SFA 209 SFA Template 9

Special Financial Assistance by PBGC

Template 9 v20220701p.xlsx

Application for Special Financial Assistance

OMB: 1212-0074

Document [xlsx]
Download: xlsx | pdf

Overview

Template 9 Instructions
9-1A Reconciliation
9-1B Reconciliation
9-1C Reconciliation
9-1D Reconciliation
9-1E Reconciliation
9-1F Reconciliation
9-2 Recon Details


Sheet 1: Template 9 Instructions

TEMPLATE 9












v20220701p
Reconciliation and Assumption Change for SFA Amount from Interim Final Rule Application




























File name: Template 9 Plan Name, where "Plan Name" is an abbreviated version of the plan name.
Instructions for Addendum C for Supplemented Applications, Sections F, G and H















Provide a reconciliation of the change in the requested amount of SFA under the final rule as shown in Template 4A or Template 4B (whichever is applicable) from the total amount of SFA approved under the interim final rule as shown in Template 4 of the application approved under the interim final rule.















If the filer is proposing a change to the plan's employer contribution assumption to exclude contribution rate increases agreed to on or after July 9, 2021, as permitted under § 4262.4(c)(3) of PBGC’s SFA regulation, provide a deterministic projection using the "basic method" of determining the SFA amount described in
§ 4262.4(a)(1) without reflecting the changed assumption, in the same format as sheet 4A-4 SFA Details .4(a)(1) of Template 4A.















Additional instructions for each individual worksheet:




























Complete sheet 9-1A, 9-1B, 9-1C, 9-1D, 9-1E, or 9-1F depending on the method used to calculate the requested SFA amount under the final rule, and depending on whether the filer is proposing a change to the plan's employer contribution assumption. See below for more explanation of which sheet is required.















Sheet













9-1A Section F, Item (1): Reconciliation - Summary for non-MPRA plans using the "basic method" under § 4262.4(a)(1) with no contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.















9-1B Section F, Item (1): Reconciliation - Summary for non-MPRA plans using the "basic method" under § 4262.4(a)(1) with contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, and include the deterministic projection in Sheet 9-2 Recon Details.

For Item number 3, show the SFA amount determined under the final rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.















9-1C Section G, Item (2): Reconciliation - Summary for MPRA plans for which the requested amount of SFA is determined under the "increasing assets method" described in § 4262.4(a)(2)(i) with no contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

For Item number 3, show the SFA amount determined under the final rule using the "increasing assets method" with no assumption changes other than using the non-SFA and SFA interest rates, as shown in Sheet '4A-5 SFA Details .4(a)(2)(i)' of Template 4A.















9-1D Section G, Item (2): Reconciliation - Summary for MPRA plans for which the requested amount of SFA is determined under the "increasing assets method" described in § 4262.4(a)(2)(i) with contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, and include the deterministic projection in Sheet 9-2 Recon Details.

For Item number 3, show the SFA amount determined under the final rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

For Item number 4, show the SFA amount determined under the final rule using the "increasing assets method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021, as shown in Sheet '4A-5 SFA Details .4(a)(2)(i)' of Template 4A.















9-1E Section H, Item (2): Reconciliation - Summary for MPRA plans for which the requested amount of SFA is determined under the "present value method" described in § 4262.4(a)(2)(ii) with no contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

For Item number 3, show the SFA amount determined under the final rule using the "alternative present value method" with no assumption changes other than using the non-SFA and SFA interest rates, as shown in Template 4B.















9-1F Section H, Item (2): Reconciliation - Summary for MPRA plans for which the requested amount of SFA is determined under the "present value method" described in § 4262.4(a)(2)(ii) with contribution increases agreed to on or after July 9, 2021
For Item number 1, show the SFA amount determined under the interim final rule, as shown in Template 4 of the application that was approved under the interim final rule.

For Item number 2, show the SFA amount determined under the final rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates, and include the deterministic projection in Sheet 9-2 Recon Details.

For Item number 3, show the SFA amount determined under the final rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021, as shown in Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

For Item number 4, show the SFA amount determined under the final rule using the "alternative present value method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021, as shown in Template 4B.















9-2 Section F, Item (1): Reconciliation - Details for SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates
Sheet 9-2 is not required if all the assumptions used in determining the requested SFA amount under the final rule are the same as those used in the application that was approved under the interim final rule (except for the non-SFA and SFA interest rates).

See Template 4A instructions for Sheet 4A-4, except provide the projection used to determine the intermediate Item number 2 SFA amount from Sheets 9-1B, 9-1D, or 9-1F (whichever applies), under the "basic method" described in § 4262.4(a)(1) and before any assumption change related to excluded contribution increases agreed to on or after July 9, 2021. Unlike Sheet 4A-4, it is not necessary to explicitly identify the projected SFA exhaustion year in Sheet 9-2.






























Version Updates (newest version at top)













Version Date updated










v20220701p 7/1/2022

Sheet 2: 9-1A Reconciliation

TEMPLATE 9 - Sheet 9-1A




v20220701p
Reconciliation - Summary for non-MPRA plans using the "basic method" under § 4262.4(a)(1) with no contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1A.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: No Recon Details sheets are required for any of the Item numbers.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.


Sheet 3: 9-1B Reconciliation

TEMPLATE 9 - Sheet 9-1B




v20220701p
Reconciliation - Summary for non-MPRA plans using the "basic method" under § 4262.4(a)(1) with contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1B.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: A sheet with Recon Details is only required for Item number 2.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
Show details supporting the SFA amount on Sheet 9-2.

3 SFA amount under the Final Rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021 $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.


Sheet 4: 9-1C Reconciliation

TEMPLATE 9 - Sheet 9-1C




v20220701p
Reconciliation - Summary for MPRA plans using the "increasing assets method" under § 4262.4(a)(2)(i) with no contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1C.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: No Recon Details sheets are required for any of the Item numbers.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

3 SFA amount under the Final Rule using the "increasing assets method" with no assumption changes other than using the non-SFA and SFA interest rates $0
From Sheet '4A-5 SFA Details .4(a)(2)(i)' of Template 4A.


Sheet 5: 9-1D Reconciliation

TEMPLATE 9 - Sheet 9-1D




v20220701p
Reconciliation - Summary for MPRA plans using the "increasing assets method" under § 4262.4(a)(2)(i) with contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1D.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: A sheet with Recon Details is only required for Item 2.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
Show details supporting the SFA amount on Sheet 9-2.

3 SFA amount under the Final Rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021 $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

4 SFA amount under the Final Rule using the "increasing assets method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021 $0
From Sheet '4A-5 SFA Details .4(a)(2)(i)' of Template 4A.


Sheet 6: 9-1E Reconciliation

TEMPLATE 9 - Sheet 9-1E




v20220701p
Reconciliation - Summary for MPRA plans using the "alternative present value method" under § 4262.4(a)(2)(ii) with no contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1E.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: No Recon Details sheets are required for any of the Item numbers.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

3 SFA amount under the Final Rule using the "alternative present value method" with no assumption changes other than using the non-SFA and SFA interest rates $0
From Template 4B.


Sheet 7: 9-1F Reconciliation

TEMPLATE 9 - Sheet 9-1F




v20220701p
Reconciliation - Summary for MPRA plans using the "alternative present value method" under § 4262.4(a)(2)(ii) with contribution increases agreed to on or after July 9, 2021












See Template 9 Instructions for Additional Instructions for Sheet 9-1F.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





SFA Measurement Date:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: A sheet with Recon Details is only required for Item 2.
1 SFA amount under the Interim Final Rule N/A
From Template 4 of the application that was approved under the Interim Final Rule provisions.
2 SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates $0
Show details supporting the SFA amount on Sheet 9-2.

3 SFA amount under the Final Rule using the "basic method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021 $0
From Sheet '4A-4 SFA Details .4(a)(1)' of Template 4A.

4 SFA amount under the Final Rule using the "alternative present value method" reflecting the assumption change related to excluded contribution increases agreed to on or after July 9, 2021 $0
From Template 4B.


Sheet 8: 9-2 Recon Details

TEMPLATE 9 - Sheet 9-2











v20220701p
Reconciliation - Details for SFA amount under the Final Rule using the "basic method" with no assumption changes other than using the non-SFA and SFA interest rates


























See Template 4A instructions for Sheet 4A-4, except provide the projection used to determine the intermediate SFA amount.





















PLAN INFORMATION












Abbreviated
Plan Name:











EIN:












PN:












MPRA Plan?












If a MPRA Plan, which method yields the greatest amount of SFA?












SFA Measurement Date:












Fair Market Value of Assets as of the SFA Measurement Date:












SFA Amount as of the SFA Measurement Date under the method calculated in this Sheet:












Non-SFA Interest Rate:












SFA Interest Rate:




























On this Sheet, show payments INTO the plan as positive amounts, and payments OUT of the plan as negative amounts.


(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
SFA Measurement Date / Plan Year Start Date Plan Year End Date Contributions Withdrawal Liability Payments Other Payments to Plan (excluding financial assistance and SFA) Benefit Payments Make-up Payments Attributable to Reinstatement of Benefits Suspended through the SFA Measurement Date Administrative Expenses (excluding amount owed PBGC under 4261 of ERISA) Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from SFA Assets SFA Investment Income Based on SFA Interest Rate Projected SFA Assets at End of Plan Year
(prior year assets +
(7) + (8))
Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from Non-SFA Assets Non-SFA Investment Income Based on Non-SFA Interest Rate Projected Non-SFA Assets at End of Plan Year
(prior year assets +
(1) + (2) + (3) +
(10) + (11))
































































































































































































































































































































































































































































File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy