Model Plan Amendme Model Plan Amendment, Reinstatement

Special Financial Assistance by PBGC

Model.Plan.Amendment.Under.4262.6(e)(2).Re.Reinstatement

Application for Special Financial Assistance

OMB: 1212-0074

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AMENDMENT TO THE
[NAME OF PLAN DOCUMENT]
TO REINSTATE SUSPENDED BENEFITS
Background
1. The Board of Trustees of the [PLAN NAME] (the “Board”) has applied to the Pension
Benefit Guaranty Corporation (“PBGC”) under section 4262 of the Employment
Retirement Income Security Act of 1974, as amended (“ERISA”), and 29 C.F.R. § 4262
for special financial assistance for the [PLAN NAME] (the “Plan”).
2. 29 C.F.R. §§ 4262.6(e)(2) and 4262.15(a) require that the plan sponsor of a plan that is
applying for special financial assistance and that suspended benefits under section
305(e)(9) or 4245(a) of ERISA amend the written instrument governing the plan to
reinstate such suspended benefits and provide make-up payments in accordance with
guidance issued by the Secretary of the Treasury under section 432(k) of the Internal
Revenue Code (which was issued in IRS Notice No. 2021-38).
3. 29 C.F.R. § 4262.7(e)(2) requires that an application for special financial assistance for a
plan that suspended benefits under section 305(e)(9) or 4245(a) of ERISA include a copy
of the proposed plan amendment required under section 4262.6(e)(2) of ERISA and
certification by the plan sponsor that the plan amendment will be timely adopted. Section
4262.7(e)(2) further requires (1) that such certification be signed either by all members of
the plan’s board of trustees or by one or more trustees duly authorized both to sign the
certification on behalf of the entire board and to commit the board to timely adopting the
amendment after the plan’s application for special financial assistance is approved, and
(2) that each signature be accompanied by the printed name and title of the signer.
4. Benefits under the Plan have been suspended under [CHOOSE EITHER: ‘section
305(e)(9) of ERISA’ OR ‘section 4245(a) of ERISA due to plan insolvency’].
5. Under [REFERENCE TO APPROPRIATE PROVISION] of the [NAME AND DATE OF
CURRENT PLAN DOCUMENT] (the “Plan Document”), the Board has the power to
amend the Plan Document.
6. [INCLUDE ONLY IF LESS THAN THE ENTIRE BOARD OF TRUSTEES WILL BE
SIGNING:] Section [REFERENCE TO APPROPRIATE PROVISION] of the [NAME
AND DATE OF PLAN’S CURRENT TRUST DOCUMENT], as amended, authorizes
[DESCRIBE HOW TRUST DOCUMENT OR OTHER GOVERNING DOCUMENT
AUTHORIZES THE SIGNERS BOTH TO SIGN ON BEHALF OF THE ENTIRE BOARD
AND TO COMMIT THE BOARD TO TIMELY ADOPTING THE AMENDMENT AFTER
THE PLAN’S APPLICATION FOR SPECIAL FINANCIAL ASSISTANCE IS
APPROVED].

- Amendment Required by 29 C.F.R. § 4262.6(e)(2), Page 1 of 2 -

Amendment
The Plan Document is amended by adding a new [ARTICLE/SECTION #] to read as follows:
“i. Effective as of the first month in which special financial assistance is paid to the Plan,
the Plan shall reinstate all benefits that were suspended under section 305(e)(9) or
4245(a) of ERISA.
ii. The Plan shall pay each participant and beneficiary that is in pay status as of the date
special financial assistance is paid to the Plan the aggregate amount of their benefits that
were not paid because of the suspension, with no actuarial adjustment or interest. Such
payment shall be made [choose whichever applies: ‘in a lump sum no later than 3 months
after the date the special financial assistance is paid to the Plan, irrespective of whether
the participant or beneficiary dies after the date special financial assistance is paid’ or ‘in
equal monthly installments over a period of 5 years, commencing no later than 3 months
after the date the special financial assistance is paid to the Plan, with all installments to be
paid irrespective of whether the participant or beneficiary survives to the end of the
5-year period’].”
[IN ACCORDANCE WITH 29 C.F.R. § 4262.7(e)(2), DO NOT EXECUTE OR DATE PRIOR TO
SUBMISSION OF SPECIAL FINANCIAL ASSISTANCE APPLICATION TO PBGC. INSERT
ONE SIGNATURE BLOCK FOR EACH TRUSTEE, EACH WITH A PRINTED NAME AND
TITLE:]
___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

___________________________
[PRINTED NAME]
[TITLE]

Date: [DATE OF EXECUTION]

- Amendment Required by 29 C.F.R. § 4262.6(e)(2), Page 2 of 2 -


File Typeapplication/pdf
AuthorAllender Emily
File Modified2022-08-10
File Created2022-08-10

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