMENTS
Nothing in this Order shall require PBGC:
a. To pay any benefits not permitted under ERISA or the Code;
b. To provide any type or form of benefit or any option not paid by PBGC with respect to the
Plan;
c. To pay benefits to the Participant and Alternate Payee with a total value that exceeds the
value of the benefits the Participant otherwise would receive under title IV of ERISA;
d. To pay benefits to the Alternate Payee that are required to be paid to another alternate
payee under a QDRO that is in effect prior to this Order;
e. To pay benefits to the Alternate Payee for any period before PBGC receives this Order; or
f. To change the benefit form if the Participant is already receiving benefit payments.

SECTION 12. RESERVATION OF JURISDICTION
The Court reserves jurisdiction to amend this Order to establish or maintain its status as a
QDRO under ERISA and the Code.

PBGC Model Treat-as-Spouse QDRO Instructions
The instructions for the PBGC Model Shared Payment and Separate Interest QDROs are
generally applicable to the PBGC Model Treat-as-Spouse QDRO. See pages 13-24 for those
instructions. Below are instructions for items unique to this model.
Do not use this model if the alternate payee will receive part of the participant's benefit
as a shared payment or separate interest. This model should be used if the sole purpose of the
Order is to treat the alternate payee as the participant's spouse for a qualified preretirement survivor
annuity (QPSA), a qualified joint-and-survivor annuity (QJSA), or both. To also provide an
alternate payee with part of the participant's benefit, use the PBGC Model Separate Interest QDRO
or the PBGC Model Shared Payment QDRO instead of this model.

Section 1.

Section 2.

Identification of
Plan–see instructions
for section 1 of Model
QDRO Instructions.

Section 5. PBGC Benefit Adjustments
Under this model order, the alternate
payee will receive a survivor annuity upon
the death of the participant. The survivor
annuity is based on the amount of the
participant's benefit, and this section states
that the alternate payee's benefit will be
adjusted if PBGC adjusts the participant's
benefit.

Identification of
Participant and
Alternate Payee(s) –
see instructions for
section 2 of Model
QDRO Instructions.

Section 3.

Surviving Spouse
Rights of Alternate
Payee–see
instructions for
section 10 of Model
QDRO Instructions.

Section 4.

Amount of Benefit to
Be Paid to Alternate
Payee.

Section 6. Benefits Start
The date on which the alternate payee's
benefit payments will begin depends on
whether the benefit is a QJSA or a QPSA. A
QJSA may start only on the first of the month
following the month of the participant's
death. In the case of a QPSA, the benefit may
start only after the participant's death.
However, the QPSA may not be paid before
the date the participant would have first been
entitled to begin receiving a benefit. The
alternate payee may defer receipt of the
benefit. In either case, an application must be
submitted by the alternate payee before
PBGC will start making benefit payments.

Section 7. Form of Benefit
Because the alternate payee will receive a
survivor annuity upon the death of the
participant, this section refers to sections 3
and 7, which describe the survivor annuity.

Under the QJSA, the form of benefit is a
survivor annuity paid as a straight life annuity
for the alternate payee's life. However, an
alternate payee who is entitled to a survivor
45

annuity under a QPSA may elect from PBGC
a straight life annuity (which ends on the
alternate payee's death) or a certain-andcontinuous annuity (which continues until the
later of the alternate payee's death or the end
of the period certain) when applying for the
benefit. An alternate payee who is entitled to
a QJSA may consent, in writing on a
notarized form, to an election by the
participant of a PBGC optional form
(straight-life, certain-and-continuous, or
joint-life) when the participant retires.

Section 8. Benefits Stop
The time when benefits stop for the
alternate payee generally is governed by the
form elected in the PBGC benefit application.

Section 9. Death of Participant
In a treat-as-spouse QDRO, the death of
the participant makes the alternate payee
eligible for a survivor annuity (either the
QPSA or the QJSA, depending on when the
participant dies).

Section 10. Death of Alternate Payee
In a treat-as-spouse QDRO, the death of
the alternate payee before the participant
effectively ends the alternate payee's
entitlement to any portion of the participant's
survivor benefit.

Section 11. Other Requirements–
see instructions for
section 11 of Model
QDRO Instructions.
Section 12. Reservation of
Jurisdiction–see
instructions for
section 12 of Model
QDRO Instructions.
46

Appendix F—Language for Including a Contingent
Alternate Payee
[If a contingent alternate payee is to be named in the PBGC Model Separate
Interest QDRO, use this language for section 9.]
(NOTE: If the contingent alternate payee does receive benefit payments, the
monthly benefit amount will be calculated based on the age of the contingent
alternate payee as of the time payments begin to the contingent alternate payee.)

SECTION 9. DEATH OF ALTERNATE PAYEE
a. Death Before Commencing Benefits
(i) If the Alternate Payee dies before commencing benefits, the Contingent Alternate Payee
named in subsection c, below, shall be paid an amount actuarially equivalent to the value of the
Alternate Payee’s benefit determined under section 3. In such case, all references in this Order
to the Alternate Payee shall apply to the Contingent Alternate Payee, except as otherwise
indicated (for example, survivor benefits may only be paid to the spouse or former spouse).
Payments cannot start before the participant’s “earliest PBGC retirement date,” which is
defined in 29 C.F.R. §4022.10. PBGC shall pay the Contingent Alternate Payee’s benefit in the
form elected by the Contingent Alternate Payee on the PBGC benefit application.
(ii) If the Alternate Payee and the Contingent Alternate Payee die before commencing
benefits, the separate interest shall revert to the Participant if the participant is alive.
b. Death After Commencing Benefits
If the Alternate Payee or, if applicable, the Contingent Alternate Payee named in subsection
c, below, dies after commencing benefits, any remaining fixed payments under a certain-andcontinuous annuity shall be paid to the beneficiary designated on the PBGC benefit application.
If the Alternate Payee (or, if applicable, the Contingent Alternate Payee) was receiving a straight
life annuity at death, no further benefits will be payable.

c. Contingent Alternate Payee
The Contingent Alternate Payee is [Name of the Contingent Alternate Payee], and is
the [spouse/former spouse/child/other dependent] of the Participant. The Contingent
Alternate Payee’s mailing address is [address]. The Contingent Alternate Payee’s
Social Security Number is [Social Security Number].
[If a contingent alternate payee is to be named in the PBGC Model Shared
Payment QDRO, use this language.]

SECTION 9. DEATH OF ALTERNATE PAYEE
a. If the Alternate Payee dies before the Participant, the Contingent Alternate Payee named
in subsection d, below, shall be paid [$x/x%] of each of the Participant’s monthly benefit
payments. PBGC shall start payments to the Contingent Alternate Payee when PBGC starts
payments to the Participant, or, if payments to the Participant have already started, after the
Alternate Payee dies. Payments shall not be made until the Contingent Alternate Payee submits
a PBGC benefit application to PBGC.
b. Notwithstanding any other provision in this Order, PBGC shall make payments to the
Contingent Alternate Payee until the [earlier of the Participant’s or Contingent Alternate
Payee’s death/earlier of: the Participant’s or Contingent Alternate Payee’s death, a specific
date, or the date PBGC is notified in writing of the occurrence of [insert specific event].
c. If the Alternate Payee and the Contingent Alternate Payee die before the Participant,
PBGC shall return the Participant’s monthly benefit payments to the amount that the
Participant would be receiving had there been no Order.
d. The Contingent Alternate Payee is [name of the Contingent Alternate Payee], and
is the [spouse/former spouse/child/other dependent] of the Participant. The Contingent
Alternate Payee’s mailing address is [address]. The Contingent Alternate Payee’s
Social Security Number is [Social Security Number].

Appendix G—How to Obtain Certain Participant
Information from PBGC
Participants' records in PBGC's possession are protected under the Privacy Act of 1974 (5
U.S.C. § 552a (2012) and PBGC's implementing regulations. In accordance with these rules, to
obtain certain information about the participant's pension entitlement in order to draft or amend a
domestic relations order, the prospective alternate payee or the alternate payee’s representative
must send in a written request to PBGC's Disclosure Officer. The request must:


State that the information the alternate payee is requesting "will be used solely to obtain a
qualified domestic relations order under state domestic relations laws";



Be signed by the alternate payee;



Provide the participant's name (and the participant's social security number if known);



Describe the alternate payee's relationship to the participant; and



Ask for the following information only:
•

The name of a participant's pension plan;

•

The actual or estimated amount of the participant's benefit under title IV of ERISA;

•

The form(s) in which the participant's benefit is payable; and

•

Whether the participant currently is receiving benefit payments under the plan or,
if not, the earliest date(s) such payments could commence to the participant.

The request should be submitted directly to PBGC's Disclosure Officer at:
Disclosure Officer
Pension Benefit Guaranty Corporation
1200 K Street, NW
Washington, DC 20005-4026
If you have additional questions about this request, you can contact PBGC's Disclosure Office at
202-326-4040.

Glossary
The following terms may be useful in understanding this booklet. These definitions are simplified
and apply to the information discussed in this booklet.
Actuarially Equivalent. Different benefits
or benefit forms having the same value as of
a given date using a specified set of
assumptions.

includes contributions made by the employer
and, if applicable, the employee. Retirement
benefits are based on the amount in each
participant's account, adjusted for investment
experience and plan expenses. The most
common types of defined contribution plans
include profit-sharing plans, 401(k) plans,
employee stock ownership plans (ESOPs),
and money purchase plans.

Alternate Payee. A participant's spouse,
former spouse, child, or other dependent
who, under a QDRO, has a right to receive
all, or a portion, of the participant's pension
benefits under a plan.

Domestic Relations Order. Any judgment,
decree, or order (including approval of a
property settlement agreement) that (1)
provides child support, alimony payments, or
marital property rights to a spouse, former
spouse, child, or other dependent of a
participant, and (2) is made pursuant to a
state's domestic relations law.

Annuity. A form of benefit in which
payments are made at regular intervals for a
specified period of time. The most common
form of annuity pays monthly benefits for
life.
Beneficiary. The person named to receive
benefits upon the death of a participant or
alternate payee.

Earliest PBGC Retirement Date (EPRD).
The "earliest PBGC retirement date" has a
specific meaning for PBGC purposes and is
defined in PBGC regulation 29 C.F.R.
§4022.10. Typically, a participant's age as of
his or her EPRD will be 55 unless (1) under
the plan's terms, the participant cannot
receive a benefit until a later age, or (2)
PBGC determines under a facts-andcircumstances test that the participant could
retire earlier than 55. PBGC tells each
participant what his or her EPRD is in a
benefit determination.

Benefit. A payment provided for under a
pension plan.
Certain-and-Continuous (C&C) Annuity.
An annuity that pays benefits over the longer
of the recipient's life or a specified period.
Contingent Alternate Payee. An alternate
payee under a QDRO whose benefit is
contingent upon the death of an alternate
payee.
Defined Benefit Plan. A type of pension
plan that promises participants specified
benefits at retirement. Retirement benefits
usually are based on the number of years
worked for a company or in an industry and
may also be based on salary during that time.

Early Retirement Benefit. An annuity
benefit payable under the terms of the plan,
under which the participant is entitled to
begin receiving payments before the plan’s
normal retirement age and which is not
payable on account of the disability of the
participant. Not all plans offer an early
retirement benefit.

Defined Contribution Plan. A type of
pension plan in which an employee receives
the amount in an individual account, which
50

Early Retirement Subsidy. A portion of the
early retirement benefit that is payable under
the terms of the plan in addition to, or that is
more valuable than, the actuarial equivalent
of the benefit payable at the plan’s normal
retirement age. Not all plans include an early
retirement subsidy with an early retirement
benefit.

participant's lifetime. This model is designed
to provide child support only; it is a simpler
version of the PBGC Model Shared Payment
QDRO.
PBGC Model Separate Interest QDRO.
The PBGC Model Separate Interest QDRO
divides the value of the participant's benefits
into two separate parts-one for the participant
and one for the alternate payee. This model
also allows for the assignment of survivor
benefits.

Guaranteed Benefits. The amount of a
pension plan's benefit that is guaranteed by
PBGC as of the plan's termination date.
However, if the plan terminates while the
plan sponsor is in bankruptcy and the
bankruptcy was initiated on or after
September 16, 2006, the guarantee amount is
fixed as of the bankruptcy filing date.

PBGC Model Shared Payment QDRO.
The PBGC Model Shared Payment QDRO
gives the alternate payee a portion of the
participant's benefit payments under the plan
during the participant's lifetime. In other
words, the participant and the alternate payee
share the payments. This model also allows
for the assignment of survivor benefits.

Joint-and-Survivor Annuity. An annuity
that pays benefits over the participant's
lifetime and thereafter over the lifetime of the
person named as the survivor.

PBGC Model Treat-as-Spouse QDRO.
The PBGC Model Treat-as-Spouse QDRO
treats the alternate payee as the participant's
spouse for purposes of a qualified
preretirement survivor annuity (QPSA), a
qualified joint-and-survivor annuity (QJSA),
or both. This model does not provide any part
of the participant's benefit to the alternate
payee as a shared payment or separate
interest.

Life Expectancy. The number of years a
person is expected to live, on average, after a
given age.
Lump Sum. A form of benefit payment in
which the entire benefit is paid at one time.
Normal Retirement Age. The age for
normal retirement defined under a plan. In
most cases, the normal retirement age will
not be greater than 65 years of age or, if later,
the fifth anniversary of the date the
participant commenced participation under
the plan.

Plan Administrator. The person or persons
who administer the plan. If no one is
designated as the administrator in the plan
document, the employer is considered to be
the plan administrator.

Participant.
An employee or former
employee who may be entitled to a benefit
under a pension plan, or whose beneficiaries
may be entitled to a benefit. A participant is
said to participate in or to be covered by the
plan.

Qualified Domestic Relations Order
(QDRO). A QDRO is a domestic relations
order that gives an alternate payee the right to
receive all or a portion of the benefits payable
to a participant under the plan, and that
PBGC determines meets certain legal
requirements with respect to information that
must be provided, and provisions that cannot
be included, in such an order.

PBGC Model Child Support Shared
Payment QDRO. The PBGC Model Child
Support Shared Payment QDRO gives the
alternate payee a portion of the participant's
benefit payments under the plan during the
51

Qualified Joint-and-Survivor Annuity
(QJSA). A QJSA is a joint-and-survivor
annuity where (1) the participant receives a
definite amount of money at regular intervals
for life, and (2) after the participant dies, the
surviving spouse (who may be the spouse to
whom the participant was married at
retirement, or a former spouse who is treated
by a QDRO as the participant's spouse)
receives a definite amount of money (not less
than 50% or more than 100% of the amount
received by the participant before death) at
regular intervals for life.

Straight Life Annuity. An annuity that pays
benefits over the recipient's lifetime. Once
the recipient dies, no further annuity
payments are payable to anyone.
Subsidized Early Retirement Benefit. An
early retirement benefit that also includes an
early retirement subsidy.
Survivor Benefit. The survivor part of a
preretirement survivor annuity or a joint-andsurvivor annuity that is paid to a beneficiary
after the participant dies.
Value. The actuarially determined amount
needed at a point in time to provide a specific
monthly benefit at some time in the future.
Value depends on the amount of the monthly
benefit payment, when the benefit payments
start and stop, the age(s) of the recipient(s),
mortality
assumptions,
and
interest
assumptions. Also referred to as "present
value" or "actuarial present value."

Qualified Preretirement Survivor Annuity
(QPSA). A QPSA is an annuity provided to
a surviving spouse when a vested participant
dies before receiving payment of his or her
benefit. The annuity is paid for the life of the
surviving spouse (who may be the spouse to
whom the participant was married at the time
the participant died, or a former spouse who
is treated by a QDRO as the participant's
spouse), is calculated based on the benefit
that had been earned by the participant before
death, and generally is equal to the survivor's
portion of the QJSA. In PBGC-trusteed
plans, the surviving spouse may elect to
receive the QPSA in the form of a straight life
annuity or certain-and-continuous annuity.
Single Life Annuity. An annuity that pays
benefits over a period of time that depends, at
least in part, on the survival of only one
person, for example, a straight life annuity or
certain-and-continuous annuity.
Spousal Consent. A spouse's written and
notarized agreement to allow the participant
to waive the QPSA or elect a form of benefit
other than a QJSA.
Spouse. Husband or wife as determined
under applicable law. A QDRO can provide
that the participant's former spouse be treated
as the participant's spouse for certain pension
benefits.

ADDITIONAL INFORMATION AND SUPPORT
For information about a pension plan that PBGC has trusteed, benefit information with respect to a
participant in such a plan, or information about Qualified Domestic Relations Orders, call PBGC's Customer
Contact Center, 1-800-400-7242, or write to PBGC QDRO Coordinator, P.O. Box 151750, Alexandria,
VA 22315-1750. (TTY/TDD users should call the Federal Relay Service toll-free at 1-800-877-8339 and ask
to be connected to 1-800-400-7242.)
To submit a domestic relations order to PBGC (or a draft order for a preliminary, informal review),
send it to PBGC QDRO Coordinator, P.O. Box 151750, Alexandria, VA 22315-1750.

PRIVACY ACT NOTICE

PBGC is giving you this notice (whether you are a participant or an alternate payee) pursuant to
the Privacy Act of 1974, as amended, 5 U.S.C. §552a (2012), as part of a collection of information
from you related to a qualified domestic relations order. PBGC uses the information collected to
determine whether an alternate payee is entitled to a portion (or all) of the participant's benefit and
to make appropriate payments. PBGC uses the Social Security Numbers you provide to identify the
participant's and the alternate payee's records within PBGC, to report income for tax purposes, and
to respond to lawful requests for information from other individuals and entities. Your response is
voluntary (although a court may require you to give PBGC some or all of this information in order
to receive a benefit due to you as a participant or alternate payee). However, PBGC generally cannot
pay any portion of a living participant's benefit to someone else, except as provided in a qualified
domestic relations order. Failure to provide information to PBGC, including a Social Security
Number, may delay or prevent PBGC from paying a benefit to an alternate payee.
PBGC may release information about you to other individuals and entities when necessary and
appropriate under the Privacy Act, including: to third parties to make benefit payments to you; to a
company that was responsible for the pension plan or to entities related to that company; to a labor
organization that represents you; to obtain information from the Federal Aviation Administration
relevant to a pilot or former pilot's eligibility for a disability benefit; to obtain your address from
other sources when PBGC does not have a current or valid address for you; and, to a limited extent,
to your spouse, former spouse, child, or other dependent when such individual may be entitled to
benefits from PBGC.
PBGC may also release information about you to appropriate law enforcement agencies when
PBGC becomes aware of a possible violation of civil or criminal law. If PBGC, an employee of
PBGC, the United States, or another agency of the United States, is involved in litigation, PBGC
may provide relevant information about you to a court or other adjudicative body or to the
Department of Justice when it represents PBGC. PBGC may also provide information about you to
the Office of Management and Budget in connection with review of private relief legislation or to a
Congressional office in response to an inquiry that office makes about you at your request.
PBGC publishes notices in the Federal Register that describe in more detail when information
about you may be made available to others. A copy of the most recent Federal Register notice may
be obtained from PBGC Privacy page (www.pbgc.gov/privacy), or by contacting PBGC's Customer
Contact Center by calling 1-800-400-7242. If you use a TTY/ASCII, call toll-free 1-800-877-8339
and give the communications assistant PBGC's telephone number. PBGC's authority to collect
information from you, including your Social Security Number, is derived from 29 U.S.C. §§1055,
1056(d)(3), 1302, 1321, 1322, 1322a, 1341, and 1350 (2012).

Pension Benefit Guaranty Corporation
1200 K Street, N.W.
Washington, DC 20005-4026
www.pbgc.gov
PBGC Publication 100
Revised October 2018

File Type	application/pdf
Author	Levin Karen
File Modified	2018-11-15
File Created	2018-11-15