Rp 2015-34

Part III. Administrative, Procedural, and Miscellaneous
Application Procedures for Approval of Benefit Suspensions for Certain Multiemployer Defined Benefit
Pension Plans under § 432(e)(9)

Revenue Procedure 2015–34
SECTION 1. BACKGROUND AND
PURPOSE
Section 201 of the Multiemployer Pension Reform Act of 2014, Division O of
the Consolidated and Further Continuing
Appropriations Act, 2015, Public Law
113–235 (128 Stat. 2130 (2014))
(MPRA), amended the Internal Revenue
Code (Code) and the Employee Retirement Income Security Act of 1974, Public
Law 93– 406 (88 Stat. 829 (1974)), as
amended (ERISA), to permit the sponsor
of a multiemployer defined benefit plan in
critical and declining status to suspend
benefits in certain situations.
In particular, MPRA amended
§ 432(e)(9) of the Code and section
305(e)(9) of ERISA to permit the sponsor
of a multiemployer defined benefit plan in
critical and declining status to submit to
the Secretary of the Treasury (Secretary) a
proposal to suspend benefits in certain situations. MPRA requires the Secretary to
approve a plan sponsor’s proposed suspension if the plan is eligible for the proposed suspension and the proposed suspension satisfies § 432(e)(9)(C) through
(F).1
On February 18, 2015, the Treasury
Department issued a Request for Information on benefit suspensions under MPRA
in the Federal Register (80 FR 8578).
The Request for Information stated that
the Treasury Department intends to issue guidance implementing § 432(e)(9)
and that a plan sponsor should not submit an application for a suspension of
benefits until a date specified in that
future guidance.
Applications for a suspension of benefits under a multiemployer defined benefit
pension plan that is in critical and declining status under § 432(e)(9) will be accepted on or after June 19, 2015. This

revenue procedure prescribes the application process for approval of a proposed
benefit suspension in accordance with
§ 432(e)(9)(G) and provides a model notice that a plan sponsor proposing a benefit suspension may use to satisfy the content and readability requirements of
§ 432(e)(9)(F)(ii) and (iii)(II). See Appendix A for the model notice. This revenue
procedure does not affect the standards
that will be applied in reviewing an application for a suspension of benefits under
§ 432(e)(9).
Proposed and temporary regulations
under § 432(e)(9) were published in the
Federal Register on June 19, 2015. The
provisions of this revenue procedure should
be interpreted in a manner consistent with
the provisions of the proposed and temporary regulations under § 432(e)(9). Final
regulations will be issued following a
public hearing and consideration of public
comments. If, and to the extent that, the
final regulations differ from the proposed
and temporary regulations in a manner
that affects the provisions of this revenue
procedure, or if changes to the application
process are identified that would be necessary or helpful, a revised revenue procedure will be issued to take those
changes into account.
While proposed and temporary regulations have been issued (and, as noted,
applications proposing a benefit suspension will be accepted on or after June 19,
2015), it is expected that any such applications will not be approved prior to consideration of public comments on the regulations and subsequent issuance of final
regulations. If a plan sponsor chooses to
submit an application for approval of a
proposed benefit suspension in accordance with the proposed and temporary
regulations before the issuance of final
regulations, then the plan sponsor may
need to revise the proposed suspension
(and potentially the related notices to plan
participants) or supplement the application to take into account any differences in

the regulatory provisions that might be
included in the final regulations.
SECTION 2. APPLICATION
PROCEDURES
This section prescribes procedures for
applying for approval of a proposed suspension of benefits, including information
that must be included in the application. A
plan sponsor may be required to provide
additional information with respect to any
application after it is submitted. For example, the plan sponsor may be required
to provide individual participant data that
would permit the Secretary to confirm that
the sample and actuarial calculations provided in the application, such as those
provided for purposes of section 4 of this
revenue procedure, are accurate and applied in a consistent manner.
.01 Who may submit application. An
application for approval of a proposed
benefit suspension under § 432(e)(9)
must be submitted by the plan sponsor
as defined in § 432(j)(9) (generally, the
joint board of trustees of the plan) or by
an authorized representative of the plan
sponsor. The application must be
signed and dated by an authorized
trustee who is a current member of the
board of trustees or by an authorized
representative of the plan sponsor who
is described in section 7.01(13) of Rev.
Proc. 2015–1, 2015–1 I.R.B. 1.2
.02 Terms of proposed benefit suspension. The application must include a
description of the proposed benefit suspension. The description must include
the following information:
(1) The effective date of the proposed suspension.
(2) If the proposed suspension will
expire by its own terms, the expiration date.
(3) The categories or groups of individuals who would be affected
by the proposed suspension and
how those categories or groups
are defined. If the proposed suspension would have a different

1
The Secretary’s approval of a proposed suspension would apply for purposes of section 305(e)(9) of ERISA, as well for purposes of § 432(e)(9) of the Code. Accordingly, the provisions
of this revenue procedure pertaining to § 432(e)(9) of the Code apply also for purposes of the corresponding provisions of section 305(e)(9) of ERISA.
2
Section 7.01(13) of Rev. Proc. 2015–1 provides that the following parties may be authorized representatives if appropriately accredited or authorized: attorney, certified public accountant,
enrolled agent, enrolled actuary, and enrolled retirement plan agent.

July 6, 2015

4

Bulletin No. 2015–27

effect on different categories or
groups, the description must describe the differences, including
the formula used to calculate the
amount of the proposed benefit
suspension for individuals in each
category or group. Although any
benefit suspension must take into
account the limitations on a benefit suspension under the rules of
§ 432(e)(9)(D)(i), (ii) and (iii), for
ease of presentation and understanding, the amount of the proposed benefit suspension described in this section 2.02 for an
individual must be calculated as if
the limitations of § 432(e)(9)(D)(i),
(ii) and (iii) did not apply to that
individual. (Note that the application of those limitations must be
described pursuant to section 4.01
of this revenue procedure, below.)
.03 Penalties of perjury. The following
statement signed by an authorized
trustee on behalf of the board of trustees that the application is submitted
under penalties of perjury: “Under penalties of perjury, I declare that I have
examined this request, including accompanying documents, and, to the
best of my knowledge and belief, the
request contains all the relevant facts
relating to the request, and such facts
are true, correct, and complete.”
.04 Public disclosure. A statement signed
by an authorized trustee on behalf of
the board of trustees acknowledging
that, pursuant to § 432(e)(9)(G)(ii), the
application for approval of the proposed suspension of benefits, and the
application’s supporting material, will
be publicly disclosed through publication
on the Treasury Department website.
.05 Where to submit application. An
application must be submitted to:
www.treasury.gov/mpra
.06 Signature. Any signature required
by this revenue procedure must be submitted electronically in Portable Document Format as part of the application.
A stamped signature is not permitted.
.07 Duty to correct. If, after submission
of an application for a suspension of
benefits, any error in that application is
discovered, the plan sponsor must pro3

vide prompt notice to the Treasury Department.
SECTION 3. DEMONSTRATION
THAT PLAN IS ELIGIBLE FOR
SUSPENSION
The application must include the following information providing support for
the plan sponsor’s method of satisfying
the benefit suspension criteria under
§ 432(e)(9), including the plan’s eligibility for the suspension:
.01 Plan actuary’s certification of critical and declining status. The plan actuary’s certification required under
§ 432(b)(3)(B)(iv) that the plan is in
critical and declining status as defined
in § 432(b)(6) for the plan year in
which the application is submitted.
Documentation supporting the actuarial
certification of status must be included
with the certification, including a yearby-year projection of the available resources as defined in § 418E(b)(3) and
the benefits under the plan, demonstrating that the plan is projected to become
insolvent during the relevant period. The
documentation must include a description of each of the assumptions used,
including the total contribution base units
and average contribution rates. The yearby-year projection must separately identify the market value of assets as of the
beginning and end of each year in the
relevant period and the following cashflow items for each of those years:
(1) Contributions.
(2) Withdrawal liability payments.
(3) Benefit payments.
(4) Administrative expenses.
(5) Investment returns.
.02 Plan actuary’s certification that the
plan is projected to avoid insolvency.
The plan actuary’s certification to the
plan sponsor under § 432(e)(9)(C)(i)
that the plan is projected to avoid insolvency within the meaning of
§ 418E, taking into account the proposed benefit suspension (and, if applicable, a proposed partition of the plan
under section 4233 of ERISA) and assuming that the proposed suspension
continues until it expires by its own
terms or, if no such expiration date is

set, indefinitely. Documentation supporting the actuarial certification under
§ 432(e)(9)(C)(i) must be included
with the certification, including a yearby-year projection of the available resources within the meaning of
§ 418E(b)(3) and the benefits under the
plan demonstrating the avoidance of
insolvency of the plan over the relevant
period. The documentation must include a description of each of the assumptions used, including the total
contribution base units and average
contribution rates. The year-by-year
projection must separately identify the
market value of assets as of the beginning and end of each year in the relevant period and the following cashflow items for each of those years:
(1) Contributions.
(2) Withdrawal liability payments.
(3) Benefit payments.
(4) Administrative expenses.
(5) Investment returns.
.03 Plan sponsor’s determination of projected insolvency. The plan sponsor’s determination under § 432(e)(9)(C)(ii) that
the plan is projected to become insolvent
unless benefits are suspended, even
though all reasonable measures to avoid
insolvency have been taken. The determination must include the documentation set forth in section 5 of this revenue
procedure.
SECTION 4. DEMONSTRATION
THAT THE PROPOSED
SUSPENSION SATISFIES THE
STATUTORY REQUIREMENTS
The application must include the following information to demonstrate that
certain statutory limitations and notice requirements are satisfied with respect to the
proposed suspension of benefits:
.01 Demonstration that limitations on
individual suspensions are satisfied. A
demonstration of how the proposed
suspension satisfies the limitations described in § 432(e)(9)(D)(i), (ii), and
(iii).3 The demonstration must include:
(1) A sample calculation applying
the 110 percent limitation under
§ 432(e)(9)(D)(i) for an individual in each category or group
identified in accordance with

The sample calculations submitted pursuant to this section 4.01 must not include personally identifiable information relating to any individual.

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July 6, 2015

section 2.02(3) of this revenue
procedure. Each sample calculation must identify how the
monthly benefit that would be
guaranteed under section 4022A
of ERISA is calculated (assuming, for this purpose, that no portion of the individual’s benefit under the plan is subject to permitted
forfeiture under § 411(a), due, for
example, to a failure to vest in
accordance with the vesting
schedule specified under the
plan). The calculation must
identify the extent, if any, to
which the monthly guaranteed
benefit calculated under section
4022A is reduced on account of
any of the following limitations
or exclusions:
(a) The section 4022A(a) exclusion of certain forfeitable
benefits (for example, increased benefits that have
not become part of the accrued benefit).
(b) The section 4022A(b)(1)(A)
exclusion of certain benefits
and benefit increases in effect for less than 60 months.
(c) The limitations contained in
the section 4022A(c)(2) definition of the accrual rate
used for calculating the
monthly guaranteed benefit
(the accrual rate must be
based on a benefit that is no
greater than the monthly
benefit payable under the
plan at normal retirement
age in the form of a single
life annuity (for example, if
the benefit reflected an actuarial increase related to delayed retirement or is paid in
the form of a social security
level income option) and
must be calculated without
regard to any reduction under § 411(a)(3)(E), divided
by years of credited service
(credited service cannot exceed 1 year for any year of
participation)).
(d) The section 4022A(d) limitation that the guaranteed
benefit will not exceed the

July 6, 2015

benefit calculated under the
plan as reduced under
§ 411(a)(3)(E).
(e) The section 4022A(e) exclusion, pursuant to section
4022(b)(6), of benefits that
would not be guaranteed if
paid under a single-employer
plan (benefits paid from a plan
that does not satisfy the requirements of § 401(a) or
§ 404(a)(2)).
(2) With respect to benefits based on
disability, as calculated using the
plan’s definition of disability:
(a) A description of each benefit
based on disability, as defined under the plan, that is
paid to an individual under
the plan, and
(b) A sample calculation under
§ 432(e)(9)(D)(iii) for an individual in each category or
group identified in accordance with section 2.02(3)
of this revenue procedure for
each type of benefit based on
disability that shows how
the plan determines the extent to which any retirement
benefit paid with respect to a
participant who commenced
benefits as a result of disability is, or is not, treated as
a benefit based on disability.
If the plan provides to a disabled individual a benefit
that is not described in the
plan as a disability benefit
(for example, a retirement
benefit paid at normal retirement age that is greater than
a disability benefit paid before normal retirement age),
then the calculation must
show the extent to which the
retirement benefit is, or is
not, a benefit based on disability.
(3) A sample calculation for an individual in each category or
group identified in accordance
with section 2.02(3) of this revenue procedure that shows how
the proposed suspension satisfies the age-based limitations of
§ 432(e)(9)(D)(ii), taking into

6

account the guarantee-based
limitation of § 432(e)(9)(D)(i).
If the plan provides a benefit of
the type described in the second
sentence of paragraph 4.01(2)(b)
of this revenue procedure, then
the sample calculation must
show how the proposed suspension satisfies the age-based limitations taking into account both
the guarantee-based limitation
and the disability-based limitation.
.02 Demonstration that the proposed
suspension is reasonably estimated to
enable the plan to avoid insolvency. A
demonstration that, in accordance with
§ 432(e)(9)(D)(iv), the proposed benefit suspension (considered, if applicable, in combination with a proposed
partition of the plan under section 4233
of ERISA) is reasonably estimated to
enable the plan to avoid insolvency.
The demonstration must include:
(1) An illustration, prepared on a deterministic basis, showing that:
(a) For each plan year beginning
on the effective date of the
proposed suspension and
throughout an extended period as described in regulations under § 432(e)(9), the
plan’s solvency ratio – the
ratio of the plan’s available
resources (as defined in
§ 418E(b)(3)) to the scheduled benefits payable under
the plan for the plan year – is
projected to be at least 1.0.
(b) If the plan’s projected funded
percentage at the end of the
extended period is less than or
equal to 100 percent, then neither the plan’s solvency ratio
nor its available resources are
projected to decrease in any
of the last five plan years of
the extended period.
(2) An illustration using stochastic
projections that reflect variance
in investment return that the
probability the plan will avoid
insolvency throughout the extended period as a result of the
proposed suspension is greater
than 50 percent. (The plan sponsor of a plan that is not described

Bulletin No. 2015–27

in § 432(e)(9)(B)(v)(I) is not required to use stochastic projections in demonstrating that the
plan will avoid insolvency;
however, if the plan sponsor
chooses to use stochastic projections for this purpose, then it
must provide this illustration.)
(3) A description of each of the assumptions used, including:
(a) If the actuarial assumptions
used for the deterministic
projections differ from those
used under section 3.01 of
this revenue procedure, a
justification for that difference.
(b) With respect to the stochastic projections described in
section 4.02(2) of this revenue procedure, the assumed
mix of assets (and how it
compares with the current
mix of assets), the distribution of returns for each asset
class, and the correlation
among those rates of returns
and any other economic
variables in the projections.
(c) If the actuarial assumptions
used for stochastic projections as described in section
4.02(2) of this revenue procedure differ from those
used for deterministic projections as described in section 4.02(1) of this revenue
procedure (other than those
related to investment returns), a justification for that
difference.
.03 Demonstration that the proposed
suspension is reasonably estimated to
not materially exceed the level necessary to avoid insolvency. In the case of
a plan that is not applying for a partition in combination with a suspension,
a demonstration that, in accordance
with § 432(e)(9)(D)(iv), the proposed
benefit suspension is reasonably estimated to not materially exceed the
level necessary to enable the plan to
avoid insolvency. For this purpose, the
assumptions used must be the same as
those used for purposes of 4.02 of this
4

revenue procedure. The demonstration
must include an illustration of the measures described in section 4.02(1) of
this revenue procedure (and, if applicable to the plan, section 4.02(2) of this
revenue procedure) showing that, if the
dollar amount of the proposed suspension for each participant and beneficiary were reduced by 5 percent, then
the proposed suspension would not
reasonably be estimated to enable the
plan to avoid insolvency.
.04 Demonstration that the proposed
benefit suspension is distributed equitably. A demonstration that, in accordance with § 432(e)(9)(D)(vi), the proposed benefit suspension is distributed
in an equitable manner across the participant and beneficiary population.
(1) With respect to this demonstration, the application must identify
the factors (for example, those
listed in section § 432(e)(9)(D)
(vi)(I) through (XI)) that were
taken into account in designing
the proposed suspension.
(2) If none of the factors listed in
§ 432(e)(9)(D)(vi)(I) through
(XI) were taken into account,
then the application must explain why those factors were not
considered relevant in designing
the proposed suspension.
(3) If the proposed suspension applies differently to different categories or groups of individuals,
then the application must state
the approximate number of individuals in each category or
group, the average monthly benefit before and after the suspension for individuals in that category or group, and the aggregate
present value of the reduction in
benefits for all individuals in
that category or group. The application must also explain how
any differences in the applicable
benefit suspension formulas for
the different categories or
groups of individuals result
from a reasonable application of
the relevant factors.
(4) A demonstration of the distribution of the benefit suspension

within each different category or
group of individuals referred to
in section 4.04(3) of this revenue
procedure, taking into account the
effect of the individual limitations
under § 432(e)(9)(D)(i), (ii), and
(iii). This can be expressed as a
count of individuals within the
category or group whose benefits
are not reduced, or are reduced by
a percentage within a range not
exceeding 10 percent. For example, the distribution could show a
count of the individuals who have
no reduction, a reduction of 10
percent or less, a reduction of 20
percent or less but more than 10
percent, etc.
.05 Notice. A description of the plan
sponsor’s method for satisfying the notice requirements under § 432(e)(9)(F),
including the following information:
(1) For each category or group of
individuals described in section
2.02(3) of this revenue procedure, a copy of each type of actual notice4 that has been or will
be given to an individual in that
category or group. (This is required even if the plan sponsor
uses the model notice in Appendix A.)
(2) A description of the efforts that
are being made to contact participants, beneficiaries and alternate payees.
(3) A description of the steps the
plan sponsor has taken to ensure
that any electronically delivered
notices are reasonably accessible to the recipients.
(4) A list of:
(a) Each employer that has an obligation to contribute within
the meaning of section 4212(a)
of ERISA, and
(b) Each employee organization
representing participants under the plan.

The copy of the notice(s) attached to the application must not include personally identifiable information with respect to any individual, such as a name or social security number.

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July 6, 2015

SECTION 5. PLAN SPONSOR
DETERMINATION RELATING TO
REASONABLE MEASURES TAKEN
TO AVOID INSOLVENCY
With respect to the plan sponsor’s determination required under section 3.03 of
this revenue procedure that the plan is
projected to become insolvent unless benefits are suspended, the application must
include the following information:
.01 Measures taken to avoid insolvency. A detailed description of measures taken in order to avoid insolvency over the past 10 plan years
immediately preceding the plan year in
which the application is submitted.
.02 Plan factors. In accordance with
§ 432(e)(9)(C)(ii), the following specific information with respect to the
plan:
(1) For the past 10 plan years immediately preceding the plan
year in which the application is
submitted:
(a) Contribution levels.
(b) Levels of benefit accruals,
including any prior reductions in the rate of benefit
accruals.
(c) Prior reductions, if any, of
adjustable benefits under
§ 432(e)(8).
(d) Any prior suspension of
benefits under § 432(e)(9).
(e) Measures undertaken by the
plan sponsor to retain or attract contributing employers.
(2) The impact on plan solvency of
the subsidies and ancillary benefits, if any, available to active
participants.
(3) Compensation levels of active
participants relative to employees in the participants’ industry
generally.
(4) Competitive and other economic
factors facing contributing employers.
.03 How plan factors were taken into
account. For each of the factors listed
under section 5.02 of this revenue procedure and the factors described in
§ 432(e)(9)(C)(ii)(VIII) (the impact of
benefit and contribution levels on retaining active participants and bargaining groups under the plan) and

July 6, 2015

§ 432(e)(9)(C)(ii)(IX) (the impact of
past and anticipated contribution increases under the plan on employer
attrition and retention levels), the application must describe how that factor
was taken into account (or why that
factor was not taken into account) in
the plan sponsor’s determination that
all reasonable measures have been
taken to avoid insolvency.
.04 Other factors considered. If the
plan sponsor considered any other factors, then the application must discuss
how and why that factor was taken into
account in the plan sponsor’s determination that all reasonable measures
have been taken to avoid insolvency.
SECTION 6. OTHER REQUIRED
INFORMATION.
The application must also include the
following information:
.01 Ballot. A proposed ballot intended
to satisfy the requirements of
§ 432(e)(9)(H)(iii) (without the statement in opposition to the proposed
benefit suspension described in
§ 432(e)(9)(H)(iii)(II) or the individualized estimate that was provided as
part of the notice described in
§ 432(e)(9)(F)).
.02 Partition. Whether the plan sponsor is requesting approval from the
PBGC of a proposed partition under
section 4233 of ERISA. If the plan
sponsor is requesting approval of a
proposed partition, then the application
for the proposed benefit suspension
must include the proposed effective
date of the partition and a year-by-year
projection of the amount of the reduction in benefit payments (that is, the
guaranteed amounts covered by financial assistance under the successor plan
for each year) attributable to the partition.
.03 Ten-year experience for certain
critical assumptions. With respect to
each of the 10 plan years immediately
preceding the plan year in which the
application is submitted, a disclosure
that separately identifies:
(1) Total contributions.
(2) Total contribution base units.
(3) Average contribution rates.
(4) Withdrawal liability payments.
(5) Rate of return on plan assets.

8

.04 Demonstration of sensitivity of projections. The application must include
deterministic projections of the sensitivity of the plan’s solvency ratio
throughout the extended period to certain key assumptions. For this purpose,
the application must include the following separate projections calculated
using the same assumptions as those
used under section 4.02(1) of this revenue procedure, except that:
(1) The assumed rate of return is
reduced by 1 percentage point.
(2) The assumed rate of return is
reduced by 2 percentage points.
(3) Future contribution base units
increase or decrease at a rate
equal to the average annual rate
of increase or decrease that the
plan experienced over the period
of years described in section
6.03 of this revenue procedure.
(4) Future contribution base units
increase or decrease at a rate
equal to the rate described in
section 6.04(3) of this revenue
procedure reduced by 1 percentage point.
.05 Projection of funded percentage.
The plan sponsor must include an illustration, prepared on a deterministic basis, of the projected value of plan assets, the accrued liability of the plan
(calculated using the unit credit funding method) and the funded percentage
for each year in the extended period.
.06 Plan sponsor certifications relating
to plan amendments. The plan sponsor
must certify that if it receives final authorization to implement the suspension as described in § 432(e)(9)(H)(vi)
and chooses to implement the authorized suspension, then, in addition to
the plan amendment implementing the
suspension, the following plan amendments will be timely adopted and not
modified at any time thereafter before
the suspension of benefits expires:
(1) A plan amendment providing
that in accordance with § 432(e)
(9)(C)(ii) the benefit suspension
will cease as of the first day of
the first plan year following the
plan year in which the plan
sponsor fails to determine that
both:

Bulletin No. 2015–27

(a) All reasonable measures to
avoid insolvency continue to
be taken during the period of
the benefit suspension.
(b) The plan is projected to become insolvent unless benefits continue to be suspended.
(2) A plan amendment providing
that any future benefit improvements must satisfy the requirements of § 432(e)(9)(E).
.07 Whether a plan is described in
§ 432(e)(9)(D)(vii)(III). Whether the
plan is a plan described in § 432(e)(9)
(D)(vii)(III) and, if so, how that fact is
reflected in the proposed benefit suspension.
.08 Optional additional information.
The plan sponsor may include other
information about the plan, such as a
narrative statement of the reasons the
plan is in critical and declining status.
SECTION 7. IDENTIFICATION
AND BACKGROUND
INFORMATION ON THE PLAN
The application must include the following identification and background information:
.01 Plan sponsor. Name, contact information (for example, address, telephone number, email address and fax
number) and employer identification
number (EIN) of the plan sponsor.
.02 Plan identification. Name of the
plan, plan number and plan EIN (if
different from the plan sponsor EIN)
for which the application is submitted.
.03 Retiree representative. If applicable, name and contact information of
the retiree representative for the plan
described in § 432(e)(9)(B)(v).
.04 Plan’s enrolled actuary. Name, enrollment number, and contact information of the plan’s enrolled actuary
within the meaning of § 7701(a)(35).
.05 Power of Attorney. A designation
of power of attorney for each authorized representative who will represent

the plan sponsor in connection with the
application. See Appendix B.
.06 Plan documents. With respect to
the plan document, the most recent
plan document, including all amendments adopted since the last restatement5 as well as the following documents related to that plan document:
(1) The most recent summary plan
description as defined under section 102 of ERISA and any subsequent summaries of material
modification.
(2) The most recent determination
letter issued to the plan.
.07 Collective bargaining and side
agreements. Excerpts from collective
bargaining agreements and side agreements (such as participation agreements or reciprocity agreements) pursuant to which the plan is maintained.
The plan sponsor must not submit the
entire collective bargaining or side
agreement. The required excerpts are:
(1) Language from any portions of a
collective bargaining agreement
that are relevant to the plan or
the proposed suspension, and
(2) Language from any portions of a
side agreement that are relevant
to the plan or the proposed suspension.
.08 Annual return. Excerpts from the
most recently filed Form 5500, Annual
Return/Report of Employee Benefit
Plan. The required excerpts are:
(1) Pages 1 and 2 of the Form 5500,
without attachments or schedules.
(2) The Schedule MB, including attachments, and
(3) The Schedule R, including attachments.
.09 Rehabilitation plan. The rehabilitation plan described in § 432(e)(3) as
most recently updated. If the rehabilitation plan includes more than one contribution or benefit schedule, then the
application must specify the extent to
which each schedule applies (either
pursuant to collective bargaining or,
with respect to the designated default

schedule, as imposed on an employer),
expressed as a percentage of the total
contributions for the most recent year
for which the information is available.
.10 Completed checklist. A completed
checklist of information required to be included in the application. See Appendix C.
SECTION 8. PAPERWORK
REDUCTION ACT
The collections of information contained in this revenue procedure have
been approved by the Office of Management and Budget in accordance with the
Paperwork Reduction Act of 1995 (44
U.S.C. 3507(c)) under control number
1545-2260.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection of information displays
a valid OMB control number.
The collections of information in this
revenue procedure appear in Appendix B
(sample Power of Attorney form) and Appendix C (checklist for completeness of
the application). Burden estimates with
respect to information described in sections
2, 3, 4, 5, 6 and 7 of this revenue procedure
are reported in the preamble to the proposed
regulations under § 1.432(e)(9)–1.
We estimate the total number of respondents to be 28.
We estimate it will take 2 hours to
comply. The estimated total annual and/or
recordkeeping burden is 56 hours.
Estimates of the annualized cost to respondents for the hour burdens shown are
not available at this time.
CONTACT INFORMATION
For general information regarding this
revenue procedure, please contact the
Treasury Department MPRA guidance information line at (202) 622-1559 (not a
toll-free number). For information regarding a specific application for benefit suspension, please contact the Treasury Department at (202) 622-1534 (not a toll-free
number).

5
Submission of the plan document and amendments to the Treasury Department as part of the application for approval of a proposed suspension under this revenue procedure will not be
treated as a request to the IRS for a favorable determination on the qualified status of the plan under § 401 or the exempt status of the related trust under § 501(a). For procedures governing
an application to the IRS for a favorable determination under §§ 401 and 501(a), see Rev. Proc. 2015– 6, 2015–1 I.R.B. 194, and Rev. Proc. 2007– 44, 2007–2 C.B. 54, as modified.

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Appendix A
MODEL NOTICE OF APPLICATION FOR APPROVAL OF A PROPOSED REDUCTION OF BENEFITS
[This is a model notice that can be used to satisfy the requirements of § 432(e)(9)(F). If the plan sponsor applies for a partition
of the Plan under section 4322 of ERISA, then this notice can be combined with the notice required under section 4322 assuming
all other requirements, such as the timing of providing each notice, are satisfied.]
[DATE]
NOTICE OF APPLICATION FOR APPROVAL OF A PROPOSED REDUCTION OF BENEFITS UNDER [Insert name
of plan]
This notice is to inform you that, on [insert date], the joint board of trustees of the [insert Plan name] (“Board of Trustees”) [insert
submitted/will submit] an application to the U.S. Treasury Department for approval to reduce benefits under the [insert Plan name]
(“Plan”), effective [insert effective date of proposed suspension of benefits]. If the application is approved and other requirements
are satisfied, then the Board of Trustees will be permitted to reduce, by plan amendment, benefits otherwise payable to
participants or beneficiaries. This type of benefit reduction is authorized by the Multiemployer Pension Reform Act of 2014,
which refers to it as a “suspension” of benefits. It is a reduction of any current or future payments from a multiemployer defined
benefit pension plan to any participant or beneficiary, including retirees and beneficiaries who are receiving benefits at the time
of the reduction.
Federal law requires the Board of Trustees to send this notice to contributing employers, unions representing participants, and every
plan participant and beneficiary, even if his or her benefit is not being reduced. To see whether and how the proposed reduction
applies to you, go to “How the proposed reduction in benefits would affect you” on page [insert page number] of this notice.
PLAN’S ELIGIBILITY TO REDUCE BENEFITS
Federal law permits the Board of Trustees to apply for a proposed reduction of benefits because the Plan’s actuary certified that the
Plan is in “critical and declining” status for the plan year beginning [insert first day of plan year]. This means that the Plan is
experiencing funding and/or liquidity problems, such that it is in “critical” status, and it is projected to become insolvent (that is, not
have enough assets to pay benefits) in the year [insert year].
The Board of Trustees determined that it has taken “all reasonable measures” to avoid insolvency of the Plan, but that those measures
have been insufficient to meet that goal, and that the proposed reduction of benefits is necessary to avoid insolvency. If the Plan were
to become insolvent, benefits could be reduced below the proposed reduction. If this were to happen, the Pension Benefit Guaranty
Corporation (“PBGC”) would be required to provide a guarantee for a certain level of benefits that is set by federal law
(“PBGC-guaranteed level”).6
DESCRIPTION OF THE PROPOSED BENEFIT REDUCTION AND FACTORS CONSIDERED BY THE BOARD OF
TRUSTEES IN DESIGNING THE REDUCTION
Federal law imposes limits on how a reduction of benefits can be designed. For example, a participant’s or beneficiary’s monthly
benefit may not be reduced below 110% of the PBGC-guaranteed level. In addition, no reduction can apply to benefits based on
disability. Finally, an individual’s age affects the amount of the reduction that may apply to the monthly benefit. No reduction applies
to the benefits of an individual who has reached age 80 as of the effective date of the reduction. For an individual who is between
ages 75 and 80 as of the effective date of the reduction, the maximum amount of the reduction that can apply to his or her benefit
is reduced. The closer the individual is to age 80 as of the effective date of the reduction, the smaller the reduction to the individual’s
benefit can be. If the age-based limits on the amount of a reduction apply for a participant, then the same limits will continue for
any beneficiary of the participant after the participant’s death, regardless of the beneficiary’s age.
Federal law requires that any reduction of benefits be distributed fairly among the various categories or groups of participants and
beneficiaries under the Plan. In deciding whether the proposed reduction would be distributed fairly under the Plan, the Board of
Trustees took into account the following factors: [List the factors the Board of Trustees took into account in designing the proposed
suspension of benefits. This list may include (but is not limited to) factors found in § 432(e)(9)(D)(vi).]
The Board of Trustees proposes the following reduction of benefits: [Describe the proposed suspension of benefits and its effect.
Describe each category or group of individuals who would be affected differently by the suspension (including categories or groups
that would be unaffected) and how those categories or groups are defined; describe the formula used to determine how the amount
of the proposed suspension is determined for individuals in each category or group; specify whether the proposed suspension will
6

For more information about the amount of benefits guaranteed by PBGC, visit: http://pbgc.gov/prac/multiemployer/multiemployer-benefit-guarantees.html.

July 6, 2015

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remain in effect indefinitely or will expire by its own terms (and if so, when it will expire); describe any proposed phase-in of the
suspension; and describe the effect of the proposed suspension on the plan’s projected insolvency.]
If you are a participant or beneficiary, the last part of this notice provides a dollar estimate of how the proposed reduction
applies to you.
AVAILABILITY OF THE APPLICATION AND HOW YOU CAN COMMENT ON IT
The application for approval of the proposed reduction of benefits will be made publicly available within 30 days after the application
has been received by the Treasury Department. The application includes more information about the proposed reduction, including
details about: 1) the Plan actuary’s certification that the Plan is in critical and declining status; 2) how the proposed reduction would
satisfy the requirement that it be large enough so that the Plan is projected to avoid insolvency, while not being larger than needed
to avoid insolvency; and 3) the sensitivity of the projection to the assumptions used.
The application also includes a description of the measures the Board of Trustees has already taken to try to avoid insolvency of the
Plan, as well as why the Board of Trustees believes that the proposed reduction is distributed fairly. Comments will be accepted
regarding the application from employees, deferred vested participants (participants who are no longer earning benefits under the
Plan but are not yet receiving benefits from the Plan), retirees, beneficiaries, contributing employers, unions representing participants,
and other interested parties (such as the retiree representative, if any).
See www.treasury.gov/mpra for a copy of the Plan’s application, for instructions on how to send a comment on the application, and
for how to contact the Treasury Department for further information and assistance. The Treasury website will also provide updated
information on the application, such as whether the application has been modified or withdrawn. If the application is withdrawn (or
rejected), and the Board of Trustees submits a new application, you may receive a notice for that new application that supersedes
this notice.
You may also contact the Treasury Department for further information and assistance at the following address:
Department of the Treasury
Attn: MPRA, Room 1001
1500 Pennsylvania Ave., NW
Washington, D.C. 20220
RETIREE REPRESENTATIVE
The board of trustees of a multiemployer plan applying for approval to reduce benefits may select a retiree representative to
advocate for the interests of retirees, beneficiaries, and deferred vested participants in connection with the approval
process. If the plan has 10,000 or more participants, the board of trustees is required by Federal law to select a retiree
representative.
[If the Board of Trustees has selected a retiree representative under § 432(e)(9)(B)(v)(I), insert the following]
On [insert date], [insert name] was selected to act as the retiree representative. The retiree representative, who is one of the retirees
currently receiving benefits under the Plan, [is/is not] a member of the Board of Trustees of the Plan. Participants and beneficiaries
may contact [insert name of retiree representative] at [insert phone number, address, and e-mail address].
[If the Board of Trustees has not selected a retiree representative under § 432(e)(9)(B)(v)(I), insert the following]
The Board of Trustees has not chosen to select a retiree representative.
RIGHTS AND REMEDIES OF PLAN PARTICIPANTS AND BENEFICIARIES
Vote on Proposed Benefit Reduction
If the application for the proposed reduction of benefits is approved by the Treasury Department, then participants and beneficiaries
will be given the opportunity to vote to approve or reject the proposed reduction. Unless a majority of all participants and
beneficiaries of the Plan vote to reject the reduction, the reduction will be permitted to go into effect following the vote.
Final Authorization to Reduce Benefits
If a majority of all plan participants and beneficiaries do not vote to reject the proposed reduction of benefits, then the Treasury
Department is required to issue a final authorization to permit the reduction of benefits to take effect.
[If the Board of Trustees believes that the PBGC will or may determine that the Plan is a systemically important plan (a plan with
a present value of projected PBGC financial assistance payments that exceeds $1 billion), insert the following]

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If the Plan is a systemically important plan (a plan with a present value of projected PBGC financial assistance payments that exceeds
$1 billion) and a majority of participants and beneficiaries vote to reject the proposed reduction of benefits, then Federal law requires
the Treasury Department, notwithstanding the participants’ and beneficiaries’ vote to reject, to issue a final authorization to permit
either the proposed reduction of benefits, or a modified version of the proposed reduction of benefits, to take effect. Before this
occurs, the PBGC’s Participant and Plan Sponsor Advocate may submit recommendations to the Treasury Department regarding
possible modifications to the proposed reduction.
Claims Process for Incorrect Calculations
If you think the reduction to your benefits was calculated incorrectly, then you have the right to submit a claim to the Plan to have
the calculation corrected. Your Plan’s summary plan description is required to include the Plan’s claims procedures, including
information on your right to have a court review the Plan’s final decision on your claim.
Access to Plan Documents
You, your contributing employer, the union representing you, and the retiree representative (if any) also have the right to request the
documents listed below from the Plan. You may want to review these documents to help you understand your rights and the proposed
reduction to your benefits:
• The Plan document (including any amendments adopted to reflect an authorized reduction of benefits), trust agreement, and other
documents governing the Plan (such as collective bargaining agreements),
• The most recent summary plan description (SPD or plan brochure) and any summary of material modifications,
• The Plan’s Form 5500 annual reports, including audited financial statements, filed with the U.S. Department of Labor during the last
six years,
• The annual funding notices furnished by the Plan during the last six years,
• Actuarial reports, including reports prepared in anticipation of the benefit reduction, furnished to the Plan within the last six years,
• The Plan’s current rehabilitation plan, including contribution schedules and annual plan-sponsor determinations that all
reasonable measures to avoid insolvency continue to be taken and that the Plan is not projected to avoid insolvency unless
benefits are reduced, and
• Any quarterly, semi-annual or annual financial reports prepared for the Plan by an investment manager, fiduciary or other advisor and
furnished to the Plan within the last six years.
The plan administrator must respond to your request for these documents within 30 days, and may charge you the cost per page to
the Plan for the least expensive means of reproducing documents, but cannot charge more than 25 cents per page. The Plan’s Form
5500 Annual Return/Report of Employee Benefit Plan is also available free of charge at www.dol.gov/ebsa/5500main.html. Some of
the documents also may be available for examination, without charge, at the plan administrator’s office, your worksite or union hall.
INDIVIDUAL ESTIMATE OF EFFECT OF PROPOSED REDUCTION IN BENEFITS
[Distribute this estimate to the affected individual]
[Affected Individual’s Name]
[Address]
[Town, State, Zip]
How the proposed reduction in benefits would affect you
The Plan’s actuary has calculated that if the proposed reductions are not implemented, then the Plan is projected to be insolvent and
unable to pay benefits when due in [insert year of projected insolvency]. If the Plan becomes insolvent, your benefit would be reduced
to the monthly PBGC-guaranteed level. Your estimated monthly PBGC-guaranteed level is [insert $xxxx.xx].
[Choose (a), (b), (c) or (d), as appropriate for an affected individual. Affected individuals include a participant (including a retiree),
a beneficiary of a deceased participant, or an alternate payee. If (a), (b) or (c) is chosen, then insert a narrative description of the
effect of the suspension if it is not possible to estimate its effect quantitatively (on an annual or monthly basis), such as in the case
of a suspension that affects the payment of any future cost of living adjustment.]
[(a) For an affected individual who is in pay status and who has a proposed suspension]
Effective [insert effective date of proposed suspension], your monthly benefit is proposed to be reduced from [insert current monthly
benefit] to [insert monthly benefit reflecting proposed suspension].
[(b) For an affected individual who has a proposed suspension, is not yet in pay status, and is below the participant’s normal
retirement age]

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Your future monthly benefit, based on the years of service you have (or, if you are a beneficiary or alternate payee, the participant
has) already worked as of [insert service calculation date, i.e. no earlier than 1 year before date this notice is sent], if paid beginning
[insert participant’s normal retirement date] (your normal retirement date) in the form of a [insert normal form of benefit] is
proposed to be reduced from [insert monthly benefits earned as of proposed effective date of suspension] to [insert monthly benefits
earned as of date of suspension reflecting proposed suspension].7
[(c) For an affected individual who has a proposed suspension, is not yet in pay status, and is above the participant’s normal
retirement age]
Your future monthly benefit, based on the years of service you have (or, if you are a beneficiary or alternate payee, the participant
has) already worked as of [insert service calculation date, i.e. date no earlier than 1 year before date this notice is sent], payable
as of [insert date] in the form of a [insert normal form of benefit] is proposed to be reduced from [insert monthly benefit as of
proposed effective date of suspension] to [insert monthly benefit as of that date reflecting proposed suspension].8
[(d) For an affected individual whose benefits are not proposed to be suspended]
Your monthly benefit would not change under the proposed reduction.
INFORMATION USED IN CALCULATING THE ESTIMATED BENEFIT REDUCTION
This is an estimate of your benefit under the proposed reduction. It is not a final benefit calculation. This estimate of the proposed
reduction is based on an assumed effective date for the benefit reduction of [insert proposed effective date] (this date may be subject
to change, but in no event will the proposed reduction be effective earlier). If the proposed reduction is effective at a later date, then
the amount of the reduction to your benefit might change.
This estimate is also based on the following information:
Years of Service
[If (a) or (d) above applies to the affected individual]
Plan records show that you have [insert total years and months of credited service] under the Plan.
[If (b) or (c) above applies to the affected individual]
Plan records show that you have [insert total years and months of credited service as of the service calculation date] under the Plan.
Age as of the Effective Date of the Proposed Reduction
Plan records show that you will be [insert age in years and months] as of the effective date of the proposed reduction.
Disability Benefits
Plan records show that the portion of your benefit that is based on disability is [insert amount].
PLAN OFFICE CONTACT INFORMATION
If you believe the information used to calculate your estimate is incorrect, please contact the Plan office at [insert phone number,
address, and e-mail address].

7
The amount of your benefit before and after the proposed reduction will depend on when you decide to begin receiving benefits and the form of benefit you choose as well as, if applicable,
whether you continue to work and earn years of service after the service calculation date. The amounts shown above are based on an assumed commencement at age [insert the participant’s
normal retirement age] (the plan’s normal retirement age) without any additional years of service for future work. If you choose to begin receiving benefits before your normal retirement
age, or if you choose a form of benefit that includes additional survivor benefits after your death, then any actuarial reduction for early commencement or survivor benefits will be applied
to your benefit after reflecting the effect of the separate reduction due to the proposed amendment to the Plan described above. However, the combined reductions are not allowed to result
in a benefit that is less than 110 percent of the PBGC-guaranteed level.
8
This is the largest amount of proposed reduction that will apply and is based on commencement of benefits in the specified form of benefit. If you choose a form of benefit that includes
additional survivor benefits after your death, then any actuarial reduction for those benefits will be applied to your benefit after reflecting the effect of the separate reduction due to the
proposed amendment to the Plan described above. However, the combined reductions are not allowed to result in a benefit that is less than 110 percent of the PBGC-guaranteed level.

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Appendix B
POWER OF ATTORNEY AND DECLARATION OF REPRESENTATIVE BEFORE THE DEPARTMENT OF THE
TREASURY
Applicant information [include name of plan, address, plan number, employer identification number, name of contact, title
of contact, telephone number, email address, and fax number]:
Applicant hereby appoints the following representative(s) as attorney(s)-in-fact to represent the taxpayer before the Department
of the Treasury and perform acts related to the attached application dated ______________ for suspension of benefits under
§ 432(e)(9) of the Internal Revenue Code of 1986, as amended.
Representative information: [include name, address, employer identification number, telephone number, email address,
and fax number]:
Send copies of notices and communications to representative [answer yes or no]
With the exception of the acts described below, I authorize my representative(s) to receive and inspect my confidential tax
information and to perform acts that I can perform with respect to the attached application dated ______________ for suspension
of benefits under § 432(e)(9). For example, my representative(s) shall have the authority to sign any agreements, consents, or similar
documents.
Specific acts not authorized: [If the representative is not authorized to perform any act described above, describe the act that the
representative is not authorized to perform.]
Signature of Applicant and Date

Declaration of Representative
Under penalties of perjury, by my signature below I declare that:
● I am not currently suspended or disbarred from practice before the Internal Revenue Service;
● I am authorized to represent the Applicant for the matter(s) specified in this Power of Attorney and Declaration of
Representative; and
● I am one of the following:
a Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below.
b Certified Public Accountant— duly qualified to practice as a certified public accountant in the jurisdiction shown below.
c Enrolled Agent
d Officer—a bona fide officer of the Applicant.
e Full-Time Employee—a full-time employee of the Applicant.
f Enrolled Actuary— enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the
authority to practice before the Internal Revenue Service is limited by section 10.3(d) of Circular 230).
g Enrolled Retirement Plan Agent
Required information for Representative [include the appropriate designation of a through g above. In addition, an officer or
full-time employee of the Applicant must include the title or position with the Applicant, and other Representatives must include the
licensing jurisdiction if applicable, and the bar, license, certification, registration, or enrollment number as applicable.]:
Signature of Representative and date:

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APPENDIX C
CHECKLIST - IS THE SUBMISSION COMPLETE?
Instructions The application must include a completed checklist placed on top of the application. This will help ensure that the
application is complete. Answer each question in the checklist by circling Y for yes, N for no or N/A for not applicable, as
appropriate, in the blank next to the item. Also insert in the appropriate blank next to each item the page number or numbers where
the item appears in the application.
APPLICATION FOR APPROVAL OF BENEFIT SUSPENSION FOR [INSERT NAME OF PLAN]

Response
Yes
No
N/A

Item
number
1.

Description of item
Does the application include an original signature of the plan sponsor
or an authorized representative of the plan sponsor. See section 2.01.

Yes
No
N/A

2.

Yes
No
N/A

3.

Does the application include a penalties-of-perjury statement signed by an
authorized trustee on behalf of the board of trustees. See Section 2.03.

Yes
No
N/A

4.

Does the application include a statement, signed by an authorized trustee on
behalf of the board of trustees, acknowledging that the application and the
application’s supporting material will be publicly disclosed on the Treasury
Department’s website. See section 2.04.

Yes
No
N/A

5.

Does the application include the plan actuary’s certification of critical and
declining status and the supporting illustrations, including:

Yes
No
N/A

6.

Does the application describe the assumptions used. See section 3.01.

Yes
No
N/A

7.

Does the application include the plan actuary’s certification that the plan is
projected to avoid insolvency if the suspension takes effect and the supporting illustrations, including:

Page number
in application

Does the application include a description of the proposed benefit suspension
- calculated as if no other limitations apply - that includes:
●
●

the suspension’s effective date (and its expiration date, if applicable),
a description of the different categories or groups of individuals affected, and
● how the suspension affects these individuals differently. See section
2.02.

●

the year-by-year projections demonstrating projected insolvency during
the relevant period and
● separately identifying the available resources (and the market value of
assets and changes in cash flow) during each of those years. See section 3.01.

●

the year-by-year projections demonstrating projected solvency during
the relevant period and
● separately identifying the available resources (and the market value of
assets and changes in cash flow)during each of those years. See section 3.02.

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July 6, 2015

Response
Yes
No
N/A

Item
number
8.

Description of item
Does the application include the plan sponsor’s determination of projected
insolvency that includes the documentation set forth in section 5 of the revenue procedure. See section 3.03.

Yes
No
N/A

9.

Yes
No
N/A

10.

Does the application include a demonstration that the proposed suspension is
reasonably estimated to achieve the level necessary to avoid insolvency for
the extended period, including illustrations regarding the plan’s solvency
ratio and available resources. See section 4.02(1).

Yes
No
N/A

11.

Does the application include the required illustration utilizing stochastic projections. (This illustration is not required if the plan is not required to appoint a retiree representative under § 432(e)(9)(B)(v)(I) and stochastic projections were not used in making the required determination.) See section
4.02(2).

Yes
No
N/A

12.

Does the application include a demonstration that the proposed suspension is
not projected to materially exceed the level necessary to avoid insolvency,
including illustrations regarding the plan’s solvency ratio and available resources. See section 4.03.

Yes
No
N/A

13.

Does the application include a demonstration that the proposed suspension is
equitably distributed, including

Yes
No
N/A

14.

Does the application include a copy of the actual notices (including redacted
sample calculations) that meet the requirements under § 432(e)(9)(F). See
section 4.05(1).

Yes
No
N/A

15.

Does the application include a description of the efforts that are being taken
to contact participants, beneficiaries in pay status, and alternate payees. See
section 4.05(2).

Yes
No
N/A

16.

Does the application describe the steps the plan sponsor has taken to ensure
that notices delivered electronically are reasonably accessible to the recipients. See section 4.05(3)

Yes
No
N/A

17.

Does the application include a list of each employer who has an obligation
to contribute under the Plan and each employee organization representing
participants under the Plan. See section 4.05(4).

July 6, 2015

Page number
in application

Does the application include a demonstration that the limitations on individual suspensions are satisfied, including calculations regarding:
●
●
●

the guarantee-based limitation,
the disability-based limitation, and
the age-based limitation. See section 4.01.

●
●

a list of the factors taken into account,
an explanation of why none of the factors listed in § 432(e)(9)(D)(vi)
were taken into account (if applicable), and
● how any difference in treatment among categories or groups of individuals results from a reasonable application of the relevant factors.
See section 4.04.

16

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Response
Yes
No
N/A

Item
number
18.

Description of item
Does the application include information on past and current measures taken
to avoid insolvency. See section 5.01.

Yes
No
N/A

19.

Does the application include the plan information required by section 5.02.

Yes
No
N/A

20.

Does the application describe how the plan sponsor took into account – or
did not take into account – the factors listed in section 5.02 in the determination that all reasonable measures were taken to avoid insolvency. See section 5.03.

Yes
No
N/A

21.

Does the application describe how the plan sponsor took into account - or
did not take into account - in the determination that all reasonable measures
have been taken to avoid insolvency the impact of

Page number
in application

●

benefit and contribution levels on retaining active participants and bargaining groups under the plan, and
● past and anticipated contribution increases under the plan on employer
attrition and retention levels. See section 5.03.

Yes
No
N/A

22.

Does the application include a discussion of any other factors the plan sponsor took into account including how and why those factors were taken into
account. See section 5.04.

Yes
No
N/A

23.

Does the application include a copy of the proposed ballot. See section 6.01.

Yes
No
N/A

24.

Does the application indicate whether the plan sponsor is requesting approval from the PBGC of a proposed partition under section 4233 of ERISA.
See section 6.02.

Yes
No
N/A

25.

If the answer to item 24 is yes, does the application specify the effective
date of the proposed partition and include a year-by-year projection of the
amount of the reduction in benefit payments attributable to the partition. See
section 6.02.

Yes
No
N/A

26.

Does the application describe the plan’s experience with certain critical assumptions, including a disclosure for each of the 10 plan years immediately
preceding the application that separately identifies
●
●
●
●
●

Yes
No
N/A

27.

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total contributions,
total contribution base units,
average contribution rates,
withdrawal liability payments, and
the rate of return on plan assets. See section 6.03.

Does the application include deterministic projections of the sensitivity of
the plan’s solvency ratio throughout the extended period by taking into account more conservative assumptions of investment experience and future
contribution base units than assumed elsewhere in the application. See section 6.04.

17

July 6, 2015

Response

Item
number

Yes
No
N/A

28.

Yes
No
N/A

29.

Page number
in application

Description of item
Does the plan include deterministic projections for each year in the extended
period of
●
●
●

the value of plan assets,
the plan’s accrued liability, and
the plan’s funded percentage. See section 6.05.

Does the application include the plan sponsor’s representation that, if it receives the Treasury Department’s final authorization to suspend and then
chooses to implement the suspension, it will also amend the plan
●

to indicate that the suspension will cease upon the plan sponsor’s failure to determine that both all reasonable measures continue to be
taken to avoid insolvency and that the plan is projected to become
insolvent without a suspension,
● to require that any future benefit improvements must satisfy
§ 432(e)(9)(E), and
● to specify that the plan sponsor will not modify these amendments,
notwithstanding any other provision of the plan document.
See section 6.06.
Yes
No
N/A

30.

Does the application indicate whether the plan is a plan described in
§ 432(e)(9)(D)(vii)(III) and, if so, how is that fact reflected in the proposed
benefit suspension. See section 6.07.

Yes
No
N/A

31.

Does the application include the required plan sponsor information, including
●
●
●
●
●
●
●

name
address
telephone number
email address
fax number
employer identification number (EIN) and
3-digit plan number (PN).

See section 7.01.
Yes
No
N/A

32.

Does the application include the required plan identification information. See
section 7.02.

Yes
No
N/A

33.

Does the application include the required retiree representative information
(if applicable). See section 7.03.

Yes
No
N/A

34.

Does the application include the required enrolled actuary information. See
section 7.04.

Yes
No
N/A

35.

Does the application include a designation of power of attorney for each
authorized representative who will represent the plan sponsor in connection
with the application. See section 7.05 and Appendix B.

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Response
Yes
No
N/A

Item
number
36.

Description of item

Page number
in application

Does the application include
●
●
●
●
●

the required plan documents,
any recent amendments,
the summary plan description (SPD),
the summary of material modifications, and
the most recent determination letter.

See section 7.06.
Yes
No
N/A

37.

Does the application include the required excerpts from the relevant collective bargaining agreements and side agreements. See section 7.07.

Yes
No
N/A

38.

Does the application include the required excerpts from the most recently
filed Form 5500. See section 7.08.

Yes
No
N/A
Yes
No
N/A

39.

Does the application include the most recently updated rehabilitation plan.
See section 7.09.

40.

Does the application include this checklist, completed and placed on top of
the application. See section 7.10.

Signature

Date

Title or Authority
Typed or printed name of person signing checklist

Bulletin No. 2015–27

19

July 6, 2015