Special Financial Assistance by PBGC

Forms and Documents

Document Name	Status
Form SFA Lock-In Applic Lock-In Application Form and Instruction	Unchanged
Form SFA Filing Instruc Notice of reinstatement Form and Instruction	Unchanged
Form SFA 300 Annual Statement of Compliance Form and Instruction	Unchanged
Form SFA 201 Application for Special Financial Assistance Form and Instruction	Modified
Justification Nonmaterial Change TOP and LeapFile.04.docx Justification for No Material/Nonsubstantive Change	2023-09-25
Special Financial Assistance ICR (July 2023 Renewal) Supporting Statement.12.docx Supporting Statement A	2023-07-17
sfa-assumptions-guidance July 2023.03.pdf Supplementary Document	2023-06-02

IC Document Collections

IC ID	Document Title	Status
254199	Lock-In Application Form and Instruction	Unchanged
247988	Requests for determination	Unchanged
247977	Notice of reinstatement Form and Instruction	Unchanged
247976	Annual Statement of Compliance Form and Instruction	Unchanged
247975	Application for Special Financial Assistance Form and Instruction	Modified

ICR Details

OMB Control No: 1212-0074	ICR Reference No: 202309-1212-001
Status: Received in OIRA	Previous ICR Reference No: 202305-1212-002
Agency/Subagency: PBGC	Agency Tracking No:
Title: Special Financial Assistance by PBGC
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/25/2023

	Requested	Previously Approved
Expiration Date	07/31/2026	07/31/2026
Responses	210	210
Time Burden (Hours)	938	938
Cost Burden (Dollars)	2,248,400	2,248,400

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Abstract: Under section 4262 of the Employee Retirement Income Security Act of 1974 (ERISA) PBGC administers a Special Financial Assistance program for financially troubled multiemployer plans. The statute sets forth the requirements for this program, including specifying which plans are eligible to apply, the cutoff date for applications, actuarial assumptions, determinations on applications, restrictions and conditions on plans that receive SFA, and the requirements for certain plans with suspended benefits to reinstate those benefits and provide make-up payments to restore previously suspended benefits. Unlike financial assistance under section 4261 of ERISA, which is provided in the form of a loan and in periodic payments, a plan receiving SFA under section 4262 has no obligation to repay SFA. This information collection contains the requirements necessary to implement the SFA program and to provide proper stewardship of taxpayer funds. These information requirements include: • An application for SFA (including calculating the amount of SFA) that the plan sponsor of an eligible multiemployer plan must file with PBGC to receive payment of SFA. PBGC needs the information in the application to review a plan’s eligibility for SFA, priority group status (if applicable), and amount of requested SFA. • A lock-in application that plan may, but is not required, to use to lock in its base data. PBGC needs the information in the lock-in application to garner a plan's base data when the plan files a full application for SFA> • An Annual Statement of Compliance (with the restrictions and conditions under section 4262 of ERISA and 29 CFR part 4262) that a plan that has received SFA is required to file with PBGC. PBGC needs the information in the Annual Statement of Compliance to ensure that a plan is compliant with the imposed restrictions and conditions. • A notice of reinstatement that a plan sponsor of a plan with benefits that were suspended under sections 305(e)(9) or 4245(a) of ERISA must issue to participants and beneficiaries whose benefits are reinstated. Participants and beneficiaries need the notice of reinstatement to better understand the calculation and timing of their reinstated benefits and, if applicable, make-up payments. • A request for a determination from PBGC for approval for an exception under certain circumstances for SFA conditions under § 4262.16 relating to reductions in contributions, transfers or mergers, benefit increases, and settlement of withdrawal liability. PBGC needs the information required for a request for determination to determine whether to approve an exception from the specified condition.

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Authorizing Statute(s): PL: Pub.L. 117 - 2 9704 Name of Law: American Rescue Plan Act of 2021
  

Citations for New Statutory Requirements: US Code: 29 USC 1432 Name of Law: American Rescue Plan Act of 2021

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 9914	02/15/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 34906	05/31/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Annual Statement of Compliance	SFA 300	Annual Statement of Compliance
Application for Special Financial Assistance	SFA Application Amendment Cover Letter, SFA Filing Instructions, Addendum A, SFA 202, SFA 201, SFA 204-B, SFA 205-A, SFA 206-A, SFA 207, SFA 208, SFA 209, SFA 100-Supplemented , SFA Filing Instructions, Addendum C, SFA Filing Instructions, Addendum D, PBGC E-filing Portal, SFA 204-A, SFA 205-B, SFA 206-B, Model Plan Amendment, Compliance, Model Plan Amendment, Reinstatement, Model Certification, SFA 203, SFA 100, SFA 210	SFA Template 1 ,   SFA Template 2 ,   SFA Template 4B ,   SFA Template 5A ,   SFA Template 6A ,   SFA Template 7 ,   SFA Template 8 ,   SFA Template 9 ,   SFA Template Checklist, Supplemented Application ,   SFA Filing Instructions, Addendum A ,   SFA Filing Instructions, Addendum C ,   SFA Filing Instructions, Addendum D ,   PBGC E-filing Portal ,   SFA Template 5B ,   SFA Template 6B ,   Model Plan Amendment, Compliance ,   Model Plan Amendment, Reinstatement ,   Model Certification ,   SFA Template 4A ,   SFA Template 3 ,   SFA Application Checklist ,   SFA Template 10 ,   SFA Application Amendment Cover Letter
Lock-In Application	SFA Lock-In Application	SFA Lock-In Application
Notice of reinstatement	SFA Filing Instructions, Addendum B	SFA Filing Instructions, Addendum B
Requests for determination

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	210	210	0	0	0	0
Annual Time Burden (Hours)	938	938	0	0	0	0
Annual Cost Burden (Dollars)	2,248,400	2,248,400	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increases in hourly and cost burden are attributable to the additions in the application instructions of the new template and the request for census data for terminated vested participants to the SFA application.

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Annual Cost to Federal Government: $15,170,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/25/2023

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