Final SECURE Act 5500 FR Notice Published 12.29.21

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DEPARTMENT OF LABOR
Employee Benefits Security
Administration
29 CFR Part 2520
RIN 1210–AB97

Revision of Annual Information Return/
Reports
Employee Benefits Security
Administration, Labor.
ACTION: Final forms revisions.
AGENCY:

This document contains final
revisions to the instructions for the
Form 5500 Annual Return/Report of
Employee Benefit Plan and Form 5500–
SF Short Form Annual Return/Report of
Small Employee Benefit Plan effective
for plan years beginning on or after
January 1, 2021. These final revisions to
the instructions were included in a
broader proposal of form and
instruction changes published on
September 15, 2021. The limited
number of instruction changes in this
document implement annual reporting
changes for multiple-employer plans
(including pooled employer plans) that
result from statutory provisions in
section 101 of the Setting Every
Community Up for Retirement
Enhancement Act of 2019 (SECURE
Act). The other changes to the Form
5500 Annual Return/Report included in
the September 2021 proposal will be the
subject of one or more separate and later
final notices.
DATES: The final instruction revisions in
this document are effective for plan
years beginning on or after January 1,
2021. The Form 5500 Annual Return/
Report for the 2021 plan year generally
is not required to be filed until seven
months after the end of the 2021 plan
year, e.g., July 2022 for calendar year
plans, and a 21⁄2-month extension is
available.
SUMMARY:

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FOR FURTHER INFORMATION CONTACT:

Janet Song or Florence Novellino, Office
of Regulations and Interpretations,
Employee Benefits Security
Administration, U.S. Department of
Labor, (202) 693–8500, (this is not a tollfree number).
Customer service information:
Individuals interested in obtaining
information from the DOL concerning
Title I of Employee Retirement Income
Security Act of 1974 (ERISA) may call
the EBSA Toll-Free Hotline at 1–866–
444–EBSA (3272) or visit the DOL’s
website (www.dol.gov/agencies/ebsa).
SUPPLEMENTARY INFORMATION:

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I. Background
Titles I and IV of Employee
Retirement Income Security Act of 1974
(ERISA) and the Internal Revenue Code
(Code), generally require pension and
other employee benefit plans to file
annual returns/reports concerning,
among other things, the financial
condition and operations of the plans.
Filing a Form 5500 Annual Return/
Report of Employee Benefit Plan (Form
5500) or, if eligible, a Form 5500–SF
Short Form Annual Return/Report of
Small Employee Benefit Plan (Form
5500–SF), together with any required
schedules and attachments (together
‘‘the Form 5500 Annual Return/
Report’’),1 in accordance with their
instructions, generally satisfies these
annual reporting requirements. ERISA
section 103 broadly sets out annual
financial reporting requirements for
employee benefit plans under Title I of
ERISA. The Form 5500 Annual Return/
Report for Title I purposes is
promulgated pursuant to DOL
regulations under the ERISA provisions
authorizing limited exemptions and
simplified reporting and disclosure for
welfare plans under ERISA section
104(a)(3), simplified annual reports
under ERISA section 104(a)(2)(A) for
pension plans that cover fewer than 100
participants, and alternative methods of
compliance for all pension plans under
ERISA section 110. The Form 5500
Annual Return/Report, and related
instructions and regulations, are also
promulgated under the DOL’s general
regulatory authority in ERISA sections
109 and 505.
The Setting Every Community Up for
Retirement Enhancement Act of 2019
(SECURE Act), included various
provisions designed to improve the
private employer-based retirement
system that either directly changed or
necessitated changes to the annual
reporting requirements under ERISA
and the Code.2 On September 15, 2021,
the DOL, the Internal Revenue Service
(IRS), and the Pension Benefit Guaranty
Corporation (PBGC) (collectively ‘‘the
Agencies’’) published a notice of
proposed forms revisions (NPFR) to
amend the Form 5500 Annual Return/
Report to implement the SECURE Act
and related reporting changes with a

limited number of proposed forms
revisions beginning with the 2021
reporting year; with most of the
proposed revisions not applying until
the 2022 reporting year. 86 FR 51488
(Sept. 15, 2021). The DOL
simultaneously published a proposed
rulemaking (NPRM) required to
implement the proposed forms
revisions. 86 FR 51284 (Sept. 15, 2021).
The Agencies received 114 comments
on the NPFR and NPRM. The
comments, which were all posted on the
Department’s website, generally focus
on the proposed changes for the 2022
plan year forms. This document is
limited to the changes for the 2021 plan
year forms. Specifically, the reporting
changes are revisions to the instructions
that: (1) Implement the SECURE Act
amendment to ERISA section 103(g) by
requiring multiple employer defined
contribution pension plans to include
aggregate account balance information
by employer on their existing Form
5500 attachment on participating
employer information; and (2) noting
that a pooled employer plan is a
multiple employer plan that files a
single Form 5500 Annual Return/
Report, and requiring such plans to
indicate in an attachment to their Form
5500 (i) whether the plan’s pooled plan
provider complied with the Form PR
registration requirements for pooled
plan providers; and (ii) if the answer is
yes, to provide the AckID number for
the pooled plan provider’s latest Form
PR filing.3 Although not a change to the
instructions, in response to comments
raising the issue, this document also
advises filers that the Department is
continuing the current requirement that
welfare plans that file a Form 5500 must
include participating employer
information notwithstanding that the
SECURE Act amended ERISA section
103(g) to limit that specific section to
retirement plans. No changes to the
DOL’s implementing regulations are
required for these instruction changes.
The Agencies intend to address the
other changes to the Form 5500 and
related regulations proposed in the
September 2021 NPFR and NPRM in
one or more other separate and later
Notices of Adoption of Final Forms
Revisions and Notices of Final
Rulemaking. The instruction changes

1 References to the ‘‘Form 5500 Annual Return/
Report’’ may include, depending on the context, the
Form 5500, the Form 5500–SF, and the Form 5500–
EZ, Annual Return of One Participant (Owners and
Their Spouses) Retirement Plan. The Form 5500–EZ
is a return that is required only to satisfy the Code.
Form 5500–EZ filers are not subject to Title I of
ERISA.
2 The SECURE Act was enacted on December 20,
2019, as Division O of the Further Consolidated
Appropriations Act, 2020 (Pub. L. 116–94).

3 These requirements for pooled employer plans
are limited to the Form 5500 because the Form
5500–SF instructions provide, consistent with the
proposal, that pooled employer plans are not
eligible to file the Form–SF. The proposal would
also have required that all multiple employer plans
file the Form 5500 regardless of whether they
would otherwise be eligible to file the Form 5500–
SF. The Department is not adopting that change for
all MEPs in the 2021 forms but intends to address
that proposed change in a separate and later Notice.

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being added beginning with the 2021
reporting year are discussed below.
II. 2021 Form 5500 Annual Return/
Report Changes for MEPs and Pooled
Empoyer Plans
SECURE Act section 101 amended
ERISA section 3(2) and added ERISA
sections 3(43) and 3(44) to allow for a
new type of ERISA-covered multiple
employer pension plan (MEP) for plan
years beginning on or after January 1,
2021—a defined contribution pension
plan called a ‘‘pooled employer plan’’
operated by a ‘‘pooled plan provider.’’
Pooled employer plans allow multiple
unrelated employers to participate
without the need for any common
interest among the participating
employers (other than having adopted
the plan). Under section 3(2) of ERISA,
as amended by the SECURE Act, a
pooled employer plan is treated for
purposes of ERISA as a single plan that
is a multiple employer plan. New
section 3(44) of ERISA establishes
requirements for pooled plan providers,
including a requirement to register with
the DOL before beginning operations as
a pooled plan provider. A parallel
requirement to file a registration
statement with the Secretary of Treasury
is in section 413(e)(3)(A)(ii) of the Code.
On November 16, 2020, the DOL
published a notice of final rulemaking
establishing the registration requirement
for pooled plan providers. 85 FR 72934
(Nov. 16, 2020). The Treasury
Department and the IRS have advised
that filing the Form PR with the DOL
will satisfy the requirement to register
with the Secretary of the Treasury. The
instructions to the Form PR (Pooled
Plan Provider Registration) (Form PR)
advised registrants to use the same
identifying information on the Forms
5500 Annual Return/Report filed by the
pooled employer plans, particularly
name; EIN for the pooled plan provider;
any identified affiliates providing
services; trustees; and plan name and
number for each pooled employer plan.
Section 101 of the SECURE Act also
amended ERISA section 103(g), effective
for plan years beginning on or after
January 1, 2021. Section 103(g) was
added to ERISA by the Cooperative and
Small Employer Charity Pension
Flexibility Act (CSEC Act) in 2014.4
Prior to the SECURE Act amendment,
section 103(g) required multiple
employer plans to include with their
annual reports ‘‘a list of participating
employers’’ and, with respect to each
participating employer, ‘‘a good faith
estimate of the percentage of total
contributions made by such
4 Public

Law 113–97 (Apr. 7, 2014).

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participating employer during the plan
year.’’ In response to the CSEC Act, the
Form 5500 instructions for 2014 and
later were amended to provide for all
multiple employer plans to include the
section 103(g) information as a
nonstandard attachment.5 SECURE Act
section 101(d) amended ERISA section
103(g) by providing that annual reports
for ‘‘any plan to which [ERISA] section
210(a) applies (including a pooled
employer plan)’’ also must include two
additional pieces of information: (1) The
aggregate account balances attributable
to each employer in the plan
(determined as the sum of the account
balances of the employees of such
employer and the beneficiaries of such
employees), and (2) with respect to a
pooled employer plan, identifying
information for the person designated
under the terms of the plan as the
pooled plan provider.
As discussed in the NPFR, the
statutory establishment of pooled
employer plans as a type of multiple
employer plan under Title I of ERISA
requires some adjustments to the Form
5500 Annual Return/Report to
acknowledge the existence of this new
type of plan and to confirm that pooled
employer plans must file a Form 5500
Annual Return/Report in accordance
with the requirements that apply to
other MEPs that file the Form 5500. The
adjustments to accommodate pooled
employer plan reporting on the Form
5500 were presented in the NPFR
largely in the form of a new proposed
Schedule MEP and its instructions that
would be a required part of the Form
5500 Annual Return/Report for various
types of MEPs, including pooled
employer plans. As proposed, however,
the Schedule MEP would not be
effective until plan years beginning on
or after January 1, 2022, but under the
SECURE Act, pooled employer plans
could begin operating for plan years
beginning on or after January 1, 2021. In
order to implement core elements of the
SECURE Act section 101(d) reporting
requirements on a timely basis, the
NPFR included proposed amendments
to the instructions for the 2021 Form
5500 and Form 5500–SF, specifically for
the multiple-employer plan check box
that is currently on Part I, line A of the
Form 5500 and Form 5500–SF. Upon
review of the public comments, the
Department continues to believe that
amending those instructions is an
efficient and appropriate way to provide
for the reporting of ERISA section 103(g)
information for the 2021 reporting year.
5 79

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Specifically, the instructions to the
2021 Form 5500 6 for Part I, Line A (the
multiple-employer plan checkbox) are
being amended to note that (1) a pooled
employer plan operated by a pooled
plan provider that meets the definition
under ERISA section 3(43) is a multiple
employer plan, and (2) like other
ERISA-covered pension MEPs, a single
Form 5500 Annual Return/Report is
required to be filed for a pooled
employer plan.7 The 2021 instructions
to the Form 5500 and Form 5500–SF for
the multiple-employer plan check box
are being further amended to require
MEPs to include a new data element on
the currently required 2021 nonstandard attachment, specifically the
‘‘Aggregate Account Balances
Attributable to Participating Employer’’
(element 4). The instructions to the
multiple-employer plan check box
currently provide that the Annual
Return/Report filed for a multipleemployer plan (MEPs and multiple
employer welfare plans) must include a
non-standard attachment that identifies
the participating employers in the plan
by name and employer identification
number (EIN) and include for each
participating employer an estimate of
6 As noted above, pooled employer plans are not
eligible to file the Form 5500–SF so the instructions
describing the pooled employer plan’s status as a
MEP are not being added to the Form 5500–SF
instructions.
7 A commenter presenting itself as representing
accounting industry interests asked for clarification
regarding audit requirements for pooled employer
plans. To some extent, however, the comment
incorrectly assumed that a pooled employer plan
operates as an aggregation of many plans, rather
than as a single ERISA-covered plan. For example,
the commenter asked ‘‘If a pooled employer plan is
comprised of hundreds of plans, will each plan be
required to be audited annually?’’ The commenter
also asked ‘‘If the DOL permits rotation of audit
procedures for plans participating in a pooled
employer plan, how will that be determined?’’ The
commenter also asked ‘‘Will the DOL provide
guidance for the auditor if there are one or more
plans within the pooled employer plan that are not
compliant with the plan document or with ERISA?’’
A pooled employer plan, like other MEPs, is a
single plan covering the employees of multiple
employers. It is not comprised of multiple separate
plans, as would be true of the proposed new direct
filing entity the ‘‘DCG.’’ The Department notes that
nothing in the SECURE Act changed the ERISA
independent qualified public accountant (IQPA)
audit requirements as they apply to pooled
employer plans. Rather, under ERISA, pooled
employer plans are subject to the Form 5500
Annual Return/Report requirements that apply
generally to employee pension benefit plans,
including the audit requirements under ERISA that
apply to employee pension benefit plans generally.
As such, the audit must be performed in accordance
with Generally Accepted Auditing Standards
(GAAS), which are established by the accounting
industry not the Department. How GAAS applies to
pooled employer plans, including any differences
in audit procedures that may be required under
GAAS, are issues that are beyond the scope of these
forms revisions.

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the percentage of total contributions for
the plan year made by each employer.8
Some commenters asked that the
Department interpret the SECURE Act’s
requirement to report employer-level
aggregate account balances as applying
only to defined contribution MEPs. The
commenters noted that neither the
operative language of the SECURE ACT
nor its legislative history support
applying this requirement to defined
benefit pension plans that do not
maintain ‘‘account balances’’ for each
employee. Two of these commenters
noted that this requirement is
particularly inappropriate for defined
benefit MEPs established before 1989
that determine their minimum funding
requirements as if all participants were
employed by a single employer and,
therefore, did not elect ‘‘employer-byemployer’’ treatment under the
Technical and Miscellaneous Revenue
Act of 1988 (TAMRA). One of the
commenters also noted that participants
already receive annual funding notices
on their defined benefit pension plan, so
reporting of an artificial ‘‘account
balance’’ could give the false impression
that, in these MEPs, specific assets are
set aside to provide benefits for
employees of each employer when, in
fact, all of the assets of a defined benefit
MEP (like any other defined benefit
pension plan) are available to pay all of
the benefits of all of the participants in
that MEP, regardless of where the
participants are employed.
The Department agrees that the
SECURE Act’s requirement to report
employer-level aggregate account
balances should not apply to defined
benefit pension MEPs. The SECURE Act
expressly states that the aggregate
account balances attributable to each
employer in the plan is to be
determined ‘‘as the sum of the account
balances of the employees of such
employer (and the beneficiaries of such
employees).’’ Although the SECURE Act
amended ERISA section 103(g) to
provide that it applies to plans subject
to ERISA section 210(a), and there may
be a relatively small number of defined
benefit MEPs that are subject to ERISA
section 210(a), in the Department’s
view, it would not be a reasonable
reading of the statutory text to conclude
that Congress intended by the reference
to ERISA section 210(a) to mandate that
aggregate account balance information
8 The instruction further provides that unfunded,
fully insured, or combination unfunded/insured
multiple employer welfare plans that are exempt
under 29 CFR 2520.104–44 from filing financial
statements with their annual report must attach a
list of participating employers, but do not have to
include an estimated amount of contributions from
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be reported by defined benefit plans that
do not maintain account balances for
covered participants. Accordingly, the
final instructions for the 2021 reporting
year provide that only defined
contribution MEPs must report the new
SECURE Act required employer-level
aggregate account balances.
One commenter requested
clarification of the requirement to report
the ‘‘Percentage of Total Contributions
for the Plan Year’’ (element 3 for the
2021 non-standard attachment).
Specifically, the commenter asked
whether the total of all participating
employers must equal 100 percent, and
whether it will cause red flags with the
DOL/IRS if it does not. They also asked
whether filers should round the
percentage entry for each employer to
decimal places, and if so, how many.
The Department read these commenter’s
questions as primarily directed at issues
that may arise when in the context of a
standardized Schedule MEP structure
for reporting this information. The
Agencies will take into account such
questions in designing the form and
developing appropriate instructions and
edit tests. For the 2021 reporting year,
as noted above, the instructions will
continue to allow filers to use a nonstandard attachment to report the
required information. The Department
also notes that this is not a new
reporting requirement. It has been part
of the Form 5500 since it was added in
2014 in response to the CSEC Act
addition of section 103(g) to Title I of
ERISA. Nonetheless, for the 2021
reporting year, it would be acceptable
for filers to round to the nearest whole
number similar to rounding conventions
that apply to the Form 5500 financial
statements and schedules. To the extent
the filer’s concern is whether rounding
could result in the total reported
percentage either slightly above or
slightly below 100 percent, the filer can
indicate that on the non-standard
attachment as part of its filing.
A commenter asked for guidance on
the asset values that should be used for
the ‘‘Aggregate Account Balances
Attributable to Participating Employer’’
(element 4 for the 2021 non-standard
attachment) and, in particular, whether
the end of year net value may be used
based on the values reported on the
Schedules H and I. The SECURE Act
expressly states that the aggregate
account balances information should be
determined as the sum of the account
balances of the employees of such
employer and the beneficiaries of such
employees. In the Department’s view, an
end of year valuation is an appropriate
reporting requirement as it will provide
the most up to date value for the plan

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year covered by the Form 5500 report.
The final instructions include directions
to that effect. Further, rounding to the
nearest dollar, as with the financial
reporting on other parts of the Form
5500 and schedules, would be
appropriate. The final instructions have
been revised to provide this clarification
as well.9
With respect to the additional ERISA
section 103(g) information regarding
pooled employer plans that must be
included for the 2021 reporting year, the
Department had proposed that the
substance of the proposed Schedule
MEP changes would apply to the 2021
reporting year requirements except that
the information could be filed as a nonstandard attachment. The Department
received comments opposing or
expressing concern about some
elements of the proposed Schedule
MEP. Since the Department intends to
address those comments and resolve the
Schedule MEP content requirement in a
later final rule, the Department agrees
that it would be premature to impose
the requirements wholesale to the 2021
Form 5500 Annual Return/Reports.
Rather, for the 2021 reporting year, in
addition to the participating employer
information required for all MEPs,
pooled employer plans only will be
required to indicate, on a non-standard
attachment, whether they are in
compliance with the Form PR
registration requirements and provide
the AckID number for their latest Form
PR filing.10
Some commenters complained that
pooled employer plans should not be
required to provide the AckID number,
claiming that this requirement was
unnecessary because the Department
already has the Form PR and issued the
AckID number. Some commenters
suggested that asking any questions
about the pooled plan provider was
duplicative of the Form PR and that the
‘‘AckID’’ could be found by a separate
9 The Department understands from some
comments on the proposal that, depending on the
treatment of receivables and forfeitures by the plan,
the sum of the account balances of the employees
of each employer and the beneficiaries of such
employees may not match the net asset value
reported on Schedule H or I. The Department
believes that the aggregate account balance
information should be calculated and reported in
accordance with the statutory direction in the
SECURE Act. Filers can add an explanatory
statement to the extent they wish to explain any
difference between that sum and other total asset
values reported on the Form 5500.
10 AckID is the acknowledgement code generated
by the system in response to a completed filing for
the most recent Form PR submitted. The
instructions to the Form PR advise the pooled plan
provider that it must keep, under ERISA section
107, the electronic receipt for the Form PR filing as
part of the records of the pooled employer plans
operated by the pooled plan provider.

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internet search. A few commenters also
argued that pooled employer plans
should not be subject to special
reporting standard and that subjecting
pooled employer plans to heightened
scrutiny, when other plans treated as
single plans are not, is arbitrary and
unsupported by statute. A commenter
further argued that the question
regarding whether the pooled plan
provider is currently in compliance
with the Form PR (Pooled Plan Provider
Registration Statement) requirements is
ambiguous and unclear, given the lack
of guidance and pending agency
rulemakings (e.g., IRS’ one bad apple
guidance).
The Department disagrees with the
commenters opposing the collection of
information regarding the Form PR. In
the preamble to the final regulation
establishing the Form PR, the DOL
specifically noted that it would add new
questions on the Form 5500 that would
ask whether a pooled plan provider
filed its registration statement with the
Secretary, including any required
updates, and to report the electronic
confirmation number provided to the
pooled plan provider at the time that the
registration was received. Further, as
explained in the preamble to the
proposal to add this information
collection item for pooled employer
plans, the questions related to the Form
PR are intended to provide the
Department, the Treasury Department,
the IRS, participating employers, and
other stakeholders with information that
would allow them to connect the Form
PR registration with the Form 5500 for
all pooled employer plans operated by
the registrant. 85 FR 72934, 72946 (Nov.
16, 2020). In fact, one commenter
representing retirees and plan
participants specifically indicated its
support for requesting the ‘‘AckID’’ to
help workers and retirees keep track of
their assets and the plan, especially
with the anticipated limited
involvement of their employer in the
design of pooled employer plans. Also,
as discussed above, SECURE Act section
101(d) specifically requires the annual
report of pooled employer plans to
include identifying information for the
person designated under the terms of
the plan as the pooled plan provider.
Thus, the requirement is neither
arbitrary nor unsupported by the statute.
The AckID requirement is also similar to
the questions currently on the Form
5500 that require multiple employer
group health plans to report about their
compliance with registration and
reporting requirements on the Form M–
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Entities Claiming Exception (ECEs)).
The Department also does not agree that
the filing requirements are ambiguous,
that there is a lack of guidance regarding
the filing requirement, or that it is unfair
to require pooled employer plans to
report on the registration status of their
pooled plan providers. Unlike other
ERISA-covered multiple employer
plans, the SECURE Act expressly sets
forth roles and responsibilities for
pooled plan providers. One of those
clear requirements is that the pooled
plan provider must register with the
Department and with the IRS. The Form
PR was adopted after public notice and
comment to implement a specific
registration requirement added to ERISA
by the SECURE Act. The Form PR also
includes instructions for completing the
form, which also were developed as part
of the notice and comment rulemaking
process. The Form 5500 is signed by the
plan administrator stating that the
administrator has reviewed the filing
and that ‘‘to the best of my knowledge
and belief, it is true, correct, and
complete.’’ In the case of a pooled
employer plan, the pooled plan provider
is the administrator. Pooled plan
providers should be able to say whether
they believe the Form PR filing
requirements have been met. In the
Department’s view, it does not impose
any meaningful burden on the pooled
plan provider acting as the plan
administrator to acknowledge on the
plan’s Form 5500 annual report that it
believes to the best of the pooled plan
provider’s knowledge and belief that it
has fulfilled its statutory registration
obligation. Further, the DOL continues
to believe that linking the Form PR filed
by a pooled plan provider to the Forms
5500 is a reasonable method to help
make sure that workers, retirees, and the
agencies charged with oversight have
the information they need to be sure
that the Form PR information is
consistent and up to date. For example,
having the AckID number on the plan’s
Form 5500 will assist plan participants
and participating employers in finding
the relevant Form PR on the
Department’s website. The requirement
to report Form PR compliance
information on the Form 5500 will also
help the Department ensure compliance
with those registration requirements.
While there is no explicit civil penalty
for failing to file a Form PR, there is a
civil penalty for failing to file a
complete and accurate Form 5500. See
ERISA section 502(c)(2); 29 CFR
2560.502(c)(2) and the Federal Civil
Penalties Inflation Adjustment Act of
1990.

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Finally, with respect to the
requirement that multiple employer
welfare plans file the participating
employer information as a non-standard
attachment to the 2021 Form 5500
Annual Return/Report, one commenter
representing retirees and plan
participants specifically indicated its
support for continuing to require
multiple employer welfare plans to
provide participating employer
information. Two commenters argued to
the contrary that the DOL could no
longer ask multiple employer welfare
plans to report any participating
employer information because Congress,
by amending ERISA section 103(g) to
add a reference to plans subject to
ERISA section 210(a), was explicitly
saying that welfare plans should no
longer report such information. One of
the commenters noted that DOL had
cited ERISA section 103(c)(2) as
separate authority for DOL to require
welfare plans to report such
information, but argued that section
103(c)(2) was not applicable because the
DOL is not establishing this reporting
requirement to obtain ‘‘the name and
address of each fiduciary’’ but rather to
reinstate a reporting requirement that
was repealed by the SECURE Act.
Although the DOL agrees that ERISA
section 103(g) technically is not
applicable to welfare plans as a result of
the SECURE Act amendment, the DOL
does not agree the SECURE Act
amendment precludes its continued
collection of participating employer
information on the Form 5500 from
multiple employer welfare plans.11
Rather, DOL continues to believes that
the addition of the reference to ERISA
section 210(a) was meant to emphasize
that defined contribution MEPs,
including association retirement plans,
professional employer organization
plans (PEOs), and the newly created
pooled employer plan, are required to
comply with the participating employer
reporting requirements. The DOL does
not believe that the amendment was
intended to preclude the Department
from relying on other annual reporting
authorities to collect participating
employer information about multiple
employer welfare arrangements
(MEWAs). In the DOL’s view, receiving
participating employer information from
MEWAs, including multiple employer
welfare plans, is important for oversight
11 This final rule does not address comments on
the proposal in the NPFR to move the participating
employer questions to the Form M–1 for MEWA
plans and arrangements that provide medical
benefits. As noted above, the proposals relating to
changes for the 2022 reporting year will be
addressed in a later, separate Federal Register
notice.

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of such arrangements by the Department
and monitoring such arrangements by
employers and plan participants and
beneficiaries. This transparency about
participating employers is supported by
congressional findings in ERISA section
2 (Congressional Findings and
Declaration of Policy), which provides,
in relevant part, that ‘‘[i]t is hereby
declared to be in the policy of this Act
to protect interstate commerce and the
interests of participants in employee
benefit plans and their beneficiaries, by
requiring the disclosure and reporting to
participants and beneficiaries of
financial and other information with
respect thereto. . . .’’ In addition, the
Committee Report on ERISA provided
that ‘‘[t]he Subcommittee intended that
Congress provide for greater legislative
protection for beneficiaries of pension
plans through detailed public disclosure
of the administration and operation of
private pension plans.’’ S. Rep. 93–127
(Apr. 18, 1973).
DOL is also continuing to rely on
ERISA section 103(c)(2) and its general
regulatory authority under ERISA
section 505 as authority for requiring
multiple employer welfare plans to
continue reporting the participating
employer information for the 2021 plan
year filing.12 As discussed in the NPFR,
in the DOL’s view, each participating
employer is acting as a fiduciary with
respect to its decision to join the MEWA
and provide ERISA-covered benefits
through a MEWA, and has ongoing
fiduciary obligations to monitor the plan
and confirm that continued
participation in the plan is prudent and
in the best interests of its employees
who are covered participants in the
plan.13 Nothing in ERISA section
12 ERISA section 103(c)(2) states that the
administrator shall furnish as a part of a plan’s
annual report ‘‘(2) The name and address of each
fiduciary.’’ ERISA section 505 provides the
Department with general authority, subject to
certain limits not relevant here, to ‘‘prescribe such
regulations as he finds necessary or appropriate to
carry out the provisions of this subchapter.’’
13 See also Advisory Opinion 2007–06A (Aug. 16,
2007) (‘‘decisions regarding the method through
which benefits are to be paid under an employee
welfare benefit plan, including the selection of an
insurer and the negotiation of the terms of any
contractual arrangement obligating the plan, are
matters that generally are subject to the fiduciary
responsibility provisions of Title I of ERISA’’.);
Information Letter to Diana Ceresi (Feb. 2, 1998)
(‘‘when the selection of a health care provider
involves the disposition of employee benefit plan
assets, such selection is an exercise of authority or
control with respect to the management and
disposition of the plan’s assets within the meaning
of section 3(21) of ERISA, and thus constitutes a
fiduciary act . . .’’); Advisory Opinion 2018–01A
(Nov. 5, 2018) (In the context of a pension plan
rollover service provider, not covered by Title 1 of
ERISA, ‘‘When plan sponsors or other responsible
fiduciaries choose to have a plan participate in the
RCH Program, they are acting in a fiduciary

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103(c)(2) precludes the Department from
relying on that authority to collect
information about a particular class or
group of fiduciaries as opposed to
requiring the identification of all plan
fiduciaries in general. See also ERISA
section 104(a)(3) (authority to exempt
welfare benefit plans from all or part of
Title I reporting and disclosure
requirements). With respect to its
general regulatory authority under
ERISA section 505, the Department
explained in the preamble to the
proposal that the participating employer
information has proven useful to the
DOL for its oversight functions for both
MEPs and those MEWAs that file the
Form 5500, regardless of the types of
benefits provided by the MEWA. 86 FR
at 51498. This reporting requirement is
also relevant to the Department’s
enforcement of the criminal penalties
added by the Affordable Care Act under
ERISA section 519 for any person who
knowingly submits false statements or
false representations of fact in
connection with a MEWA’s financial
condition (including a plan MEWA), the
benefits it provides, or its regulatory
status as a MEWA. In light of the fact
that participating employers in a MEWA
would likely be the recipients of such
false statements or representations,
having data regarding the participating
employers in a MEWA plan would be
useful in policing whether such false
statements or representations are being
made to participating employers.
Two commenters argued that
reporting of employer names and EINs
(and the health plan to which they are
linked) on a publicly available
document exposes plan participants and
beneficiaries and their employers to
potential cybersecurity fraud. They also
argued that the list of participating
employers and contribution percentage
information is proprietary information
and contended that making the
information publicly available would
negatively impact businesses and their
employees. The commenters did not
offer empirical evidence or other data to
support their assertions about
consequences to plan participants and
beneficiaries or the participating
employers’ businesses. This reporting
requirement has been in place since the
2014 plan year and the Department is
not aware of any such consequences
resulting from the disclosure
requirement. In fact, the more powerful
argument here is likely that employers
have the freedom to choose to change
capacity, and would be subject to the general
fiduciary standards and prohibited transaction
provisions of ERISA in selecting and monitoring the
RCH Program.’’)

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plans or plan service providers, are
undoubtedly receiving marketing
solicitations about these matters now,
and that transparency about which
employers participate in a plan MEWA
may well generate competitive pressures
to offer better services at lower fees.
The DOL also has addressed similar
arguments on several prior occasions in
the context of the ERISA section 103(g)
requirement for multiple employer
plans to include participating employer
information as part of the Form 5500
Annual Return/Report. For example, in
a 2019 Field Assistance Bulletin, the
DOL noted that it had received and
considered similar objections in
connection with the Paperwork
Reduction Act (PRA) notice associated
with the publication of the interim final
rule on ERISA section 103(g) that
implemented the CSEC Act
requirement. See Proposed Extension of
Information Collection Request
Submitted for Public Comment;
Revisions to Annual Return/Report—
Multiple-Employer Plans, 79 FR 66741
(Nov. 10, 2014) (available at
www.govinfo.gov/content/pkg/FR-201411-10/pdf/2014-26499.pdf). The DOL
also pointed out, in its 2016 Federal
Register notice regarding proposed
modernization of the Form 5500, that
DOL addressed this issue when it
explained its decision at that time not
to propose changes to the ERISA section
103(g) reporting requirements. See Form
5500 Improvement and Modernization
Proposal—Proposed Revision of Annual
Information Return/Reports, 81 FR
47534, 47564–47565 (July 21, 2016)
(available at www.govinfo.gov/content/
pkg/FR-2016-07-21/pdf/201614893.pdf). In the SECURE Act itself
Congress reaffirmed and in fact
expanded the requirements for reporting
participating employer information on
the Form 5500. The Department does
not believe that a different conclusion
regarding these arguments is warranted
just because they are now being
presented separately for welfare plans.
Although, as noted above, after the
SECURE Act amendment the specific
reporting requirement in ERISA section
103(g) technically is not applicable to
welfare plans, the Department does not
view the SECURE Act amendment as an
acknowledgement that the cybersecurity
and confidential information arguments
being pressed by these commenters
somehow now has merit with respect to
just welfare plans notwithstanding the
fact that multiple employer welfare
plans have been required to file the
participating employer information
since the 2014 reporting year. The
Department also continues to be of the

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view that an employer’s sponsorship or
participation in an ERISA-covered plan
is not confidential information.14
Employers that sponsor single employer
plans are identified on the plan’s Form
5500, and we do not see the identity of
a sponsoring employer in a multiple
employer plan as somehow different for
annual reporting and disclosure
purposes. Similarly, the purported
cybersecurity issues noted by the
comments (e.g., ‘‘spoofing’’ of either the
MEWA itself, or the MEWA’s health
insurer, in order to generate a phishing
attack) are not different for an employer
(including small employers) identified
on a single-employer Form 5500
compared to a participating employer
identified on a multiple employer Form
5500. In the Department’s view, Form
5500 reporting of participating employer
information is just as important for
multiple employer welfare plans as
retirement plans because it provides
important information for oversight of
such arrangements by the Department
and monitoring such arrangements by
employers and plan participants and
beneficiaries. Accordingly, multiple
employer welfare plans will continue to
be required to file the participating
employer information as a non-standard
attachment to the 2021 Form 5500
Annual Return/Report, as they have
been required to do since the 2014 plan
year filing.
III. Regulatory Impact Analysis

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1. Executive Order 12866
This Final Rule does not constitute a
‘‘significant regulatory action’’ for
purposes of Executive Order 12866. The
changes are minor additions to existing
reporting requirements that in large part
14 Prior guidance issued by the Department has
generally rejected allegations of possible harm due
to disclosure of reporting information in favor of the
policy reasons in favor of public disclosure. See,
e.g., Aug. 14, 1994, letter to David Mintz (noting
ERISA policy of public disclosure and rejecting
concerns raised that the Form 5500 series is
available to organizations that compile and sell to
the public a directory of employee benefit plan
information); April 7, 1978, letter to Congressman
Harley O. Staggers (concluding nothing in section
110 supported changing the requirement, in
response to claims that because personal financial
information possibly could be calculated from
103(b)(3)(B) requirement for plans to include in
their annual report a statement of receipts and
disbursements during the preceding twelve-month
period aggregated by general sources and
applications, and thus should be treated as
confidential information); July 23, 1981, letter to
Mr. T.C. Heyward, Jr. (contested information did
not fit within 106(b) exception from public
disclosure and nothing in section 110 warranted
omission from the annual report required
information on distribution of benefits and
payments directly to participants or their
beneficiaries and total annual contribution of the
sponsoring organization on the grounds that the
information constitutes an invasion of privacy).

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merely adopt requirements set forth in
statutory amendments to the annual
reporting requirements that apply under
ERISA and the Code. Therefore, this
action has not been reviewed by OMB
pursuant to the Executive Order.
Pursuant to the Congressional Review
Act, OMB has determined that this final
rule is not a ‘‘major rule,’’ as defined by
5 U.S.C. 804(2).
2. Paperwork Reduction Act
In accordance with the Paperwork
Reduction Act of 1995 (PRA 95) (44
U.S.C. 3506(c)(2)(A)), the Department
solicited comments concerning the
information collection request (ICR)
included in the revision of the Form
5500 Annual Return/Report. At the
same time, the Department also
submitted an information collection
request (ICR) to the Office of
Management and Budget (OMB), in
accordance with 44 U.S.C. 3507(d).
The Department did not received
comments that specifically addressed
the paperwork burden analysis of the
information collection requirement
contained in the proposed rule.
In connection with publication of this
final rule, the Department is submitting
an ICR to OMB requesting a revision of
the collection of information under
OMB Control Number 1210–0110
reflecting the instruction changes being
finalized in this document. The
Department will notify the public when
OMB approves the ICR.
A copy of the ICR may be obtained by
contacting the PRA addressee shown
below or at www.RegInfo.gov. PRA
ADDRESSEE: Address requests for
copies of the ICRs to James Butikofer,
Office of Research and Analysis, U.S.
Department of Labor, Employee Benefits
Security Administration, 200
Constitution Avenue NW, Room N–
5655, Washington, DC 20210.
Telephone: (202) 693–8410; Fax: (202)
219–4745; Email: [email protected].
These are not toll-free numbers. ICRs
submitted to OMB also are available at
http://www.RegInfo.gov.
The burden analysis is based on data
from the 2019 Form 5500 filings (the
latest year for which complete data are
available). The burden analysis includes
the burden of the current information
collection and adjusts it for changes
made by the final rule.
Burden estimates take into account
the changes in plan counts due to the
creation of pooled employer plans, with
an increase in multiple-employer plans
and a small decrease in single employer
plans, reflecting some single employer
plans moving to pooled employer plans.
The agencies estimated that there are
4,538 defined contribution multiple-

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employer pension plans and that 75
pooled employer plans will be formed.
Reporting the information about
participating employers required by the
changes being finalized in this
document should not be burdensome for
defined contribution multiple-employer
plan administrators as current
requirements under ERISA already
require them to maintain a list of
participating employers and records of
the contributions made by each
employer. Although likely an
overestimate of the actual time required,
to ensure that we are not
underestimating the potential burden,
the Department is using an estimate of
on average 30 minutes to comply with
the new question for defined
contribution MEPs regarding aggregate
account balances on the currently
required attachment to the Form 5500
Annual Return/Report containing the
list of participating employers, their
EINs, and their percentage of total plan
contributions. The Department
estimates that the anticipated 75 pooled
employer plans would take an
additional five minutes to indicate
whether they are in compliance with the
Form PR registration requirements and
provide the AckID number for their
latest Form PR filing.
The Agencies’ burden estimation
methodology excludes certain activities
from the calculation of ‘‘burden.’’ If the
activity is performed for any reason
other than compliance with the
applicable federal tax administration
system or the Title I annual reporting
requirements, it was not counted as part
of the paperwork burden. For example,
most businesses or financial entities
maintain, in the ordinary course of
business, detailed accounts of assets and
liabilities, and income and expenses for
the purposes of operating the business
or entity. These recordkeeping activities
were not included in the calculation of
burden because prudent business or
financial entities normally have that
information available for reasons other
than federal tax or Title I annual
reporting. Only time for gathering and
processing information associated with
the tax return/annual reporting systems,
and learning about the law, was
included. In addition, an activity is
counted as a burden only once if
performed for both tax and Title I
purposes. The Agencies also have
designed the instruction package for the
Form 5500 Annual Return/Report so
that filers generally will be able to
complete the Form 5500 Annual Return/
Report by reading the instructions
without needing to refer to the statutes
or regulations. The Agencies, therefore,
have considered in their PRA

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calculations the burden of reading the
instructions and find there is no
recordkeeping burden attributable to the
Form 5500 Annual Return/Report.
This PRA calculation does not
include any burden related to Form M–
1 changes related to reporting of
participating employer information by
plans and non-plan MEWAs that are
required to file the Form M–1 because
those changes are not included in this
document. Rather, for the 2021 Form
5500 reporting year, plan MEWAs,
including those that offer or provide
coverage for medical care, will continue
to be required to provide participating
employer information as a nonstandard
attachment to the 2021 Form 5500
Annual Return/Report in substantially
the same manner as has been required
since the 2014 forms.
Note that to reflect OMB’s preference
that burden incurred by service

providers be reported as hour burden
instead of cost burden, burden that has
historically been included as cost
burden has been included here as hour
burden. This change led to an increase
in reported hour burden and an
offsetting decrease in cost burden.
A summary of paperwork burden
estimates follows. As noted above, these
estimates include the burden of the
overall Form 5500 information
collection and makes adjustments for
the final instructions revisions included
in this document.
Type of Review: Revision of existing
collection.
Title: Annual Information Return/
Report of Employee Benefit Plan.
Affected Public: Individuals or
households; Private Sector—Business or
other for-profit; Not-for-profit
institutions.
Forms: Form 5500 and Schedules.

Total Respondents: 840,923.
Total Responses: 840,923.
Frequency of Response: Annually.
Estimated Total Burden Hours:
3,031,649.
Estimated Total Annualized Costs: $0.
The aggregate hour burden for the
Form 5500 Annual Return/Report
(including schedules and short form) is
estimated to be 4.5 million hours
annually shared between the DOL, IRS,
and the PBGC. The hour burden reflects
filing activities carried out directly by
filers.
Presented below is a chart showing
the total hour and cost burden of the
revised Form 5500 Annual Return/
Report allocated to the DOL, including
the changes to the DOL burden by these
2021 SECURE Act revisions.
DOL hours

Pension .......................................................................................

Large Plans ................................................................................
Small Plans .................................................................................
Large Plans ................................................................................
Small Plans .................................................................................
Large Plans ................................................................................
Small Plans .................................................................................

895,570
931,031
1,064,998
64,616
1,960,568
995,647

DFEs .............................................................................................................................................................................................
January 2013 Revision .................................................................................................................................................................
2014 CSEC Revision ....................................................................................................................................................................
2021 SECURE Act Revision ........................................................................................................................................................

70,103
646
2,371
2,313

Total .......................................................................................................................................................................................

3,031,649

Welfare .......................................................................................
Total .....................................................................................

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3. Regulatory Flexibility Act
The Regulatory Flexibility Act
(RFA) 15 imposes certain requirements
with respect to federal rules that are
subject to the notice and comment
requirements of section 553(b) of the
Administrative Procedure Act 16 and are
likely to have a significant economic
impact on a substantial number of small
entities. Unless the head of an agency
certifies that a final rule is not likely to
have a significant economic impact on
a substantial number of small entities,
section 604 of the RFA requires the
agency to present a final regulatory
flexibility analysis of the final rule.17
The Department prepared an Initial
Regulatory Flexibility Analysis at the
proposed rule stage. However, this final
rule is focused only on a subset of the
requirements proposed. The Department
certifies that this final rule will not have
a significant impact on a substantial
number of small entities. Therefore, the

Title II of the Unfunded Mandates
Reform Act of 1995 requires each
federal agency to prepare a written
statement assessing the effects of any
federal mandate in a proposed or final
agency rule that may result in an
expenditure of $100 million or more
(adjusted annually for inflation with the
base year 1995) in any one year by State,
local, and tribal governments, in the
aggregate, or by the private sector.18 For
purposes of the Unfunded Mandates
Reform Act, as well as Executive Order
12875,19 this final rule does not include
any federal mandate that the DOL
expects would result in such
expenditures by State, local, or tribal
governments, or the private sector.

U.S.C. 1501 et seq. (1995).
the Intergovernmental Partnership,
58 FR 58093 (Oct. 28, 1993).

U.S.C. 601 et seq. (1980).
U.S.C. 551 et seq. (1946).
17 5 U.S.C. 604 (1980).
16 5

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18 2

15 5

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Department has not prepared a Final
Regulatory Flexibility Analysis.

5. Federalism Statement
Executive Order 13132 outlines
fundamental principles of federalism,
and requires the adherence to specific
criteria by federal agencies in the
process of their formulation and
implementation of policies that have
‘‘substantial direct effects’’ on the
States, the relationship between the
national government and States, or on
the distribution of power and
responsibilities among the various
levels of government.20 Federal agencies
promulgating regulations that have
federalism implications must consult
with State and local officials and
describe the extent of their consultation
and the nature of the concerns of State
and local officials in the preamble to the
final rule.
In the DOL’s view, this final rule
would not have federalism implications
because they would not have direct
effects on the States, on the relationship
between the national government and
the States, or on the distribution of

19 Enhancing

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20 Federalism,

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To implement the SECURE Act
section 101 changes, the current
instructions including the graphic, in
the Form 5500 and Form 5500–SF
instructions, as applicable, for Part I,
Line A ‘‘Box for Multiple Employer
Plan’’ and graphic entitled ‘‘MultipleEmployer Plan Participating Employer
Information,’’ are replaced with
instructions below and two separate
graphics. The second graphic, which
will appear only in the Form 5500
instructions shows information pooled
employer plans must provide in
addition to the participating employer
information. It may be attached as part
of the ‘‘Multiple-Employer Plan
Participating Employer Information’’
attachment or as a separate attachment
entitled ‘‘Pooled Employer Plan
Information.’’
Line A—Box for Multiple-Employer
Plan. Check this box if the [Form 5500
or Form 5500–SF] is being filed for a
multiple-employer plan. A multipleemployer plan is a plan that is
maintained by more than one employer
and is not one of the plans already
described. A multiple-employer plan
can be collectively bargained and
collectively funded, but if covered by
PBGC termination insurance, must have
properly elected before September 27,

1981, not to be treated as a
multiemployer plan under Code section
414(f)(5) or ERISA sections 3(37)(E) and
4001(a)(3), and have not revoked that
election or made an election to be
treated as a multiemployer plan under
Code section 414(f)(6) or ERISA section
3(37)(G). A single [Insert either Form
5500 or Form 5500–SF] Annual Return/
Report is filed for the multiple-employer
plan; participating employers do not file
individually for this type of plan.
[Following sentence is for Form 5500
Instructions only] A pooled employer
plan as defined in ERISA section 3(44)
operated by a ‘‘pooled plan provider’’
that meets the definition under ERISA
section 3(43) is a multiple-employer
plan.21
Note. Do not check this box if all of
the employers maintaining the plan are
members of the same controlled group
or affiliated service group under Code
sections 414(b), (c), or (m).
Participating Employer Information.
[Insert for Form 5500 ‘‘Except as
provided below, multiple-employer
pension plans and multiple-employer
welfare plans required to file a Form
5500’’ or Insert for Form 5500–SF
‘‘Eligible multiple-employer pension
plans that file a Form 5500–SF’’] must
include an attachment using the format
below. The attachment must be properly
identified at the top with the label
‘‘Multiple-Employer Plan Participating
Employer Information,’’ and the name of
the plan, EIN, and plan number (PN) as
found on the plan’s [Insert Form 5500
or Form 5500–SF]. Complete as many
entries as needed to report the required
information for all participating
employers in the plan.
• All multiple-employer pension
plans must complete elements 1–3 of
the ‘‘Multiple-Employer Plan
Participating Employer Information’’
attachment. For element 3, enter a good
faith estimate of each employer’s
percentage of the total contributions
(including employer and participant
contributions) made by all participating
employers during the year. The
percentage may be rounded to be
nearest whole percentage. To the extent
the rounding results in the total
reported percentage being either slightly
above or slightly below 100 percent, the
filer can indicate that on the attachment.
Any employer who was obligated to
make contributions to the plan for the

plan year, made contributions to the
plan for the plan year, or whose
employees were covered under the plan
is a ‘‘participating employer’’ for this
purpose. If a participating employer
made no contributions, enter ‘‘–0–’’ in
element 3.
• Multiple-employer pension plans
that are defined contribution plans must
also complete element 4 of the
‘‘Multiple-Employer Plan Participating
Employer Information’’ attachment to
report the aggregate account balances for
each participating employer determined
as the sum of the account balances of
the employees of such employer (and
the beneficiaries of such employees).
For element 4, the aggregate account
balance attributable to each employer is
the sum of the account balances of the
employees of such employer and their
beneficiaries at the end of the year.
Consistent with the information on the
schedules of assets for the plan as a
whole, use the end of year valuation to
calculate the amount of assets by
employer. The amounts can be rounded
to the nearest dollar, consistent with
other asset reporting on the forms and
schedules.
• [For Form 5500 Instructions Only]
Multiple-employer welfare plans that
are unfunded, fully insured, or a
combination of unfunded/insured and
exempt under 29 CFR 2520.104–44 from
the obligation to file financial
statements with their annual report are
required to complete elements 1 and 2
only of the ‘‘Multiple-Employer Plan
Participating Employer Information’’
attachment.22
• [For Form 5500 Instructions Only]
Multiple-employer pension plans that
are pooled employer plans must also
complete the ‘‘Pooled Employer Plan
Information’’ attachment. The
attachment may be attached as part of
the ‘‘Multiple-Employer Plan
Participating Employer Information’’
attachment or as a separate attachment
entitled ‘‘Pooled Employer Plan
Information.’’ For element 1b, AckID is
the acknowledgement code generated by
the system in response to a completed
Form PR submitted. The instructions to
the Form PR advise the pooled plan
provider that it must keep, under ERISA
section 107, the electronic receipt for
the Form PR filing as part of the records
of the pooled employer plans operated
by the pooled plan provider.23

21 Pooled employer plans are not eligible to file
the Form 5500–SF so the instructions describing the
pooled employer plan’s status as a MEP are not
being added to the Form 5500–SF instructions.

22 This paragraph only applies to multiple
employer welfare plans that file the Form 5500, and
thus is not needed in the Form 5500–SF
instructions.

23 As noted above, because pooled employer
plans are not eligible to file the Form 5500–SF, this
language describing the pooled employer plan
attachment is only being added to the Form 5500
instructions.

power and responsibilities among
various levels of government. This final
rule does not have federalism
implications because they would have
no substantial direct effect on the States,
on the relationship between the national
government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Section 514 of
ERISA provides, with certain exceptions
specifically enumerated, that the
provisions of Titles I and IV of ERISA
supersede any and all laws of the States
as they relate to any employee benefit
plan covered under ERISA. The
requirements implemented in these
rules do not alter the fundamental
provisions of the statute with respect to
employee benefit plans, and as such
would have no implications for the
States or the relationship or distribution
of power between the national
government and the States.
IV. Final Revisions to the Form 5500
and Form 5500–SF Instructions for the
2021 Reporting Year

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29DER1

73984

Federal Register / Vol. 86, No. 247 / Wednesday, December 29, 2021 / Rules and Regulations

Multiple-Employer Plan Participating Employer Information
(Insert Name of Plan and EIN/PN as shown on the [Insert Form 5500 or Form 5500-SF as applicable])
1. Name of participating employer

2. EIN

3. Percent of Total
Contributions for Plan
Year

4. Aggregate Account Balances at
End of Year Attributable to
Participating Employer

1. Name of participating employer

2. EIN

3. Percent of Total
Contributions for Plan
Year

4. Aggregate Account Balances at
End of Year Attributable to
Participating Employer

1. Name of participating employer

2. EIN

3. Percent of Total
Contributions for Plan
Year

4. Aggregate Account Balances at
End of Year Attributable to
Participating Employer

1. Name of participating employer

2. EIN

3. Percent of Total
Contributions for the
Plan Year

4. Aggregate Account Balances at
End of Year Attributable to
Participating Employer

1. Name of participating employer

2. EIN

3. Percent of Total
Contributions for the
Plan Year

4. Aggregate Account Balances at
End of Year Attributable to
Participating Employer

Complete as many rows as needed to report the required information for all participating employers in the plan.

[For Form 5500 Instructions only]
Pooled Employer Plan/Pooled Plan Provider Information
(Insert Name of Plan and EIN/PN as shown on the Form 5500)
Only pooled employer plans complete.
1a. Is the pooled plan provider currently in compliance with the requirements for filing the Form PR (Pooled
Plan Provider Registration Statement)? (See Form PR Instructions and 29 CFR 2510.3-44.) [] Yes [] No
1b. If "Yes" is checked in line 1a, enter the AcklD for the most recent Form PR that was required to be filed
under the Form PR filing requirements. (Failure to enter a valid AcklD will subject the Form 5500 filing subject
to rejection as incomplete.)

The following revisions are being
made to the Form 5500–SF instructions:
• In the first paragraph of the
‘‘General Instruction’’ section, add a
seventh bulleted paragraph that reads
‘‘Not be a pooled employer plan. See
ERISA section 3(43).’’
• In the ‘‘General Instruction’’
section, under the heading ‘‘Who May
File Form 5500–SF,’’ add a new
paragraph number 7 before the Note that
reads: ‘‘7. The plan is not a pooled

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employer plan. See ERISA section
3(43).’’
• In the ‘‘Specific Line-By-Line
Instructions (Form 5500–SF)’’ in
instructions for Part II, Line 6, add a
new paragraph number 7 that reads: ‘‘7.
The plan is not a pooled employer plan.
See ERISA section 3(43).’’
Statutory Authority
Accordingly, pursuant to the
authority in sections 101, 103, 104, 109,

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110, the Form 5500 Annual Return/
Report and the Form 5500–SF Short
Form Annual Return/Report are
amended as set forth herein.
Signed at Washington, DC, this 17th day of
December, 2021.
Ali Khawar,
Acting Assistant Secretary, Employee Benefits
Security Administration, U.S. Department of
Labor.
[FR Doc. 2021–27764 Filed 12–28–21; 8:45 am]
BILLING CODE 4510–29–C

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