2009

Comprehensive 

Premium Payment 

Instructions 
Contents 

Introduction and What’s New........................................................................... 1

Who Must File .................................................................................................... 3

When to File ........................................................................................................ 4

How to File .......................................................................................................... 9

How to Count Participants................................................................................ 11

How to Determine Unfunded Vested Benefits ................................................. 14

Data to be Submitted ......................................................................................... 18

Description of Data Elements............................................................................ 22

Late Payment Charges....................................................................................... 35

Correcting Filings, Reconciling Estimates, Refunding Overpayments ........ 40

Recordkeeping Requirements; PBGC Audits.................................................. 42

Appendices 

 Appendix 1 – Definitions............................................................................... 43

 Appendix 2 – Contact information ................................................................ 47

 Appendix 3 – Online Premium Filing with My PAA .................................... 49

 Appendix 4 – Business codes ........................................................................ 53

 Appendix 5 – Additional information for paper filers................................... 65

 Appendix 6 – Paperwork Reduction Act Notice............................................ 67
Introduction and What’s New 

Introduction 

Payment of premiums to the Pension Benefit Guaranty Corporation (PBGC) is required by sections 

4006 and 4007 of the Employee Retirement Income Security Act of 1974 (ERISA), and PBGC’s 

Premium Regulations (29 CFR Parts 4006 and 4007). You can find these regulations by going to 

the Practitioners Page of PBGC’s Web site (www.pbgc.gov). 

There are two kinds of annual premiums: the Flat-rate Premium, which applies to all plans, and the 

Variable-rate Premium, which applies only to Single-employer Plans. 

Every covered plan under ERISA section 4021 must make a premium filing each year. The due 

dates for these filings vary based on Plan Size. See “When to File” section. 

Electronic filing is mandatory for all plans. My Plan Administration Account (My PAA) is a secure 

Web-based application that enables pension plan professionals to electronically submit premium 

filings to PBGC in accordance with PBGC’s regulations. Electronic filings may be prepared using 

My PAA’s data entry screens or with compatible private-sector software. See “How to File” 

section for more information. For more information on e-filing options, see Appendix 3. 

PBGC may grant exemptions from the electronic filing requirement for good cause in appropriate 

circumstances. See Appendix 5 for information on how to request an exemption and what to do if 

an exemption is granted. 

This document provides information for plans paying premiums for plan years beginning in 2009, 

including instructions for each data element that must be reported. (Filing instructions for Large 

Plans paying an estimate of the 2009 Flat-rate Premium are contained in a separate document.) 

Your premium filing will be considered improper if it is not made in accordance with the Premium 

Regulations and instructions in this document, if you do not make any required premium payment, 

or if your filing is otherwise incomplete. 

If you are amending a filing for a plan year that did not begin in 2009, the rules in this document do 

not apply. You must follow the instructions and regulations applicable for that plan year. However, 

because contact information and information about electronic funds transfers change periodically, 

the most recent information (available on PBGC’s Web site) should be used in lieu of the 

information included in an instructions booklet for a prior plan year. 

Defined terms 

Appendix 1 provides definitions for terminology used throughout this document. In general, the 

defined terms are capitalized to signal the reader to refer to Appendix 1 for more information. 

However, the convention of capitalizing the defined terms is not followed for a few defined terms 

such as “participant,” “we,” “you,” and “your.” 

How to Obtain Instructions 

It is the responsibility of the Plan Administrator to obtain the necessary instructions and submit 

filings on time. The easiest way to get the most current information and instructions for premium 

filings is to go to the Practitioners Page on PBGC’s Web site (www.pbgc.gov). In addition, if you 

use My PAA to create or import filings, instructions for each data item are available by clicking the 

instructions link by the item. 

Page 1
Introduction and What’s New 

Page 2

What’s New 

There are no substantive differences between the instructions for 2008 filings and the instructions 

for 2009 filings. Examples and due dates have been updated and minor clarifying changes have 

been made to the wording. In addition, the inflation-adjusted per-participant flat premium rate for 

single-employer plans has increased from $33 to $34. The flat premium rate for multiemployer 

plans remains at $9. 
Who Must File 

All Covered Plans Must File 

The Plan Administrator of each pension plan covered under ERISA section 4021 is required 

annually to file the prescribed premium information and pay the premium due in accordance with 

PBGC’s Premium Regulations and instructions. 

Most private-sector defined benefit plans that meet tax qualification requirements are covered. If 

you are uncertain whether your plan is covered, you should promptly request a coverage 

determination. Note that a request for a coverage determination does not extend the due date for 

any premium that is finally determined to be due. 

If your plan is covered, you must make a premium filing even if no premium is owed. 

One Plan, Or More Than One? 

If several unrelated employers participate in a program of benefits wherein the funds attributable to 

each employer are available to pay benefits to all participants, then there is a single Multiemployer 

or Multiple-employer Plan and the Plan Administrator must file and pay premiums for the plan as a 

whole. Separate filings and premiums cannot be submitted for each individual employer. 

If several employers participate in a program of benefits wherein the funds attributable to each 

employer are available only to pay benefits to that employer’s employees, then there are several 

plans (one for each employer) and the Plan Administrator must file and pay premiums separately 

for the plan of each individual employer. 

If separate plans are maintained for different groups of employees, regardless of whether each is 

maintained by the same employer or by employers that are part of the same controlled group, then 

the Plan Administrator(s) must file and pay premiums separately for each plan. 

When Filing Obligation Ceases 

You must continue to make premium filings and pay premiums through and including the plan year 

in which any of the following occurs: 

 Plan assets are distributed in satisfaction of all Benefit Liabilities pursuant to the plan’s 

termination. 

 A trustee is appointed for the plan under ERISA section 4042. 

 The plan disappears by transferring all its assets and liabilities to one or more other plans in a 

Merger or Consolidation. 

 The plan ceases to be a covered plan under ERISA section 4021. 

The following examples illustrate when the filing obligation ceases: 

Example 1 – A calendar-year plan terminates in a standard termination with a termination date of 

September 30, 2008. On April 7, 2009, assets are distributed in satisfaction of all Benefit Liabilities. 

The Plan Administrator must file and make the premium payments for the 2008 and 2009 plan 

years.

Example 2 – A plan with a plan year beginning July 1 and ending June 30 terminates in a distress 

termination with a termination date of April 28, 2009. On July 7, 2009, a trustee is appointed to 

administer the plan under ERISA section 4042. Premium filings and payments must be made for 

this plan for both the 2008 and 2009 plan years, because a trustee was not appointed until after the 

beginning of the 2009 plan year. 

Page 3
When to File 

General 

This section describes when premium filings are due. A filing includes both the submission of 

required data and the payment of any required premium. In general, if a filing is not made by the 

due date, late payment charges will apply. Late payment charges include both interest charges and 

penalty charges. See “Late Payment Charges” section for more information on the ramifications of 

missing a deadline. 

The date by which a filing must be made varies depending on the number of participants for whom 

premiums were owed in the prior plan year. In addition, special rules apply if: 

 The plan year has been changed since last year, 

 The plan is a New or Newly-covered Plan, 

 The due date falls on a weekend or Federal Holiday, or 

 Disaster relief has been granted. 

Each of these situations is discussed below. 

Filing Due Dates for Pre-existing Plans with no change in plan year 

This section describes filing due dates for the most common situation—plans that are neither New 

Plans nor Newly-covered Plans and had no change in plan year since the prior plan year. 

For these plans, the filing due dates vary based on the Plan Size. For this purpose, Plan Size is 

based on the number of participants for whom Flat-rate Premiums were payable for the plan year 

preceding the Premium Payment Year. 

 Small Plans (prior year Participant Count—fewer than 100) – Both the Flat-rate Premium and 

the Variable-rate Premium are due the last day of the 16th full calendar month following the 

end of the plan year preceding the Premium Payment Year (e.g., April 30, 2010, for 2009 

calendar-year plans). 

 Mid-size Plans (prior year Participant Count—100 or more but fewer than 500) 

- Flat-rate Premium – The due date is the 15th day of the 10th full calendar month in the plan 

year (e.g., October 15, 2009, for 2009 calendar-year plans). 1

 

- Variable-rate Premium – The due date is the 15th day of the 10th full calendar month in the 

plan year.1

 However, if the Premium Funding Target is not yet known, an estimated 

Variable-rate Premium may be paid, and an amended filing made at a later date to 

reconcile the final Variable-rate Premium with the estimate. Note that this reconciliation 

date is the same date all premiums are due for Small Plans (e.g., April 30, 2010, for 2009 

calendar-year plans). 

For rules related to estimating and reconciling Variable-rate Premiums, see the “Correcting 

Filings and Reconciling Estimates” section. For information on how to avoid late payment 

penalties if an estimated Variable-rate Premium is paid on the due date, see “Automatic 

Penalty Waiver for Late Variable-Rate Premiums – Large and Mid-size Plans” in the “Late 

Payment Charges” section. Note – there is no way to avoid interest charges on late 

payments. 

 

1

 Technically, the due date is the 15th day of the 10th full calendar month following the end of the plan year preceding the 

Premium Payment Year. In situations involving a short plan year, this due date may not be “in the plan year.” 

Page 4
When to File 

 Large Plans (prior year Participant Count – 500 or more) 

- Flat-rate Premium – The due date is the last day of the 2nd full calendar month in the plan 

year (e.g., the last day of February for calendar-year plans).2

 However, if the final Flat-rate 

Premium is not known by that time, an estimate may be paid, and a reconciliation filing 

made at a later date to reconcile the final Flat-rate Premium with the estimate. Note that for 

plans that pay a Variable-rate Premium, this reconciliation date is the same date the 

Variable-rate Premium is due. 

For rules related to estimating and reconciling Flat-rate Premiums, see the “Correcting 

Filings and Reconciling Estimates” section. For information on how to avoid late payment 

penalties if an estimated Flat-rate Premium is paid on the due date, see “Automatic Penalty 

Waiver for Late Flat-rate Premiums – Large Plans” in the “Late Payment Charges” section. 

Note – there is no way to avoid interest charges on late payments. 

- Variable-rate Premium – Same as for Mid-size Plans. See above. 

Because Plan Size for due date purposes is based on the Participant Count for the prior plan year, a 

New Plan or a Newly-covered Plan is not considered a Small, Mid-size or Large Plan for this 

purpose (regardless of how many participants are in the plan). Thus, the above rules do not apply to 

New or Newly-covered Plans. See “Filing Due Dates for New and Newly-covered Plans” below. 

There are also special due date rules for pre-existing plans changing plan years. See “Filing Due 

Dates for Plans Changing Plan Years” below. 

The following table uses a calendar-year plan to illustrate the information explained above: 

Filing Due Dates for Pre-existing Calendar-Year Plansa

Plan Size Flat-rate 

Premium 

Reconciliation 

of estimated 

Flat-rate 

Premiumb

Variable-rate 

Premium 

Reconciliation 

of estimated 

Variable-rate 

Premiumb

Small April 30th 

after year-end N/A April 30th 

after year-end N/A 

Mid-size October 15th

during year N/A October 15thduring year 

April 30th 

after year-end 

Large February 28th

during year 

October 15th

during year 

October 15th

during year 

April 30th 

after year-end 

a. Table assumes none of the dates shown are Saturdays, Sundays, or Federal Holidays, and that there 

has been no change in the plan year. 

b. If certain conditions are met, late payment interest charges will apply, but late payment penalties 

will not. See “Late Payment Charges” section. 

Example – Consider a pre-existing calendar-year plan that had 525 participants on December 31, 

2007 and 490 participants on December 31, 2008. 

Because the Participant Count was 500 or more as of the Participant Count Date for the 2008 plan 

year (i.e., 12/31/2007), the plan is considered a Large Plan for the 2009 plan year and therefore, the 

2009 Flat-rate Premium is due on March 2, 2009 (the Large Plan Flat-rate Premium due date). For 

2009, the Flat-rate Premium due is based on 490 participants (the Participant Count on 12/31/2008). 

 

2

 Technically, the due date is the last day of the 2nd full calendar month following the end of the plan year preceding the 

Premium Payment Year. In situations involving a short plan year, this due date may not be “in the plan year.” 

Page 5
When to File 

The fact that premiums are due for fewer than 500 participants for 2009 does not negate the fact 

that the early Flat-rate Premium due date applies for 2009. 

However, for the 2010 plan year, the plan will be considered a Mid-size Plan (because the 

Participant Count for 2009 was more than 100 and fewer than 500 participants). Therefore, for 

2010, the Flat-rate Premium is not due until October 15, 2010. 

Saturday, Sunday, and Federal Holidays 

If a premium filing due date falls on a Saturday, Sunday or Federal Holiday, the due date is 

extended automatically to the next business day. However, if your premium payment is filed after 

the extended due date, interest and penalties will be computed from the actual (unextended) due 

date. See “Late Payment Charges” section. 

Example – The Flat-rate and Variable-rate Premium for a Small Plan with a plan year beginning on 

July 1, 2009, normally would be due on October 31, 2010. Because that day is a Sunday, the due 

date is Monday, November 1, 2010. If the filing is made after November 1, 2010, interest and 

penalty charges will be computed from October 31, 2010. 

The following table shows the due dates for pre-existing plans for plan years beginning in 2009 

(assuming there has been no change in the plan year). 

2009 Filing Due Dates 

Large Plans Mid-size Plans Small Plans 

Premium Payment 

Year Begins 

Flat-rate 

Premiuma

Variable-rate 

Premiumb

Flat-rate and 

Variable-rate 

Premiumb

Flat-rate and 

Variable-rate 

Premium 

1/1/2009 03/02/2009 c 10/15/2009 10/15/2009 04/30/2010 

01/02 - 02/01/2009 03/31/2009 11/16/2009c 11/16/2009 c 06/01/2010c 

02/02 - 03/01/2009 04/30/2009 12/15/2009 12/15/2009 06/30/2010 

03/02 - 04/01/2009 06/01/2009 c 01/15/2010 01/15/2010 08/02/2010c

04/02 - 05/01/2009 06/30/2009 02/16/2010c 02/16/2010c 08/31/2010 

05/02 - 06/01/2009 07/31/2009 03/15/2010 03/15/2010 09/30/2010 

06/02 - 07/01/2009 08/31/2009 04/15/2010 04/15/2010 11/01/2010c

07/02 - 08/01/2009 09/30/2009 05/17/2010c 05/17/2010 c 11/30/2010 

08/02 - 09/01/2009 11/02/2009c 06/15/2010 06/15/2010 12/31/2010 

09/02 - 10/01/2009 11/30/2009 07/15/2010 07/15/2010 01/31/2011 

10/02 - 11/01/2009 12/31/2009 08/16/2010c 08/16/2010 c 02/28/2011 

11/02 - 12/01/2009 02/01/2010c 09/15/2010 09/15/2010 03/31/2011

12/02 - 12/31/2009 03/01/2010c 10/15/2010 10/15/2010 05/02/2011c

a. If the estimated Flat-rate Premium is reported and paid by this date, the late payment penalty charge (but not 

the late payment interest charge) may be waived if certain requirements are met. See “Automatic Penalty 

Waiver for Late Flat-rate Premiums – Large Plans” in the “Late Payment Charges” section.

b. If the estimated Variable-rate Premium is reported and paid by this date, the late payment penalty charge (but 

not the late payment interest charge) may be waived if the variable-rate reconciliation filing is made by the 

date shown in the “Small Plans” column. 

c. The actual due date falls on a Saturday, Sunday or Federal Holiday, so the date shown above is the first 

business day following the actual due date. See “Late Payment Charges” section for information on how 

late charges are determined if filing is made after the date shown in the table. 

Page 6
When to File 

Filing Due Dates for New and Newly-covered Plans 

New Plans and Newly-covered Plans are not classified as Small, Mid-size or Large Plans because 

those classifications are based on the number of participants for whom premiums were payable for 

the plan year preceding the Premium Payment Year. Therefore, special due date rules apply to 

these first-time filers. For New Plans and Newly-covered Plans, both the Flat-rate Premium and the 

Variable-rate Premium are due on the later of: 

 The last day of the 16th full calendar month that began on or after the first day of the 

Premium Payment Year (in the case of a Newly-covered Plan) or that began on or after the 

effective date (in the case of a New Plan), or 

 90 days after the Plan Adoption Date. 

The following examples show how the filing rules work for plans filing for the first time. 

Example 1 – A new calendar-year plan was adopted and effective on January 1, 2009, and had 650 

participants on that date. Although there are more than 500 participants, the plan is not considered 

a Large Plan for 2009 because Plan Size is based on the number of participants for whom 2008 

premiums were required to be paid. Because the plan is a New Plan, the 2009 Flat-rate Premium is 

not due on March 2, 2009 (the Flat-rate Premium due date applicable for pre-existing Large Plans). 

Instead, the plan would be required to pay its Flat-rate and Variable-rate Premiums by April 30, 

2010. As a New Plan, its 2009 Participant Count Date is January 1, 2009 (the first day of the plan 

year), so the 2009 Flat-rate Premium is based on a Participant Count of 650 as of January 1, 2009. 

In 2010, this plan will be considered a Large Plan because the Participant Count for the 2009 plan 

year was above 500. As a Large Plan, the 2010 Flat-rate Premium will be due on March 1, 2010.3

Note that this is before the date 2009 premium payments are due (April 30, 2010). The 2010 

Variable-rate Premium will be due on October 15, 2010. 

Example 2 – A New Plan is adopted on December 1, 2009, and has a July 1 - June 30 plan year. 

The plan became effective on December 1, 2009. The filing due date for the plan’s first year 

(December 1, 2009 through June 30, 2010) is March 31, 2011, regardless of the Participant Count 

on the Participant Count Date (December 1, 2009). 

Example 3 – A professional service employer maintains a plan with a calendar plan year. If this 

type of plan has never had more than 25 active participants since September 2, 1974, it is not a 

covered plan under ERISA section 4021. On October 18, 2009, the plan, which always had 25 or 

fewer active participants, has 26 active participants. It is now a covered plan and will continue to 

be a covered plan regardless of how many active participants the plan has in the future. Note that 

the Premium Payment Year begins on January 1, 2009, even though the plan did not become 

covered until after that date. The due date for the plan’s first premium filing is April 30, 2010 (the 

last day of the 16th full calendar month that began on or after the first day of the Premium Payment 

Year). 

Filing Due Dates for Plans Changing Plan Years 

For a plan that changes its plan year, the filing due dates for the short year are unaffected by the 

change in plan year. For the first plan year under the new cycle, the due date is whichever is later: 

 30 days following the date on which a plan amendment changing the plan year was adopted, or 

 The date the filing would otherwise be due.

The following examples show the due dates for plans changing plan years. 

 

3

 The actual due date, February 28, 2009, is a Sunday. 

Page 7
When to File 

Page 8

Example 1 – By plan amendment adopted on December 1, 2009, a Small Plan changes from a plan 

year beginning January 1 to a plan year beginning June 1. This results in a short plan year 

beginning January 1, 2009, and ending May 31, 2009. Both the Flat-rate and Variable-rate 

Premiums for the short plan year are due April 30, 2010. 

For the new plan year beginning June 1, 2009, the due date for the Flat-rate and Variable-rate 

Premium is the date the filing would otherwise be due (September 30, 2010) because that is later 

than 30 days after the date the plan amendment changing the plan year was adopted (December 31, 

2009). 

Example 2 – By plan amendment adopted on January 7, 2010, and made retroactively effective to 

April 1, 2009, a Mid-size Plan changes from a plan year beginning on March 1 to a plan year 

beginning on April 1. For the March 1, 2009 - March 31, 2009 short plan year, both the Flat-rate 

and Variable-rate Premium are due December 15, 2009. For the new plan year beginning April 1, 

2009, the due date for the Flat-rate Premium and Variable-rate Premium is 30 days after the 

adoption of the plan amendment changing the plan year (February 8, 2010)4

 because that is later 

than the date the premium would otherwise be due (January 15, 2010). 

Example 3 – By plan amendment adopted on July 8, 2009, and made retroactively effective to May 

1, 2009, a Large Plan changes from a plan year beginning February 1 to a plan year beginning May 

1. The plan has always had 500 or more participants. For the February 1, 2009 - April 30, 2009 

short plan year, the Flat-rate Premium is due March 31, 2009, and the Variable-rate Premium is due 

November 16, 2009.5

 

For the new plan year beginning May 1, 2009, the due date for the Flat-rate Premium is 30 days 

after the adoption of the plan amendment changing the plan year (August 7, 2009) because that is 

later than the date the Flat-rate Premium would otherwise be due (June 30, 2009). 

The Variable-rate Premium for the first plan year in the new cycle is due on the date the Variablerate Premium would otherwise be due (February 16, 2010)6

 because that is later than 30 days after 

the adoption of the plan amendment (August 7, 2009). 

 

Note regarding Disaster Relief: From time to time PBGC grants disaster relief by waiving late 

filing and payment penalties for certain plans that are unable to meet the filing deadline as a result 

of a major disaster (e.g., a hurricane). Disaster Relief Announcements are available on PBGC’s 

Web site (www.pbgc.gov). 

Additional information 

You can find detailed rules about filing due dates in PBGC’s filing, issuance, computation of time, 

and record retention regulation (29 CFR Part 4000). You can access this regulation through the 

Practitioners Page of PBGC’s Web site (www.pbgc.gov). 

 

4

 The actual due date, February 6, 2010, is a Saturday. 

5

 The actual due date, November 15, 2009, is a Sunday. 

6

 The actual due date, February 15, 2009 is a Federal Holiday. 
How to File 

General 

To make a complete premium filing, you must report certain required data and submit any required 

premium payment. There are two types of filings: 

 Estimated Flat-rate Premium filings for Large Plans required to pay the Flat-rate Premium 

early in the year, and 

 Comprehensive premium filings for all other purposes. 

A comprehensive premium filing is used to report: 

 The Flat-rate Premium and related data (all plans), 

 The Variable-rate Premium and related data (Single-employer Plans), and 

 Additional data such as identifying information and miscellaneous plan-related or filing-related 

data (all plans). 

For Large Plans, the comprehensive premium filing also serves to reconcile an estimated Flat-rate 

Premium paid earlier in the year. 

A list of the data that must be reported in a comprehensive premium filing is included in the “Data 

to be Submitted” section. For simplicity, the required data elements are shown in a traditional 

“form” format. The purpose of the “form” included in this document is to provide a comprehensive 

list of data that must be submitted electronically. This “form” is for illustrative purposes only; you 

may not submit your filing using a paper form unless you request and receive an exemption from 

e-filing. 

Depending on how you choose to prepare electronic filings (My PAA data entry screens or private 

sector software), the order in which the questions are asked may differ from the order shown on the 

form. In addition, in some cases, the software may perform certain calculations instead of requiring 

that you manually enter each required data element. 

The form included in this document illustrates the data to be included in a comprehensive premium 

payment filing. Information on how to file an estimated Flat-rate Premium filing is contained in a 

separate document. 

This document provides instructions as if they related to the illustrative form. These instructions 

describe the information you must report in your comprehensive premium filing. If you use My 

PAA’s data entry and editing screens, instructions are available on-line. 

Instructions (and Forms) for Prior Years 

If you are filing for a previous year, you must follow the instructions for that year, and if you make 

a paper filing, you must use the prior year’s form(s). Prior years’ instructions and forms are 

available on PBGC’s Web site (www.pbgc.gov). You may also obtain the instructions and form(s) 

by contacting us. 

Filing method 

Electronic premium filing is mandatory for all plans. Electronic filing is done through PBGC’s efiling application, My Plan Administration Account (My PAA), which you access through the 

Practitioners Page of PBGC’s Web site (www.pbgc.gov). You may prepare the filing directly 

using My PAA’s data entry screens. Alternatively, you may use private-sector software to prepare 

a filing and then “import” the data into My PAA’s editing screens or “upload” the filing via My 

PAA. That means the software you use must be compatible with My PAA. In other words, the 

Page 9
How to File 

Page 10

software must be able to place your filing in an electronic file that is in “XML” format and meets 

PBGC specifications. 

Appendix 3 provides an introduction to My PAA. PBGC’s Web site provides detailed information 

about My PAA. 

PBGC may grant an exemption from the requirement to make a premium filing electronically for 

good cause in appropriate circumstances. If you want to request an exemption or have been 

granted an exemption from e-filing, see Appendix 5 for information related to paper filings. 

Paying premiums 

Although e-filing of premium information through My PAA is mandatory, premium payments may 

be made either within My PAA or outside of My PAA. If you choose to pay within My PAA, you 

may pay by an electronic funds transfer using automated clearing house (ACH), by electronic 

check, or by credit card. If you pay outside of My PAA, you may pay by electronic funds transfer 

(ACH or Fedwire) or paper check.

Additional information on payment options is included in Appendix 3. 
How to Count Participants 

General 

Plan participants must be counted because Flat-rate Premiums are based on the number of 

participants. In addition, the number of participants for the prior plan year affects when a filing for 

the current plan year is due (see “When to File” section). The date on which participants are 

counted is called the “Participant Count Date.” 

Participant Count Date 

The Participant Count Date is the last day of the plan year preceding the Premium Payment Year 

except as follows: 

 If the plan is a New Plan, the Participant Count Date is the first day of the Premium Payment 

Year (i.e., the effective date). 

 If the plan is a Newly-covered Plan, the Participant Count Date is the first day of the Premium 

Payment Year. This is the case even if the plan first became covered under ERISA section 

4021 after the first day of the Premium Payment Year. 

 If the plan is the transferee plan in a Merger or the transferor plan in a Spinoff to a New Plan, 

and the transaction meets the conditions described below, the Participant Count Date is the first 

day of the Premium Payment Year. A plan Merger or Spinoff (as defined in the regulations 

under section 414(l) of the Code) is covered by this rule if: 

- a Merger is effective on the first day of the transferee (the continuing) plan’s plan year, or a 

Spinoff is effective on the first day of the transferor plan’s plan year, and 

- the Merger or Spinoff is not de minimis, as defined in the regulations under section 414(l) 

of the Code with respect to Single-employer Plans, or in PBGC’s regulation under ERISA 

section 4231 (29 CFR Part 4231) with respect to Multiemployer Plans. 

The following examples illustrate the determination of the Participant Count Date. 

Example 1 – An ongoing plan changes its plan year from a calendar year to a plan year that begins 

June 1, effective June 1, 2009. The Participant Count Date for the: 

 January 1, 2009 – May 31, 2009 plan year is December 31, 2008, 

 June 1, 2009 – May 31, 2010 plan year is May 31, 2009. 

Example 2 – A new calendar-year plan is adopted February 18, 2010, retroactively effective as of 

January 1, 2009. The Participant Count Date is January 1, 2009. 

Example 3 – A new calendar-year plan is adopted January 1, 2009, effective April 1, 2009. The 

Participant Count Date is April 1, 2009. 

Example 4 – Plan A has a calendar plan year and Plan B has a July 1 - June 30 plan year. Effective 

January 1, 2009, Plan B merges into Plan A (and the Merger is not de minimis). Because the 

Merger occurred on the first day of Plan A’s 2009 plan year, Plan A’s Participant Count Date for 

the 2009 Flat-rate Premium is January 1, 2009. Note that the Participant Count includes Plan A 

participants that used to be covered by Plan B. 

Example 5 – Plan A has a calendar plan year. Effective January 1, 2009, Plan A spins off assets and 

liabilities to form a New Plan, Plan B (and the Spinoff is not de minimis). Plan A’s Participant 

Count Date is January 1, 2009. (Plan B’s Participant Count Date also is January 1, 2009, since it is 

a New Plan that became effective on that date.) 

Example 6 – A calendar-year plan that was not covered plan under ERISA section 4021 becomes 

covered on May 31, 2009. The first day of the Premium Payment Year is January 1, 2009, and the 

Participant Count Date is January 1, 2009. 

Page 11
How to Count Participants 

Participant 

For premium purposes, “participant” means an individual (whether active, inactive, retired, or 

deceased) with respect to whom the plan has Benefit Liabilities. Beneficiaries and alternate payees 

are not counted as participants. However, a deceased participant will continue to be counted as a 

participant if there are one or more beneficiaries or alternate payees who are receiving or have a 

right to receive benefits earned by the participant. 

An individual is not counted as a participant after all Benefit Liabilities with respect to the 

individual are distributed through the purchase of irrevocable commitments from an insurer or 

otherwise. In addition, a non-vested individual is not counted as a participant after: 

 A deemed “zero-dollar cashout,” 

 A one-year break in service under plan rules, or 

 Death. 

Cashouts 

If the plan has a separate cashout provision for zero benefits, terminated non-vested participants are 

deemed to be cashed out as of the date specified in the deemed cashout provision or, if no date is 

specified, as of the employment termination date. If the plan provides that zero benefit amounts 

will be deemed to be paid as soon as possible, terminated non-vested participants also will be 

deemed to be cashed out as of the employment termination date. 

If the plan does not have a separate cashout provision for zero benefits, but does have a mandatory 

cashout of small benefit amounts (e.g., benefits less than $5,000), terminated non-vested 

participants are deemed to be cashed out in the same manner as terminated vested participants. If 

the plan is silent as to the timing of actual cashouts of terminated vested participants, the plan is 

deemed to read “as soon as practicable” and the terminated non-vested participants are deemed to 

be cashed out immediately upon termination of employment. If the plan specifies a date as of 

which actual cashouts of terminated vested participants take place (e.g., on the first day of the next 

month), that rule also would apply to deemed cashouts of terminated non-vested participants. These 

rules do not apply if, despite plan language, the plan has an obvious pattern or practice of delaying 

distributions for long periods of time. 

Example – Suppose a calendar-year plan provides that if a participant terminates employment and 

the participant’s vested benefit has a value of less than $5,000, the plan will pay the vested benefit 

to the participant in a lump sum as of the first of the month following termination of employment. 

Suppose further that no plan provisions specifically address payment of benefits upon termination 

of employment by non-vested participants. If a participant with a non-vested accrued benefit 

terminates employment on December 15, 2008, the participant will be included in the Participant 

Count as of December 31, 2008 (because the cashout is deemed to occur on January 1, 2009, the 

first of the month following termination of employment). If, as is typically the case for a calendaryear plan, the plan’s Participant Count Date for 2009 is December 31, 2008, a Flat-rate Premium 

must be paid for this participant for 2009. 

Breaks in service 

A non-vested individual ceases to be a participant for premium purposes when the individual incurs 

a one-year break in service under the plan. 

Note that if the break in service occurs in a service computation period that coincides with the plan 

year preceding the Premium Payment Year, we treat the individual as not being a participant for 

purposes of determining the premium for the Premium Payment Year. 

Page 12
How to Count Participants 

Page 13

Example 1 – A calendar-year plan with five-year vesting provides that a participant who performs 

500 or fewer hours of service in a service computation period incurs a one-year break in service as 

of the last day of the computation period. The plan also provides that the annual service 

computation period begins on the anniversary of a participant’s date of hire. 

Consider an employee who was hired on December 1, 2005, and terminates employment on 

February 1, 2008. Further assume that this participant does not perform more than 500 hours of 

service during the December 1, 2007 – November 30, 2008 computation period. This participant 

incurs a one-year break in service on November 30, 2008. Since the break occurred before 

December 31, 2008 (the Participant Count Date for the 2009 premium), the individual would not be 

included in the Participant Count for 2009. 

Example 2 – A calendar-year plan provides that a participant who performs 500 or fewer hours of 

service in a service computation period incurs a one-year break in service as of the last day of the 

computation period. The plan also provides that the annual service computation period is the 

calendar year. 

Consider a non-vested employee who does not perform more than 500 hours of service during the 

2008 calendar-year computation period. This participant incurs a one-year break in service on 

December 31, 2008. Although the break occurs on the Participant Count Date for the 2009 

premium, the individual would not be included in the Participant Count for 2009. 

Comparison to Form 5500 

The Participant Count for Flat-rate Premium purposes for the Premium Payment Year and the 

number of participants reported for item 7 of Form 5500 for the plan year preceding the Premium 

Payment Year (e.g., the 2009 premium filing and the 2008 Form 5500) are generally determined as 

of the same date (i.e., the last day of the plan year preceding the Premium Payment Year). However, 

the two counts may differ. For example: 

 For Flat-rate Premium purposes, individuals who are earning or retaining credited service but 

with respect to whom a plan has no Benefit Liabilities are not counted as participants. But 

individuals who are earning or retaining credited service are considered to be participants for 

purposes of item 7 of the Form 5500, even if the plan has no Benefit Liabilities with respect to 

them. 

 There is a difference in the break-in-service rules that apply when counting participants for 

Flat-rate Premium purposes and for purposes of item 7 of Form 5500. For purposes of item 7 of 

Form 5500, whether a non-vested individual is excluded from the count because of a break in 

service depends upon the plan language; under the provisions of most plans, the instructions 

for item 7 would require that a separated non-vested individual be counted as a participant until 

the individual has incurred five or more consecutive one-year breaks in service. For premium 

purposes, on the other hand, a non-vested individual is excluded from the count because of a 

break in service when the individual has incurred a one-year break in service under the terms of 

the plan. 
How to Determine Unfunded Vested Benefits 

General 

“Unfunded vested benefits” is the term used to describe the underfunding measure on which the 

Variable-rate Premium is based. For Variable-rate Premium purposes, unfunded vested benefits 

means the excess, if any, of: 

 The Premium Funding Target, over 

 The fair market value of plan assets. 

This section describes how the Premium Funding Target and fair market value of plan assets are 

determined for this calculation. 

Both the Premium Funding Target and the fair market value of assets are measured on the funding 

valuation date (i.e., the measurement date for determining the minimum required contribution) for 

the Premium Payment Year. For premium purposes, this date is called the UVB Valuation Date to 

distinguish it from the Participant Count Date (see “How to Count Participants” section). 

Premium Funding Target 

The Premium Funding Target is the liability measure underlying the UVB calculation. It is 

determined the same way the funding target is determined under ERISA section 303 (minimum 

funding requirements) except that only vested benefits are included, and a special premium 

discount rate structure is used. With the exception of the discount rate structure, all other 

assumptions must be identical to those used to determine the minimum required contribution under 

ERISA section 303. However, you may make an election (irrevocable for five years) to use the 

same discount rates used to determine the minimum required contribution instead of the special 

premium discount rates. Different terminology is used to describe the Premium Funding Target 

depending on whether this election is in effect. 

 Standard Premium Funding Target – This term describes the Premium Funding Target that 

applies unless the above-noted election is in effect. The discount rates used to determine the 

Standard Premium Funding Target are the segment rates for the month preceding the month in 

which the Premium Payment Year begins that are determined in accordance with ERISA 

section 4006(a)(3)(E)(iv). For example, the December 2008 rates are used for plan years 

beginning in January 2009. 

The ERISA section 4006(a)(3)(E)(iv) segment rates are based on the same bond yields as used 

to determine the segment rates for the ERISA section 303 funding target. However, for funding 

purposes, the yields are averaged over 24 months, whereas under ERISA section 

4006(a)(3)(E)(iv), the yields are not averaged. In addition, for funding purposes, the segment 

rates are generally phased-in for three years beginning in 2008, whereas for the Standard 

Premium Funding Target, there is no discount rate phase-in. 

The segment rates needed to calculate a Standard Premium Funding Target are published by 

IRS each month and are also posted on the Practitioners Page of PBGC’s Web site 

(www.pbgc.gov). 

 Alternative Premium Funding Target – This term describes the Premium Funding Target if the 

above-noted election is made. In this case, the discount rates are identical to the rates used to 

determine the ERISA section 303 funding target for the Premium Payment Year7

. Thus, if an 

election is made under: 

 

7

 Note that this will not be the case if an election is made under PPA 2006 section 402, under which the funding target is determined 

using an 8.25% discount rate. See “Plans Subject to Special Funding Rules” later in this section. 

. 

Page 14
How to Determine Unfunded Vested Benefits 

- ERISA section 303(h)(2)(D)(ii) to use the full yield curve instead of the three segment 

rates for purposes of determining the minimum required contribution, that same yield curve 

is used to determine the Alternative Premium Funding Target; 

- ERISA section 303(h)(2)(E) to use one of the four months preceding the valuation date as 

the “applicable month,” instead of the month containing the valuation date, for determining 

which month’s rates to use, that same month’s rates are used to determine the Alternative 

Premium Funding Target; 

- ERISA section 303(h)(2)(G)(iv) to disregard the transition rule phasing into the new 

segments rates from the prior current liability discount rate for 2008 and 2009, the 

transition rule is also disregarded when determining the Alternative Premium Funding 

Target. 

Since all of the assumptions used to the determine the Alternative Premium Funding Target are the 

same as those used to determine the funding target under ERISA section 303, the Alternative 

Premium Funding Target is equal to the vested portion of the ERISA section 303 funding target. 

The following table compares the various 2009 funding targets for a calendar-year plan with a 

January 1 valuation date: 

ERISA section 303 Standard Premium 

Funding Target 

Alternative Premium 

Funding Target 

Benefits 

reflected in 

calculation 

All benefits earned or accrued as of the 

beginning of the plan year 

Vested portion of benefits 

included in ERISA § 303 

Funding Target 

Vested portion of benefits 

included in ERISA § 303 

Funding Target 

Discount 

rate basis 

 3 segments based on 24-month 

average of high-quality corporate 

bond yield curve phased-in over 3 

years 

 Options 

- Disregard phase-in 

- Use full yield curve, no phase-in 

or averaging 

3 segments based on highquality corporate bond 

yield curve (no averaging 

or phase-in) 

Whatever is used for 

ERISA § 303 

Which 

month’s 

yield curve? 

 January 2009 

 Options – December 2008, November 

2008, October 2008, September 2008 

December 2008 Whatever is used for 

ERISA § 303 

Mortality  As prescribed by Treasury 

 Option—with Treasury approval, a 

plan-specific table 

Whatever is used for 

ERISA § 303 

Whatever is used for 

ERISA § 303 

All other 

assumptions 

Based on actuary’s expectations with 

some prescribed modifications if plan is 

at-risk 

Whatever is used for 

ERISA § 303 

Whatever is used for 

ERISA § 303 

Page 15
How to Determine Unfunded Vested Benefits 

An election to use the Alternative Premium Funding Target cannot be revoked for five years. Until 

an election is officially revoked, it remains in place. For example: 

 If your plan is a calendar year plan and you elected to use this alternative for 2008, the election 

is still in effect; you must use it for 2009, as well as for 2010, 2011, and 2012. You may revoke 

the election for 2013 or any year after 2013. 

 If your plan is a calendar year plan and you elect to use this alternative for the first time for 

2009, the plan must also use it for 2010, 2011, 2012, and 2013. You may revoke the election 

for 2014 or any year after 2014. 

The election (or revocation) must be made by the date the Variable-rate Premium is due. An 

election to use (or revoke) the Alternative Premium Funding Target is made as part of the 

comprehensive premium filing. 

Vested benefits 

As noted previously, only vested benefits are taken into account when determining the Premium 

Funding Target. For this purpose, a benefit does not fail to be considered vested solely because it is 

not protected under Code section 411(d)(6) and thus may be eliminated or reduced by the adoption 

of a plan amendment or by the occurrence of a condition or event. Such a benefit is vested for 

premium purposes (if the other requirements for vesting have been met) so long as the benefit has 

not actually been eliminated or reduced. In addition, certain benefits payable upon a participant’s 

death do not fail to be considered vested solely because the participant is still living. The benefits 

to which this rule applies are a qualified pre-retirement survivor annuity (QPSA), a post-retirement 

survivor annuity such as the annuity paid after a participant’s death under a joint-and-survivor or 

certain-and-continuous option, and a benefit that returns a participant’s accumulated mandatory 

employee contributions. 

Also, a participant’s pre-retirement lump-sum death benefit (other than a benefit that returns 

accumulated mandatory employee contributions or a QPSA paid as a lump sum) is not vested if the 

participant is living. Similarly, a disability benefit is not vested if the participant is not disabled. 

The following examples illustrate these concepts: 

Example 1 – Under Plan A, if a participant retires at or after age 55 but before age 62, the 

participant receives a temporary supplement from retirement until age 62. The supplement is not a 

QSUPP (qualified social security supplement), as defined in Treasury Reg. §1.401(a)(4)-12, and is 

not protected under Code section 411(d)(6). The temporary supplement is considered vested, and 

its value is included in the premium funding target, for each participant who, on the UVB valuation 

date, is at least 55 but less than 62, and thus eligible for the supplement. The calculation is 

unaffected by the fact that the plan could be amended to remove the supplement after the UVB 

valuation date. 

Example 2 – Plan B provides a QPSA upon the death of a participant who has five years of service, 

at no charge to the participant. The QPSA is considered vested, and its value is included in the 

premium funding target, for each participant who, on the UVB valuation date, has five years of 

service and is thus eligible for the QPSA. The calculation is unaffected by the fact that the 

participant is alive on that date. 

Page 16
How to Determine Unfunded Vested Benefits 

Page 17

Fair Market Value of Plan Assets 

The asset measure underlying the UVB calculation is determined the same way assets are 

determined under ERISA section 303 except that any averaging method adopted for funding 

purposes is disregarded for premium purposes. For premium purposes, the market value of assets is 

measured on the UVB Valuation Date and adjusted to account for contribution receipts using the 

same methodology as is used for funding purposes. 

Adjustments for prior year contributions 

 If contributions for the prior plan year are made after the UVB Valuation Date, the market 

value is increased to reflect such contributions. Such contributions are discounted to the UVB 

Valuation Date, using the effective interest rate for the plan year for which the contributions 

were made. The effective interest rate is the rate determined under ERISA section 

303(h)(2)(A) for minimum funding purposes. For example, for a calendar year plan with a 

January 1 valuation date, contributions for 2008 made in 2009 count in the 2009 asset value, 

but the amount is discounted to January 1, 2009 using the 2008 effective interest rate.

 Prior year contributions are included only to the extent received by the plan by the date of a 

premium filing. 

Adjustments for current year contributions 

If contributions for the current plan year are made before the UVB Valuation Date, the market 

value is decreased to exclude the adjusted value of these current year contributions. For this 

adjustment, current year contributions made before the UVB Valuation Date are increased to the 

UVB Valuation Date using the ERISA section 303(h)(2)(A) effective interest rate for the current 

plan year. 

Note – this can happen only if the UVB Valuation Date is after the beginning of the plan year. 

Comparison to asset value reported on Schedule SB 

In general, the asset value used to determine unfunded vested benefits is identical to the market 

value of assets reported in the 2009 Schedule SB (item 2a). The only situation in which the 

amounts would differ is if a premium filing is made before the premium filing due date and prior 

year contributions are made after premium filing is made (and thus not included in assets). 

Plans Subject to Special Funding Rules 

Sections 104, 105, and 106 of PPA 2006 delay the effective date of the funding amendments for 

certain plans described in those sections, which in general deal with plans of cooperatives, plans 

affected by settlement agreements with PBGC, and plans of government contractors. Section 402 

of PPA 2006 applies special funding rules to certain plans of commercial passenger airlines and 

airline caterers. None of these provisions affects how UVBs are determined. Plans in this small 

group must determine UVBs in the same manner (and using the same discount rate basis) as all 

other plans. In particular, under Section 402 of PPA 2006, certain plans may elect to use an 8.25% 

discount rate for funding purposes and other plans may elect to use an 8.85% discount rate. These 

rates may not be used to determine UVBs, even if the Alternative Premium Funding Target is 

elected. 
Data to be Submitted 

Page 18

This form is for illustrative purposes only. 

Amended filing  2009 PBGC Comprehensive Premium Filing Disaster Relief (enter code) _ _ - _ _ 

Part I – General Plan Information 

1 Plan sponsor information  Check for name/address change 

a Name ___________________________________________________________________________________________________ 

b Address line 1 _____________________________________________________________________________________________ 

c Address line 2 _____________________________________________________________________________________________ 

d City _________________________ e State ______ f Zip _______________ g Country (if not U.S.) _____________ 

 h Six-digit business code _ _ _ _ _ _ _ i First six digits of CUSIP number _ _ _ _ _ _ 

2 Plan administrator information  Check if same as plan sponsor and skip to item 3  Check for name/address change 

a Name ___________________________________________________________________________________________________ 

b Address line 1 _____________________________________________________________________________________________ 

c Address line 2 _____________________________________________________________________________________________ 

d City _________________________ e State ______ f Zip _______________ g Country (if not U.S.) ______________ 

3 Plan information 

a Plan name _____________________________________________________________________ 

b Premium payment year information: 

(1) This filing is for the premium payment year commencing _ _ /_ _ / _ _ _ _ and ending _ _ /_ _ / _ _ _ _. 

(2) If the plan year commencement date has changed since the most recent PBGC filing as a result of a plan amendment changing the plan 

year, enter the date the plan year change was adopted _ _/_ _/_ _ _ _ . 

(3)  Check box if plan qualifies to pay a prorated premium for this premium payment year (i.e., if plan has less than a full year of coverage). 

c Employer Identification Number and Plan Number information: 

(1) EIN and PN: EIN _ _ _ _ _ _ _ _ _ PN _ _ _ 

(2) If the EIN and PN are not both the same as on the most recent premium filing, enter EIN and PN from most recent premium filing: 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _. Otherwise, skip to item 3c(3). 

(3) If the EIN and PN are not both the same as on the 2008 Form 5500, enter EIN and PN from 2008 Form 5500 and provide explanation: 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _. Explanation ____________________________________________________________________ 

_____________________________________________________________________________________Otherwise, skip to item 3d. 

d Plan type:  Multiemployer  Single-employer (including multiple-employer plans) 

e Plan size (based on prior year participant count):  Small (fewer than 100)  Mid-size (100-499)  Large (500 or more)  N/A; first 

year’s filing 

4 Plan contact Name: _________________________________________________ Phone number: _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ _ 

E-mail address ___________________________________________

Part II – Alternative Premium Funding Target Election 

Single-employer plans only. Multiemployer plans—skip to Part III 

5  Check box to indicate that the plan is electing to use the alternative premium funding target instead of the standard premium funding 

target, effective beginning with this premium payment year and for all subsequent plan years unless and until it is subsequently revoked. 

Note that an election cannot be revoked for any plan year that begins less than five calendar years after the date the premium payment 

year reported in this filing begins. If an election is currently in effect, do not make an election again. 
Data to be Submitted 

Page 19

Part III – Premium Information 

6 Flat-rate premium 

a Participant count date: Month ___ Day ___ Year ____ 

b Flat-rate premium calculation 

(1) Applicable rate (Single-employer plans enter $34; Multiemployer plans, enter $9) ______________ 

(2) Participant count as of participant count date ______________ 

(3) Flat-rate premium (item 6b(1) x item 6b(2)) ______________ 

7 Variable-rate premium (VRP) – Single-employer plans only (Multiemployer plans—skip to item 8)

a Exemptions – If an exemption applies, check applicable box and skip to item 8. 

 No vested participants  412(e)(3) plan  Standard termination with a proposed termination date of _ _ /_ _ /_ _ _ _ 

b VRP cap qualification – If this plan qualifies for the VRP cap applicable to certain plans of small employers (those with 25 or fewer 

employees), check box . If box is checked, items 7c through 7g(1) may, but need not, be omitted.

c UVB valuation date: Month ___ Day ___ Year ____ 

d Premium funding target information –  Check box if the reported premium funding target information is an estimate. 

(1) Premium funding target method:  Standard  Alternative 

(2) Discount rate(s) 1st segment ____% 2nd segment ____% 3rd segment ____%  N/A, full yield curve used 

(3) Premium funding target as of UVB valuation date ______________ 

e Market value of assets as of UVB valuation date ______________ 

f Unfunded vested benefits (excess, if any, of item 7d(3) over item 7e, rounded up to the next $1,000) ______________ 

g Variable-rate premium calculation 

If the plan does not qualify for the VRP cap, omit the following two items and skip to item 7g(3).

(1) Variable-rate premium before reflecting the cap (item 7f x 0.009) ______________ 

(2) Maximum VRP ($5 x item 6b(2) x item 6b(2)) ______________ 

(3) Variable-rate premium

 If the plan does not qualify for the VRP cap, item 7f x 0.009. 

 If the plan qualifies for the VRP cap, the lesser of item 7g(1) and 7g(2) or, if item 7g(1) was omitted, item 7g(2). ______________ 

8 Premium proration (If the plan does not qualify for premium proration, skip to item 9)

a Number of months (complete and partial) in the short plan year ______________ 

b Total premium before reflecting proration (item 6b(3) + item 7g(3), if applicable) ______________ 

9 Total premium 

If the plan does not qualify for premium proration, item 6b(3) + item 7g(3), if applicable 

If the plan qualifies for premium proration, item 8b x item 8a ÷ 12. ______________ 

10 Premium credit (including any payments already made for this premium payment year and any overpayment from 

the prior plan year unless refund was requested) ______________ 

11 Amount due (excess, if any, of item 9 over item 10) ______________ 

Payment method (paper filers only)  Check enclosed  Electronic funds transfer 

12 Treatment of overpayment 

a Excess, if any, of item 10 over item 9 ______________ 

b Treatment of balance (select one):

 Credit towards next year’s premium  Refund by check  Refund by electronic funds transfer (preferred refund option) 

If you select a refund by electronic funds transfer, complete the following information: 

Type of account  Checking  Savings Bank routing number _______________________ 

Account number ___________________ Sub-account number (if any) _________________ 
Data to be Submitted 

Page 20

Part IV – Miscellaneous Information 

Items that do not apply should be left blank 

13 Final filing – If this is the last filing for this plan, enter the date of event _ _ /_ _ / _ _ _ _ and check box that that best describes why filing 

obligation is ceasing:  Merger/Consolidation  Trusteeship  Distribution pursuant to termination  Cessation of covered status 

14 New and newly covered plans – If this filing is for a new plan or a newly-covered plan, report the plan effective date _ _ /_ _ / _ _ _ _, 

the adoption date _ _ /_ _ / _ _ _ _ and the plan coverage date _ _ /_ _ / _ _ _ _. 

15 Transfers from other plans – If another plan transferred assets or liabilities to this plan since the most recent comprehensive premium filing, 

provide the following information with respect to each plan from which assets or liabilities were transferred (if transfer involved a new or 

newly-covered plan, see instructions). 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _ Date of transfer _ _ /_ _ / _ _ _ _ Type of transfer:  Merger  Consolidation  Spinoff  Other 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _ Date of transfer _ _ /_ _ / _ _ _ _ Type of transfer:  Merger  Consolidation  Spinoff  Other 

If more than two transferor plans are involved, include the above information for each additional transferor plan as an attachment. 

16 Transfers to other plans – If this plan transferred assets or liabilities to another plan since the most recent comprehensive premium filing, 

provide the following information with respect to each plan to which the assets or liabilities were transferred (if transfer involved a new or 

newly-covered plan, see instructions). 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _ Date of transfer _ _ /_ _ / _ _ _ _ Type of transfer:  Merger  Consolidation  Spinoff  Other 

EIN _ _ _ _ _ _ _ _ _ PN _ _ _ Date of transfer _ _ /_ _ / _ _ _ _ Type of transfer:  Merger  Consolidation  Spinoff  Other 

If more than two transferee plans are involved, include the above information for each additional transferee plan as an attachment. 

17 Participation freeze – If, as of the beginning of the premium payment year, this plan is closed to new entrants, enter the date the plan became 

closed to new entrants _ _/_ _/_ _ _ _ . 

18 Accrual freeze – If, as of the beginning of the premium payment year, benefit accruals under this plan are partially or totally frozen, enter the 

date the freeze became effective_ _/_ _/_ _ _ _ and check box that best describes the nature of the freeze: 

 For all participants, both pay and service are frozen  For all participants, service is frozen, pay is not 

 For some participants, both pay and service are frozen  For some participants, service is frozen, pay is not

 Other (enter explanation)________________________________________________________________________________

19 Amended filing – Complete this item only if this is an amended filing

a If either the first or last day of the premium payment year reported in this amended filing (item 3b(1)) differs from what was reported in the 

filing that is being amended, provide the dates that were reported in the original filing: 

Date premium payment year commenced _ _ /_ _ /_ _ _ _ Date premium payment year ended _ _ /_ _ /_ _ _ _. 

b If the EIN and PN reported in this amended filing (item 3c(1)) are not both the same as what was reported in the filing that is being 

amended, enter the EIN and PN from the original filing: EIN _ _ _ _ _ _ _ _ _ PN _ _ _. 

c If the reason for amending the filing is other than reconciling an estimated Variable-rate Premium and the total premium reported in this 

amended filing (item 9) is less than the amount reported in the filing that is being amended, provide an explanation of why an amended 

filing is necessary: _______________________________________________________________________________________________ 

______________________________________________________________________________________________________________ 

20 Attachments (paper filers only) – If any attachments are included with this filing, check box  and see instructions.
Data to be Submitted 

Page 21

Part V – Certifications 

21 Certification of Plan Administrator – The plan administrator must sign and complete this item. 

I certify under penalty of perjury, to the best of my knowledge and belief, that all the information in the filing is true, correct and complete and 

has been determined in accordance with the PBGC's premium regulations and instructions, except that if the filing reports an estimated 

premium funding target, the estimate is reasonable, takes into account the most current information available to the enrolled actuary, and has 

been determined in accordance with generally accepted actuarial principles and practices, and that if I received variable-rate premium 

information certified by an enrolled actuary for this filing, the variable-rate premium information in the filing is the same as the variable-rate 

premium information certified by the enrolled actuary. 

Name of person signing: First name _______________ Last name _____________________________ 

____________________________________________ _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ _ 

E-mail address Telephone 

___________________________________________ _ _ /_ _ /_ _ _ _ 

Signature Date 

22 Certification of Enrolled Actuary – An enrolled actuary must sign and complete this item unless the plan is a multiemployer plan, is exempt 

from the variable-rate premium, or is eligible for and paying the maximum VRP and not reporting the uncapped VRP. 

I certify under penalty of perjury, to the best of my knowledge and belief, that the variable-rate premium information in the filing is true, correct 

and complete and has been determined in accordance with PBGC's premium regulations and instructions; except that if the premium funding 

target is estimated, the estimate is reasonable, takes into account the most current information available to me and has been determined in 

accordance with generally accepted actuarial principles and practices. 

Name of person signing: First name _______________ Last name _____________________________ 

_____________________________________________ _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ _ 

Firm Telephone 

_____________________________________________ ___________ 

E-mail address Enrollment number 

____________________________________________ _ _ /_ _ /_ _ _ _ 

Signature Date 
Description of Data Elements 

Overview 

This section provides a description of each required data element. It is presented in the same order 

as the “form” used to illustrate the data elements (see prior section). Item numbers are presented 

solely to facilitate understanding. The My PAA screens do not include item numbers. If you are 

using private sector software, item numbers may or may not be included. We recommend you 

review these instructions with a copy of the “form” in front of you. 

Note for plans with more than one plan year beginning in 2008 or 2009: 

References in these instructions to the 2008 plan year (and to filings for the 2008 plan year) should 

be considered to refer to your plan’s most recent complete plan year. For example, a plan that 

changes its plan year could have two plan years beginning in calendar 2009. When such a plan 

makes its premium filing(s) for its second 2009 plan year, the references in these instructions to the 

2008 plan year (and to filings for the 2008 plan year) should be considered to refer to the plan’s 

first 2009 plan year (and to filings for that plan year), because that is the plan’s most recent 

complete plan year. Similarly, if your plan had two plan years beginning in calendar 2008, the 

references in these instructions to the 2008 plan year (and to filings for the 2008 plan year) should 

be considered to refer to the plan’s second 2008 plan year, which is the plan’s most recent 

complete plan year. 

Note about reporting dollar amounts 

With the exception of total premium, premium credits, the amount due PBGC, and the amount of 

any overpayment, money amounts reported should be in dollars only (no cents). 

Amended filing 

Check this box only if this filing is an amendment to a previously submitted filing for the 2009 

plan year. Note that a Variable-rate Premium reconciliation filing (in which you provide final 

Premium Funding Target information after having reported an estimated Premium Funding Target) 

is considered an amended filing. 

If you amend a comprehensive filing for a reason other than reconciling an estimated Variable-rate 

Premium and the amended filing shows a lower premium than the amount that was originally 

reported, you must provide an explanation of the specific circumstances or events that caused the 

reduction. See the “Correcting Filings and Reconciling Estimates” section for more information. 

Note – If you are amending a filing for a plan year that did not begin in 2009, the rules in this 

document do not apply. 

Disaster relief 

From time to time, when major disasters occur, PBGC grants disaster relief by waiving late filing 

and payment penalties for certain plans. Disaster Relief Announcements are available on PBGC’s 

Web site (www.pbgc.gov). If your plan is covered by a PBGC Disaster Relief Announcement for 

this premium filing, report the four-digit code provided in the applicable Disaster Relief 

Announcement. 

Page 22
Description of Data Elements 

Instructions for Part I – General Plan Information. 

1 Plan sponsor information 

 a–g – Report the name and address of the Plan Sponsor. If either has changed since your last 

filing, check the box to report that fact. 

h Business Code – Report the six-digit code that best describes the nature of the employer’s 

business. If more than one employer is involved, report the business code for the predominant 

business activity of all employers. A list of business codes is included in Appendix 4. 

i CUSIP number – If a CUSIP number has been assigned to publicly traded securities of the Plan 

Sponsor or any member of the Plan Sponsor’s controlled group, report the first six digits of the 

CUSIP number. Otherwise, leave this item blank. 

A CUSIP number is a nine-digit number assigned to the publicly traded securities of a Plan 

Sponsor (or member of the Plan Sponsor’s controlled group) under the securities numbering 

system of the Committee on Uniform Securities Identification Procedures. The first six digits 

of the CUSIP number identify the securities issuer, the next two digits identify the specific 

securities issue, and the last digit is a check digit. 

2 Plan administrator information 

Report the name and address of the Plan Administrator. Note that this is the address where we send 

official correspondence to the plan (e.g., an invoice for late payment charges). To keep our records 

current and enable us to send correspondence to the correct address, you should inform us of 

address changes as soon as they occur. You may do so by contacting us either in writing or by 

e-mail. See Appendix 2 for contact information. 

If the Plan Administrator’s name and address is the same as that of the Plan Sponsor, you may 

satisfy this requirement by checking the box to report that fact. 

If the Plan Administrator’s name or address has changed since your last filing, check the box to 

report that fact (even if you informed us of the change prior to submitting this filing). 

3 Plan information 

a Plan name – Report the complete name of the plan as stated in the plan document. For example, 

“The ABC Company Pension Plan for Salaried Personnel.” 

b Premium Payment Year information 

(1) Report the date the Premium Payment Year commences and the date it ends. If you are 

filing for the first year of a New Plan, the Premium Payment Year commencement date 

(“PYC”) should generally be the plan effective date. 

(2) If the plan year commencement date has changed since the most recent PBGC filing as a 

result of a plan amendment changing the plan year, enter the adoption date of the plan year 

change. 

(3) Check box if plan qualifies to pay a prorated premium for this Premium Payment Year. A 

plan qualifies to pay a prorated premium only if the Premium Payment Year is: 

 a short first year of a New or Newly-covered Plan; 

Page 23
Description of Data Elements 

 a short year created by an amendment that changes the plan year (but note that an 

amendment is not considered to change the plan year if the plan merges into or 

consolidates with another plan or otherwise ceases its independent existence either 

during the short plan year or at the beginning of the full plan year following the short 

plan year); 

 a short year created by distribution of plan assets pursuant to plan termination; or 

 a short year created by the appointment of a trustee for a Single-employer Plan under 

ERISA section 4042. 

There is no premium proration where a plan ceases to be a covered plan before the end of 

the plan year. 

Note that the short year need not have ended by the time you pay a prorated premium, but 

if the plan year turns out to be longer than you anticipated, you will have to make up any 

premium underpayment, which will be subject to interest and penalties. 

Note also that premium proration is not available for ‘overlapping’ premium payments 

resulting from a plan merger, consolidation, or spinoff. 

c Employer Identification Number (EIN) and Plan Number (PN) information 

(1) Report the nine-digit EIN of the Plan Sponsor and the three-digit PN of the plan. 

(2) If the EIN and PN for this filing do not both match exactly the EIN and PN reported in the 

most recent premium filing, report both the EIN and PN that were reported in the most 

recent premium filing. If this is the first premium filing for this plan, leave this item blank. 

Please note the following exceptions that apply only if this is an amended filing: 

 If item 3c(2) was reported incorrectly in the original filing, provide the information 

that should have been reported in the original filing, 

 If item 3c(2) was reported correctly in the original filing, provide the same information 

that was reported on the original filing. 

(3) If the EIN and PN for this filing do not both match exactly the EIN and PN reported in the 

2008 Form 5500, report both the EIN and PN that were reported in the 2008 Form 5500, 

and attach an explanation. If a 2008 Form 5500 was not required, leave this item blank. 

d Plan type – Indicate whether the plan is a Multiemployer Plan or a Single-employer Plan. 

e Plan size – Premium due dates vary based on whether the plan is classified as a Small Plan, 

Mid-Size Plan, or Large Plan. Indicate which Plan-Size classification applies for the Premium 

Payment Year. Note that this classification is based on the Participant Count for the prior plan 

year (i.e., the number of participants for whom a Flat-rate Premium was owed for the prior 

year.) If this is a New Plan or a Newly-covered Plan, check the “N/A; first filing” box. 

4 Plan contact – Report the name and phone number of the person we may contact if we have any 

questions concerning this filing. If this person has an e-mail address, report that e-mail address. 

If the filing is completed by a plan consultant, you may report the consultant’s identifying 

information. 

Part II – Alternative Premium Funding Target election 

This Part applies only to Single-employer Plans. Multiemployer Plans should skip to Part III. 

Page 24
Description of Data Elements 

A plan may elect to use the Alternative Premium Funding Target to determine unfunded vested 

benefits instead of the Standard Premium Funding Target (see “How to Determine Unfunded 

Vested Benefits” section). Note that once an election is made, it remains in effect for all subsequent 

plan years unless and until it is subsequently revoked. Therefore, if you are making an election 

with this filing, do not make an election again in a future filing. 

An election cannot be revoked for any plan year that begins less than five years after the beginning 

of the plan year for which the election was first applicable. For example, if you make the election 

for a plan year that begins on April 1, 2009, the Alternative Premium Funding Target must be used 

to determine unfunded vested benefits for all plan years beginning before April 1, 2014. The plan 

may revoke the election first effective for any plan year beginning on or after April 1, 2014, but 

unless the election is revoked, it will remain in place. My PAA will be modified in the future to 

allow for this revocation. 

Note that if an election to use the Alternative Premium Funding Target is subsequently revoked, 

another election to use the Alternative Premium Funding Target cannot be made until five 

additional years have passed. 

5 Election – Check the box to indicate that the plan is making this election first effective for the 

Premium Payment Year. 

Part III – Premium Information 

6 Flat-rate Premium

a Report the Participant Count Date. See “How to Count Participants” section for special rules 

relating to New Plans, Newly-covered Plans, Mergers and Spinoffs. 

b Flat-rate Premium calculation 

(1) Applicable rate – Enter the per-participant flat premium rate. For 2009, the rate is $34 for 

Single-employer Plans and $9 for Multiemployer Plans. 

(2) Participant count – Report the total number of participants covered by the plan on the 

Participant Count Date. See “How to Count Participants” section. 

(3) Flat-rate Premium – Report the product of the Participant Count and the applicable 

premium rate. If the plan year is a short plan year, the required Flat-rate Premium may be a 

prorated portion of this amount; however, the amount reported in this item must reflect a 

full year’s premium.

Note that the Flat-rate Premium may be $0, but you must make a premium filing even if the Flatrate Premium is $0. This may happen, for example, if your plan is a New Plan that grants no past 

service credits, so that there are no Benefit Liabilities on the Participant Count Date. A plan with 

no Benefit Liabilities has no participants for premium purposes. 

7 Variable-rate Premium 

This item relates to Variable-rate Premium information and applies only to Single-employer Plans. 

In general, the Variable-rate Premium is $9 per $1,000, or fraction thereof, of unfunded vested 

benefits as of the UVB Valuation Date. For certain plans of small employers, this amount is capped 

at a specified amount (see item 7b). 

Page 25
Description of Data Elements 

Some Single-employer Plans are exempt from the Variable-rate Premium; others may have a 

Variable-rate Premium of $0. In either case, this section must be completed in accordance with the 

following instructions. 

a Exemptions – A Single-employer Plan may claim an exemption from the Variable-rate 

Premium only if it meets the requirements for one of the exemptions described below: 

 Plans with no vested participants – Your plan qualifies for this exemption if the plan has no 

participants with vested benefits as of the UVB Valuation Date. 

 Section 412(e)(3) plans (formerly called 412(i) plans) – Your plan qualifies for this 

exemption if the plan is described in section 412(e)(3) of the Code and regulations 

thereunder on the UVB Valuation Date. 

 Plans terminating in standard terminations – Your plan qualifies for this exemption if 

notices of intent to terminate in a standard termination were issued in accordance with 

ERISA section 4041(a)(2), setting forth a proposed termination date (i.e., the 60- to 90-day 

prospective date) that is on or before the UVB Valuation Date. However, this exemption is 

conditional on the plan’s ultimately making a final distribution of assets in full satisfaction 

of its obligations under the standard termination. If such a distribution is not made, this 

exemption does not apply and the premium(s) that would otherwise have been required 

will be due retroactive to the applicable due date(s). 

If an exemption applies, check the applicable box to indicate which exemption applies and skip 

to item 8. 

b Variable-rate Premium cap qualification – If the plan qualifies as a small-employer plan, the 

Variable-rate Premium is capped at a specified amount (based on the number of plan 

participants). 

Determining whether plan qualifies for the cap – For this purpose: 

 a plan is a small-employer plan if the aggregate number of employees of all contributing 

sponsors of the plan and all members of the contributing sponsors’ controlled groups, as of 

the first day of the Premium Payment Year, is 25 or fewer, 

 the aggregate number of employees is determined in the same manner as under section 

410(b)(1) of the Code, taking into account the provisions of section 414(m) and (n) of the 

Code, but without regard to section 410(b)(3), (4), and (5) of the Code, and

 employees are counted as of the first day of the Premium Payment Year, not as of the 

Participant Count Date or the UVB Valuation Date. 

Note that a plan with 25 or fewer participants does not necessarily qualify for the cap because 

the eligibility criterion is based on employees, not the Participant Count. For example, if a plan 

has 15 participants, but there are more than 25 employees (taking into account all employees of 

all contributing sponsors of the plan and all members of their controlled groups), the plan does 

not qualify for the cap. 

Also note that a plan with more than 25 participants might qualify for the cap. For example, 

consider a contributing sponsor with 20 employees, all of whom are participants in a plan. If 

the plan also covers 15 former employees who are either terminated vested or retired, there are 

35 participants in total. This plan would qualify for the cap (assuming there are no other 

contributing sponsors and no controlled group members). 

Reporting requirements – If your plan qualifies for this cap, check the box to report that fact. 

If your plan qualifies for this cap, instead of reporting both the uncapped Variable-rate 

Premium ($9 per $1,000 of unfunded vested benefits) and the maximum Variable-rate 

Premium and then paying the lesser of the two amounts, you may report and pay the maximum 

Page 26
Description of Data Elements 

Variable-rate Premium. If you choose not to report the uncapped Variable-rate Premium, omit 

items 7c through 7g(1) and go directly to item 7g(2). Note that if you choose to pay the 

maximum Variable-rate Premium without determining whether it is less than the uncapped 

Variable-rate Premium, you may pay a larger Variable-rate Premium than required. 

c UVB Valuation Date – Report the UVB Valuation Date for the Premium Payment Year. 

d Premium Funding Target information 

The Premium Funding Target is the liability measure used to determine the Variable-rate 

Premium. It is similar to the funding target that is used to determine the minimum funding 

requirement for the Premium Payment Year, except that only vested benefits are taken into 

account. The assumptions used to determine this amount differ depending on which calculation 

method is used: 

 With the standard method, the Premium Funding Target is calculated using the same 

assumptions used to determine the minimum required contribution for the Premium 

Payment Year with one exception. In lieu of the discount rates used for funding purposes, 

the discount rates are the segment rates for the month preceding the month in which the 

Premium Payment Year begins that are determined in accordance with ERISA section 

4006(a)(3)(E)(iv). 

 With the alternative method, the Premium Funding Target is calculated using exactly the 

same assumptions used to determine the minimum required contribution for the Premium 

Payment Year. 

See “How to Determine Unfunded Vested Benefits” section for more information, including 

information on when certain types of benefits are considered vested. 

Note for Mid-size and Large Plans – If the Premium Funding Target (and thus, the Variablerate Premium) being reported in this filing is an estimate, check the box to report that fact. 

Note that if you file on an estimated basis, you must ultimately make a reconciliation filing 

using the actual Premium Funding Target (by amending this filing). In the reconciliation filing, 

in addition to reporting the actual Premium Funding Target data, be sure to indicate that the 

reported amount is no longer an estimate by making sure the “estimate” box is no longer 

checked. See “Correcting Filings and Reconciling Estimates” section. 

Note also that to qualify for the automatic penalty relief, the estimated Premium Funding 

Target must be certified by an enrolled actuary to be a reasonable estimate that: 

 takes into account the most recent data available to the enrolled actuary, and 

 has been determined in accordance with generally accepted actuarial principles. 

In addition, note that the election to use the Alternative Premium Funding Target for the first 

time must be made by the Variable-rate Premium due date and reported on the original 

comprehensive filing, even if the Premium Funding Target being reported is an estimate. The 

election is reported in the comprehensive filing. 

See “Late Payment Charges” section for more information on the penalty relief available to 

Large and Mid-size Plans paying estimated Variable-rate Premiums on the due date. 

(1) Premium Funding Target method – If you are using the Standard Premium Funding Target 

to determine unfunded vested benefits, check the “Standard” box. If you are using the 

Alternative Premium Funding Target to determine unfunded vested benefits, check the 

“Alternative” box. 

Note that the standard method must be used unless an election to use the alternative 

method is in effect (see instructions for Part II). Also, note that if an election to use the 

alternative method is in effect, you must use the alternative method. 

Page 27
Description of Data Elements 

(2) Report the discount rate(s) used to determine the Premium Funding Target. If you are 

using the: 

 Standard Premium Funding Target, these rates must be the segment rates for the 

month preceding the month in which the Premium Payment Year begins that are 

determined in accordance with ERISA section 4006(a)(3)(E)(iv) (i.e., the rates that 

would be determined under ERISA section 303(h)(2)(C) if ERISA section 

303(h)(2)(D) were applied by using the monthly yields for the month preceding the 

month in which the Premium Payment Year begins on investment grade corporate 

bonds with varying maturities, and in the top 3 quality levels, rather than the average 

of such yields for a 24-month period). These rates are available at www.pbgc.gov. 

 Alternative Premium Funding Target, these rates must be identical to the rates that 

are used to determine the minimum required contribution for the Premium Payment 

Year as reported in item 21a of the 2009 Schedule SB, Form 5500. This includes any 

elections with respect to the optional phase-in from the prior current liability 

discount rate, the applicable month, and the option to use the full yield curve in lieu 

of segment rates. If the full yield curve is used for this purpose, rather than reporting 

the full yield curve, check the box to report that fact. 

(3) Report the Premium Funding Target (dollars only). Note that if you are using the 

Alternative Premium Funding Target, the amount reported is generally equal to the total 

funding target reported in the 2009 Schedule SB (item 3d) reduced by the non-vested 

portion of the total funding target (item 3c(1)) reported in that same Schedule. 

e Market value of assets – Report the fair market value of plan assets (dollars only) as of the 

UVB Valuation Date for the Premium Payment Year adjusted to reflect contribution receipts as 

follows: 

Adjustments for prior year contributions 

If contributions for the prior plan year were made after the UVB Valuation Date and before the 

date the premium filing is made, increase the market value to include the discounted value of 

such contributions. Prior year contributions are discounted from the date made to the UVB 

Valuation Date, using the effective interest rate for the plan year for which the contributions 

were made. 

Adjustments for current year contributions 

If contributions for the current plan year were made before the UVB Valuation Date, decrease 

the market value by the adjusted value of these current year contributions. (Note – this can 

happen only if the UVB Valuation Date is after the beginning of the plan year). For this 

adjustment, such contributions are increased to the UVB Valuation Date. 

Interest adjustments 

For both interest adjustments noted above, use the effective interest rate determined under 

ERISA section 303(h)(2)(A) and reported in item 5 of Schedule SB for the plan year for which 

the contributions were made. 

Comparison to asset value reported on Schedule SB 

In general, the asset value reported here must be the same as the market value of assets 

reported in the 2009 Schedule SB (item 2a). The amounts would differ only if a premium filing 

is made before the premium filing due date and prior year contributions are made after the 

premium filing is made (and thus not included in assets). 

f Unfunded vested benefits – Report the excess (rounded up to the next $1,000), if any, of the 

Premium Funding Target over the fair market value of assets. 

Page 28
Description of Data Elements 

g Variable-rate Premium calculation (If the plan does not qualify for the Variable-rate-Premium 

cap, skip to item 7g(3). 

(1) Variable-rate Premium before reflecting the cap – Report the product of 0.009 and the 

amount of unfunded vested benefits. If the plan does not qualify for the Variable-ratePremium cap, this item must be left blank.

(2) Maximum Variable-rate Premium – The maximum Variable-rate Premium is $5 times the 

square of the plan’s Participant Count. Report the product of the Participant Count 

multiplied by the Participant Count multiplied by $5. If the plan does not qualify for the 

Variable-rate-Premium cap, this item must be left blank.

(3) Variable-rate Premium 

 If the plan does not qualify for the Variable-rate Premium cap, report the product of 

0.009 and the amount of unfunded vested benefits.

 If the plan qualifies for the Variable-rate Premium cap, report the lesser of the 

Variable-rate Premium before reflecting the cap and the maximum Variable-rate 

Premium, or, if you choose not to calculate/report the Variable-rate Premium before 

reflecting the cap, report the maximum Variable-rate Premium. 

If this is a short plan year of coverage, the required Variable-rate Premium may be a 

prorated portion of this amount; however, the full year’s premium amount must be reported 

in this item. 

8 Premium proration (If the plan does not qualify for premium proration, skip to item 9.) 

a Number of months in the short plan year – Report the number of months (complete and 

partial) in the short plan year. For this purpose, each plan month (i.e., each month in the plan 

year) generally begins on the same day of each successive calendar month. For example, if the 

plan year begins on July 1, the first day of each successive calendar month is the beginning of 

a new month; similarly, if the plan year begins on January 15, the second plan month begins 

on February 15, the third plan month on March 15, etc. Thus, if a short final year begins on 

January 1 and ends on June 1, there would be six (full or partial) months in the short year. 

(The last (partial) month, beginning (and ending) on June 1, would count as a full month for 

purposes of prorating the premium.) Similarly, if a short first year begins on July 31 and ends 

on December 31, there also would be six (full or partial) months in the short year. 

There are two special rules when a plan year begins at or near the end of a calendar month: 

 If the plan year begins on the last day of a calendar month, successive plan months begin 

on the last day of successive calendar months. For example, if the plan year begins on 

November 30, successive plan months begin on December 31, January 31, the last day of 

February (the 28th or 29th), March 31, etc. 

 If the plan year begins on the 29th or 30th of a calendar month other than February, the plan 

month beginning in February begins on the last day of February. For example, if the plan 

year begins on November 29, successive plan months begin on December 29, January 29, 

the last day of February (the 28th or 29th), March 29, etc. If the plan year begins on 

December 30, successive plan months begin on January 30, the last day of February (the 

28th or 29th), March 30, April 30, etc. 

Counting months for New and Newly-covered Plans – The short first year of a New Plan is 

treated as beginning on the Participant Count Date (i.e., the plan effective date). The short first 

year of a Newly-covered Plan is treated as beginning on the date when the plan becomes 

covered under ERISA section 4021. 

Page 29
Description of Data Elements 

Counting months for terminating plans – The (short) plan year of a terminating plan’s final 

year is treated as ending on: 

 for a Multiemployer Plan that distributed all its assets pursuant to ERISA section 4041A, 

the date the distribution is completed; or 

 for a Single-employer Plan, the earlier of: 

- the date on which the distribution of the plan’s assets in satisfaction of all Benefit 

Liabilities was completed; or 

- the date that a trustee for the terminating plan was appointed under ERISA section 

4042. 

b Total premium before proration – Report the sum of the Flat-rate Premium and, if applicable, 

the Variable-rate Premium. 

9 Total premium – The total premium is determined as follows:

 If the plan does not qualify for premium proration, report the sum of the Flat-rate Premium 

and, if applicable, the Variable-rate Premium. 

 If the plan qualifies for premium proration, multiply the total premium before reflecting 

proration by the number of months (complete and partial) in the short plan year and then 

divide by 12. Round to two decimal places after completing the calculation. 

If this amount includes cents, report the exact amount (dollars and cents), not a rounded amount. 

10 Premium credit 

Report the total amount of premium credits available to offset the premium due. Premium 

credits include: 

 Any overpayment of the 2008 premium filing for which a refund was not requested, 

 Estimated 2009 Flat-rate Premium paid earlier in the year (Large Plans only), and 

 Any other payments made for 2009 (including an estimated Variable-rate Premium for a 

Large or Mid-size Plan when amending the filing to reconcile the estimate. See “Correcting 

Filings and Reconciling Estimates” section). 

If this amount includes cents, report the exact amount (dollars and cents), not a rounded 

amount. 

11 Amount due – If the total premium due equals or exceeds the total premium credit, subtract the 

total credit from the total premium and report the result as the amount due. This is the amount 

you owe PBGC. See Appendix 3 for information on payment options. 

If you received an exemption from e-filing, check the box to report whether payment will be 

made by check or by electronic funds transfer (EFT). 

If this amount includes cents, report the exact amount (dollars and cents), not a rounded 

amount. 

Page 30
Description of Data Elements 

12 Treatment of Overpayment 

a If the total premium is less than the total premium credit, subtract the total premium from the 

total credit and report the result as an overpayment. 

b If you have an overpayment, you must choose whether to have the overpayment refunded (by 

check or electronic funds transfer) or credited towards the next year’s premium for the plan. 

Report your choice by checking the appropriate box. 

If you request to use the overpayment as a credit towards next year’s premium for the plan, you 

should claim the overpayment amount as a credit on the next year’s premium filing for the plan. 

If you prefer a refund to a credit, the quickest way to receive your refund is to select the 

electronic funds transfer option. We strongly recommend this option. To facilitate an electronic 

funds transfer, indicate whether the account is a checking account or savings account, and 

provide the bank routing number and account number to which the refund is to be credited. If 

you want the refund credited to a sub-account within the main account, also provide the subaccount number. 

If this amount includes cents, report the exact amount (dollars and cents), not a rounded 

amount. 

Instructions for Part IV – Miscellaneous Information 

13 Final premium filing 

If this is the last premium filing for this plan, indicate the reason: (1) that the plan merged or 

consolidated with another plan, (2) that the plan was trusteed under ERISA section 4042, (3) 

that the plan completed a distribution pursuant to termination, or (4) that the plan ceased to be a 

covered plan. 

Report the date of the event that led to the cessation of the requirement to file. If the reason this 

is the last premium filing is because: 

 the plan merged or consolidated into another plan, report the effective date of the Merger 

or Consolidation; 

 the plan terminated in an involuntary or distress termination, report the effective date of the 

trusteeship; 

 there was a distribution of assets pursuant to a termination: 

- for a Single-employer Plan that completed a standard termination, report the date on 

which the distribution of the plan’s assets in satisfaction of all Benefit Liabilities was 

completed, or 

- for a Multiemployer Plan that distributed all its assets pursuant to ERISA section 

4041A, report the date the distribution is completed; 

 the plan ceased to be covered by Title IV of ERISA, report the date coverage ceased. 

14 New or Newly-covered plans 

If this plan is a New Plan or a Newly-covered Plan, report the plan effective date, the Plan 

Adoption Date, and the plan coverage date. The plan coverage date is the date the plan became 

covered under Title IV. If the plan has had one or more periods of coverage in the past, report 

the earliest date in the Premium Payment Year when the plan was covered under Title IV — 

not the date when the plan became covered in a prior year. If another plan transferred assets or 

Page 31
Description of Data Elements 

liabilities to this New or Newly-covered Plan, be sure to complete the “Transfers from other 

plans” item (see item 15). 

15 Transfers from other plans 

Pre-existing plans – If another plan transferred assets or liabilities to this plan since the date of 

the most recent comprehensive premium filing (or, if this is a filing for a plan year beginning in 

2009, since the date of the 2008 “final filing”), report the EIN and PN of the plan from which 

the assets were transferred (i.e., the “transferor plan”). 

New Plans – If this plan is a New Plan and another plan transferred assets or liabilities to this 

plan in conjunction with the creation of this plan, report the EIN and PN of the plan from 

which the assets were transferred. 

Newly-covered Plans – If this plan is a Newly-covered Plan and another plan transferred assets 

or liabilities to this plan on or after the date the plan became covered and before the date the 

premium filing is made, report the EIN and PN of the plan from which the assets were 

transferred. 

In all cases, report the date of the transfer and check the box that best describes the type of 

transfer (see definitions of Merger, Spinoff, and Consolidation). For this purpose, the date of 

transfer is the date the transfer went into effect. 

Example – A Merger agreement between two calendar-year plans (Plans A and B) provides 

that participants of Plan A will cease accruing benefits under Plan A and begin coverage and 

benefit accruals under Plan B as of January 1, 2009, and that the obligation to pay benefits to 

Plan A participants will pass from Plan A to Plan B as of that date. The agreement also 

provides that Plan A’s assets will be transferred to Plan B’s account as soon as practicable. The 

transfer does not actually occur until February 17, 2009. If you are preparing a comprehensive 

premium filing for Plan B for Plan B’s 2009 plan year, report “01/01/2009” as the date of 

transfer. 

Note that the date of a transfer is determined based on the facts and circumstances of the 

particular situation. (For transfers subject to section 414(l) of the Code, report the date 

determined under 26 CFR 1.414(l)-1(b)(11).) 

If the transfer is the result of something other than a Merger, Spinoff, or Consolidation, for 

example, a reciprocity arrangement where assets and liabilities are transferred between two 

plans when an employee changes locations or changes status (e.g., from Salaried to Hourly and 

as a result becomes covered by another plan), check the “Other” box. Also check the “Other” 

box if you have no way of determining whether the transferor plan ceased to exist in 

connection with a Merger or Consolidation into your plan. 

If more than one transferor plan is involved, provide the above information with respect to each 

transferor plan. 

If, at the time you submit your filing, you are not aware that a transfer had occurred and you 

subsequently discover that a reportable transfer had occurred, you must amend the original 

filing to report the corrected information. 

16 Transfers to other plans

Pre-existing plans – If this plan transferred assets or liabilities to another plan since the date of 

the most recent comprehensive premium filing (or, if this is a filing for a plan year beginning in 

2009, since the date of the 2008 “final filing”), report the EIN and PN of the plan to which the 

assets were transferred (i.e., the “transferee plan”). In addition, report the date of transfer and 

check the box that best describes the type of transfer. 

Page 32
Description of Data Elements 

New Plans – If this plan is a New Plan and this plan transferred assets or liabilities to another 

plan on or after the earlier of the Plan Adoption Date and the effective date, and before the date 

the premium filing is made, report the EIN and PN of the plan to which the assets were 

transferred and the type of transfer. 

Newly-covered Plans – If this plan is a Newly-covered Plan and this plan transferred assets or 

liabilities to another plan on or after the date the plan became covered and before the date the 

premium filing is made, report the EIN and PN of the plan to which the assets were transferred 

and the type of transfer. 

In all cases, if more than one transferee plan is involved, provide the above information with 

respect to each transferor plan. See instructions to item 15 for more information on what is to 

be reported for “date of transfer.” 

If, at the time a filing is made, you are not aware that a transfer had occurred and you 

subsequently discover that a reportable transfer had occurred, you must amend the original 

filing to report the corrected information. 

Example – Until November 1, 2008, Plan E covered employees at Division 1. As a result of the 

sale of Division 1 to another sponsor (Employer X), assets and liabilities are spun off from 

Plan E to Plan F (a plan sponsored by the new owner) effective November 1, 2008. If you are 

preparing a 2009 comprehensive premium filing for Plan E, report Employer X’s EIN and the 

PN of Plan F. In addition, check the “Spinoff” box to report that the transfer occurred as the 

result of a Spinoff and report “11/01/2008” as the date of transfer. 

17 Participation freeze 

If, as of the beginning of the Premium Payment Year, the plan provides that participation is 

limited to participants who were covered by the plan as of a specified date (i.e., the plan is 

closed to new entrants), enter the date the plan became closed to new entrants. 

18 Benefit accrual freeze 

If, as of the beginning of the Premium Payment Year, the plan is partially or totally frozen for 

benefit accrual purposes, enter the date the freeze became effective and indicate the nature of 

the freeze by reporting whether (1) both pay and service are frozen for all participants, (2) both 

pay and service are frozen for some participants, (3) for all participants, service is frozen, but 

pay is not, (4) for some participants, service is frozen, but pay is not, or (5) some other type of 

accrual freeze is in effect (in which case you must provide a description of the freeze). 

If more than one description applies (for example, if pay and service are frozen for employees 

at location X and only service is frozen for employees at location Y), select “Other” and 

provide a description. 

If more than one freeze has occurred, report the date and nature of the most recent freeze. 

19 Amended filings – Complete this item only if this is an amended filing. 

a. If either first day or the last day of the premium payment year reported in this amended filing 

(item 3b(1)) differs from what was reported in the filing that is being amended, provide the 

dates that were reported in the original filing. 

b. If the EIN and PN reported in this amended filing (item 3c(1)) are not both the same as what 

was reported in the filing that is being amended, report the EIN and PN from the original 

filing. 

Page 33
Description of Data Elements 

Page 34

c. If this is an amended filing for a reason other than reconciling an estimated Variable-rate 

Premium and the amended filing shows a lower premium than the amount that was 

originally reported, provide an explanation of the specific circumstances or events that 

caused the reduction.

20 Attachments (paper filers only) 

If any additional information is included as an attachment to this filing, check the box to report 

that fact. Examples of required attachments include: explanation of why you are submitting a 

paper filing if you have not received an e-filing exemption; explanation of lower premium 

amount if filing is an amendment to a prior filing; transfer information if more than two plans 

are involved; explanation if EIN or PN differs from most recent 5500 filing; etc. 

Be sure to show the EIN/PN for this filing and the date the Premium Payment Year 

commenced (identified as “PYC”) at the top of each attachment. 

Instructions for Part V – Certifications 

21 Plan Administrator Certification 

All of the information reported in this filing must be certified by the Plan Administrator. 

Follow the certification instructions for the electronic filing method that is used to make the 

filing. Be sure to provide the Plan Administrator’s name and the telephone number. If the Plan 

Administrator has an e-mail address, that address must also be reported. 

22 Enrolled Actuary Certification 

An enrolled actuary must certify the Variable-rate Premium calculation unless: 

 The plan is a Multiemployer plan (and thus, there is no Variable-rate Premium). 

 The plan is a Single-employer Plan and is either: 

- exempt from the Variable-rate Premium, or 

- eligible for and paying the maximum Variable-rate Premium (and not reporting the 

regular Variable-rate Premium). 

Be sure to provide the enrolled actuary’s name, firm and telephone number. If the enrolled 

actuary has an e-mail address, that address must also be reported. 

The actuary must follow the certification instructions for the electronic filing method that is 

used to make the filing. 
Late Payment Charges 

General 

If you file a premium payment after the due date, we will bill the plan for late charges. The late charges 

include both interest and penalty charges. The charges are based on the outstanding premium amount due 

on the due date. If your due date is extended because it falls on a weekend or federal holiday, and your 

premium payment is filed after the extended due date, interest and penalty will be computed from the 

actual (unextended) due date. PBGC also may assess penalties under ERISA section 4071 for failure to 

timely provide premium-related information. 

Late Payment Interest Charges 

The late payment interest charge is set by ERISA, and we cannot waive it. Interest accrues at the rate 

imposed under section 6601(a) of the Code (the rate for late payment of taxes) and is compounded daily. 

These rates are published by IRS quarterly and are also posted on the Practitioners Page of PBGC’s Web 

site (www.pbgc.gov). 

Late Payment Penalty Charges 

The late payment penalty charge is established by us, subject to ERISA’s restriction that the penalty not 

exceed 100 percent of the unpaid premium amount. Subject to this cap, the penalty is a percentage of the 

unpaid amount for each month (or portion of a month) it remains unpaid with a minimum penalty of $25. 

The monthly rate is higher or lower depending on whether the premium underpayment is “self-corrected.” 

The penalty rate is 1 percent of the late premium payment per month if the late payment is made on or 

before the date when PBGC issues a written notification indicating that there is or may be a premium 

delinquency (for example, a statement of account (premium invoice), a past-due-filing notice, or a letter 

initiating an audit). A penalty rate of 5 percent per month applies to payments made after the PBGC 

notification date. 

Minimizing Late Payment Charges 

If you cannot make a comprehensive filing by the due date because you are having difficulty determining 

some of the required information, you can minimize late payment charges by submitting payment (the 

amount due or an estimate) without submitting the certified comprehensive filing. If you choose to do this, 

you must pay by check or wire transfer outside of My PAA (see Appendix 3). The payment should be 

clearly identified with the Employer Identification Number (EIN), Plan Number (PN) and the plan year 

commencement date (PYC) for the plan. You should then submit your certified filing as soon as possible. 

PBGC does not recommend this procedure. We may assess a penalty under ERISA section 4071 for 

failure to furnish premium-related information by the required due date, and making a premium payment 

without an accompanying premium information filing may cause significant delay in providing a 

statement of account for the plan. However, when the information filing is ultimately made, the payment 

will be credited as of the date it was filed and thus stop the accrual of late payment charges on the amount 

paid. 

Saturday, Sunday, and Federal Holidays 

As explained in the “When to File” section, if your premium filing due date falls on a Saturday, Sunday 

or Federal Holiday, it is extended automatically to the next business day. However, if your premium 

payment is filed after the extended due date, interest and penalties will be computed from the actual 

(unextended) due date. 

Page 35
Late Payment Charges 

Example – The Flat-rate and Variable-rate Premium for a Small Plan with a plan year beginning on July 1, 

2009, normally would be due on October 31, 2010. Because that day is a Saturday, the due date is 

Monday, November 2, 2010. If your filing is made on Wednesday, November 4, 2010, any applicable late 

payment charges will be computed from Saturday, October 31, 2010, not November 2, 2010. 

Notices from PBGC 

Statements of Account 

If your payment is late or less than the required amount, we will send a “statement of account” (SOA). 

The SOA is, in essence, an invoice for premium, penalty, and interest amounts owed to PBGC. To ensure 

that the amount due does not increase, the premium and interest must be paid within 30 days of the SOA's 

issue date. If you receive an SOA that appears to be in error, contact our customer service representative 

(see Appendix 2 for contact information). 

Past Due Filing Notices

If our records indicate that a premium filing is missing for a particular plan year, we will send a “Past Due 

Filing Notice” to the address reported on the most recent filing. If you receive a Past Due Filing Notice 

that appears to be in error, contact our customer service representatives (see Appendix 2 for contact 

information). If a filing was in fact required, after we receive the late filing, we will send a statement of 

account assessing late payment charges. 

Penalty Waivers 

Hardship (i.e., “Statutory”) Waivers 

If, before the filing due date, you can show substantial hardship and that you will be able to pay the 

premium within 60 days after the filing due date, you may request that we waive the late payment penalty 

charge. If we grant your request, we will waive the late payment penalty charge for up to 60 days. To 

request a waiver, write to the address provided in Appendix 2. 

Reasonable Cause Waivers 

Waivers of the late payment penalty charge may also be granted based on a demonstration of reasonable 

cause. Failure to obtain premium instructions from PBGC is not reasonable cause for a waiver. 

If you wish to request a reasonable cause waiver, write or email the PBGC after you receive a statement 

of account (SOA) assessing penalties. Penalty waiver requests must be received within 30 days after the 

date of the SOA. PBGC will consider the facts and circumstances and send the plan administrator a 

written response, generally within 90 days after the request. If the penalty waiver request is denied or 

granted to a lesser extent than requested, you may request reconsideration of our initial determination 

within 30 days after the date of the initial determination (unless we ordered the initial determination to be 

final). PBGC will consider the request for reconsideration independently and will respond to you in 

writing. This response will be the agency's final determination on the matter. 

See Appendix 2 for information on where to send a request for a penalty waiver or reconsideration. 

Page 36
Late Payment Charges 

Automatic Penalty Waiver for Late Flat-rate Premiums – Large Plans 

The Flat-rate Premium owed for a plan year is based on the number of plan participants as of the 

Participant Count Date. However, a Large Plan may not have an accurate Participant Count by its Flatrate Premium due date, which falls early in the year (generally the end of February in the Premium 

Payment Year for calendar-year plans). For this reason, PBGC permits Large Plans to compute the 

amount owed on the basis of an estimated Participant Count. However, a Large Plan’s full Flat-rate 

Premium (not merely an estimate) is due by the plan’s Flat-rate Premium due date. If the full amount due 

is not paid by that date, the plan will be subject to late payment interest charges and may also be subject 

to late payment penalty charges. 

If you make an estimated Flat-rate Premium filing (based on an estimate of the plan’s Participant Count), 

you must reconcile that filing by the 15th day of the tenth full calendar month following the end of the 

plan year preceding the Premium Payment Year (October 15th of the Premium Payment Year for 

calendar-year plans). 

No penalty will be charged (although interest will be charged) until the date the flat-rate reconciliation 

filing is due if the premium (based on an estimated Participant Count) that you pay by the Flat-rate 

Premium due date equals at least the lesser of: 

 90 percent of the full Flat-rate Premium, or 

 an amount equal to the Participant Count for the year before the Premium Payment Year multiplied 

by the applicable flat premium rate for the Premium Payment Year. This test will be met if the 

amount paid is sufficient using either the actual Participant Count for the plan year preceding the 

Premium Payment Year or a smaller count that was erroneously reported. 

In addition, no penalty will be charged (although interest will be charged) until the date the reconciliation 

is due if you did not make a Flat-rate Premium payment by the Large Plan Flat-rate Premium due date 

because either: 

 you erroneously reported fewer than 500 participants for the plan year preceding the Premium 

Payment Year, or 

 the due date for paying the Flat-rate Premium for the plan year preceding the Premium Payment Year 

is later than the due date for paying the Flat-rate Premium for the Premium Payment Year. This could 

happen, for example, if a calendar-year plan were new for Year 1 (and thus had a Year 1 due date of 

April 30 of Year 2) and had 550 participants for Year 1, making it a Large Plan for Year 2 (with a 

Year 2 Flat-rate Premium due date of February 28 of Year 2). 

For purposes of determining whether a penalty is due, the Participant Count “erroneously reported” for 

the plan year preceding the Premium Payment Year refers to the premium filing (or last amended filing) 

for the plan year preceding the Premium Payment Year made to PBGC by the Flat-rate Premium due date 

for the Premium Payment Year. See the separate instructions for Estimated Flat-rate Premiums for Large 

Plans for more details. 

If you have an accurate Participant Count for a Large Plan by the time the Flat-rate Premium is due, you 

should pay the amount owed by that date. If you do so, you will avoid the interest charge and any penalty 

charge. 

Page 37
Late Payment Charges 

If you have all the information needed to make a comprehensive filing by the date the Flat-rate Premium 

is due, you may make a comprehensive filing at that time.8

 If you make an estimated Flat-rate Premium 

filing, you will still be required to make a comprehensive filing by the date the Flat-rate Premium 

reconciliation filing is due. 

Automatic Penalty Waiver for Late Variable-Rate Premiums – Large and Mid-size Plans 

The Variable-Rate Premium owed for a plan year is based on the Premium Funding Target as of the UVB 

Valuation Date. However, a Large or Mid-size Plan may not be able to calculate an accurate Premium 

Funding Target by its Variable-rate Premium due date (generally October 15th of the Premium Payment 

Year for calendar-year plans). For this reason, PBGC permits Large and Mid-size Plans to compute the 

Variable-Rate Premium owed on the basis of an estimated Premium Funding Target. However, a Large or 

Mid-size Plan’s full Variable-rate Premium (not merely an estimate) is due by the plan’s Variable-rate 

Premium due date. If the full amount due is not paid by that date, the plan will be subject to late payment 

interest charges and may also be subject to late payment penalty charges. 

If you make an estimated Variable-rate Premium filing, you must reconcile that filing by the last day of 

the 16th full calendar month following the end of the plan year preceding the Premium Payment Year 

(April 30th following the Premium Payment Year for calendar-year plans). 

No penalty will be charged (although interest will be charged) until the date the reconciliation is due or (if 

earlier) the date the reconciliation filing is made if, by the plan’s Variable-rate Premium due date: 

 You report: 

- The fair market value of the plan’s assets for the Premium Payment Year, and 

- An estimate of the Premium Funding Target that is certified by an enrolled actuary to be a 

reasonable estimate that: 

o takes into account the most current data available to the enrolled actuary; 

o has been determined in accordance with generally accepted actuarial principles and 

practices; and 

o uses the calculation methodology (alternative or standard) in effect for the plan year; and 

 You pay at least the amount of Variable-rate Premium determined from the value of assets and 

estimated Premium Funding Target so reported. 

Note that the fair market value of the plan’s assets that you report must be final, not an estimate. If you 

subsequently make an amended filing reflecting a different value of assets, this penalty relief will be lost. 

However, PBGC will consider a request for an appropriate penalty waiver in such a situation and in acting 

on the request will consider such facts and circumstances as the reason for the mistake, whether assets 

were over- or understated, and, if assets were overstated, the extent of the overstatement. 

In addition, note that the election to use the Alternative Premium Funding Target must be made by the 

Variable-rate Premium due date even if the Premium Funding Target being reported is an estimate. The 

 

8

 Note – For Large plans with Flat-rate Premium due dates early in the year (for example, a calendar-year Large 

Plan), My PAA might not be updated to accept comprehensive filings by the time the Flat-rate Premium is due. In 

such cases, it will be necessary to submit an estimated Flat-rate Premium filing and then reconcile that filing later 

in the year (when the comprehensive filing is made). 

Page 38
Late Payment Charges 

Page 39

election is reported on the original comprehensive filing. The reconciliation filing serves to finalize a 

previously estimated Premium Funding Target; it does not afford an opportunity to elect the alternative 

method after the due date for such election (or to revoke a prior election after the due date for such 

revocation). 

If you know the final Premium Funding Target for a Mid-size or Large Plan by the time the Variable-rate 

Premium is due, you should pay the amount owed by that date. If you do so, you will avoid the interest 

charge and any penalty charge. If you report that you are making a filing based on an estimated Premium 

Funding Target, you will be required to make an amended filing reflecting the actual Premium Funding 

Target by the date the variable-rate reconciliation filing is due. 
Correcting Filings, Reconciling Estimates, and Refunding Overpayments 

Correcting Errors 

Making Payment Without Filing Information 

If you make a premium payment without filing the related premium information, file the 

information as soon as possible to get proper credit for your payment and minimize any late filing 

penalty. Follow the instructions in this document or in My PAA for identifying your payment so 

that we can associate it with your information filing. 

Filing Information Without Making Required Payment 

If you make a filing of premium information without making a required payment, send the payment 

as soon as possible to minimize late payment charges. Follow the instructions in this document or 

in My PAA for identifying your payment so that we can associate it with your information filing. 

Amended Filings 

If, after submitting a filing, you discover an error has been made (e.g., originally reported 

information is incorrect), you must amend the filing to report the correct information even if the 

correction has no impact on the premium amount. A filing can be amended by resubmitting the 

filing with the corrected information. Be sure to indicate that the filing is an amendment to a 

previously submitted filing (see “Description of Data Elements” section). 

In the amended filing, report all of the required information, including information that was correct 

in the original filing. Include as credits all the credits you previously claimed increased by the 

amount you paid with your most recent filing and reduced by any refund you requested. 

If the originally reported premium: 

 was too low, the additional premium due will equal the excess of the revised total premium 

amount over the revised total credit. Pay the additional premium due when you submit your 

amended filing. In this case, late payment interest charges will apply and late payment penalty 

charges may apply. You will receive an invoice for these charges after your amended filing is 

received. You may include payment of anticipated late payment charges when you pay the 

additional premium, but the amount reported on the amended filing should reflect only the 

additional premium due.

 was too high, the overpayment will equal the excess of the revised total credit over the revised 

total premium. Indicate whether you want the overpayment refunded or applied to the next 

year’s premium for the plan. 

If you request that an overpayment be applied to the next year’s premium, you should claim the 

amount of the overpayment as a credit on the next year’s premium filing for the plan. If you 

want a refund by electronic funds transfer, provide the necessary information; we will make the 

transfer through the automated clearing house (ACH) system. A request for a refund must be 

made within the period specified in the applicable statute of limitations (generally six years 

after the overpayment was made). 

If there are unpaid premiums, interest, or penalties for your plan for prior years, you may 

request PBGC to apply all or part of an overpayment toward payment of those unpaid prior 

year amounts. Such a request should be made in writing (e-mail, letter or fax—see Appendix 2). 

Note that an overpayment for one plan cannot be applied to offset an underpayment on another 

plan. 

Page 40
Correcting Filings, Reconciling Estimates, and Refunding Overpayments 

Page 41

Required explanation if premium amount decreases 

If you amend a comprehensive filing for a reason other than reconciling an estimated Variable-rate 

Premium and the amended filing shows a lower premium than the amount that was originally 

reported, you must provide an explanation of the specific circumstances or events that caused the 

reduction. (For example, if your original final filing’s Participant Count included employees at a 

division that is not covered by the plan, you would explain why the employees were erroneously 

counted as participants and how the error was discovered.) 

Note that if you are amending a filing for an earlier year, you must follow the instructions for that 

year except that current mailing and Electronic Funds Transfer addresses should be used instead of 

the addresses that were included in the instructions for the original filing. Prior year instructions are 

available at www.pbgc.gov. 

Refunds 

If we determine that a requested refund is in order, we will send the plan administrator a letter 

confirming that the refund will be forthcoming. This letter will include an account history 

describing how the overpayment was used to satisfy any outstanding premium, interest, or penalty 

amounts. The refund will subsequently be issued by the U.S. Treasury. You should receive the 

refund typically within 60 days after you receive the PBGC refund letter. Please be aware that 

refunds will take longer to process during peak filing periods, which begin in February and October. 

PBGC may apply all or a portion of an overpayment to the satisfaction of outstanding premium, 

penalty and interest charges. Overpayments are refunded only if there are funds remaining after 

outstanding premium, penalty and interest charges are satisfied. 

Reconciling Estimates 

For Large and Mid-size Plans that filed an estimated Variable-rate Premium, the reconciliation is 

made by amending the filing that included the Variable-rate Premium estimate. 

See “Description of Data Elements” section for additional information on how to reconcile an 

estimated Variable-rate Premium. 

For Large Plans, the Flat-rate Premium reconciliation filing is due on the same date the 

comprehensive premium filing is due. The comprehensive premium filing is designed to enable 

you to reconcile an estimate Flat-rate Premium and report the other premium information 

(Variable-rate Premium data, miscellaneous data, etc.) as part of the same filing. 

Failure to reconcile these estimates in a timely manner will result in late payment charges if the 

estimate to be reconciled was too low. PBGC may also assess penalties under ERISA section 4071 

for failure to reconcile estimated premium filings by the reconciliation due date. 
Recordkeeping Requirements and PBGC Audits 

Recordkeeping Requirements 

Plan Administrators are required to retain all plan records that are necessary to establish, support 

and validate the amount of any PBGC premium required to be paid and any information required to 

be reported. The records must include calculations and other data prepared by an enrolled actuary, 

the Plan Sponsor, and an employer required to contribute to the plan with respect to its employees; 

or for a plan described in section 412(e)(3) of the Code, by the insurer from which the insurance 

contracts are purchased. The records must be kept for six years after the premium due date. 

Records that must be retained include, but are not limited to, records that establish the number of 

plan participants and the amount of unfunded vested benefits on which the Variable-rate Premium 

is based. Records retained pursuant to this paragraph must be made available or submitted to 

PBGC promptly upon request. If a record to be produced for PBGC inspection and copying exists 

in more than one format, it must be produced in the format that PBGC specifies. 

Records also include, but are not limited to, plan documents; participant data records; personnel 

and payroll records; actuarial tables, worksheets, and reports; records of computations, projections, 

and estimates; benefit statements, disclosures, and applications; financial and tax records; insurance 

contracts; records of plan procedures and practices; and any other records, whether in written, 

electronic, or other format, that are relevant to the determination of the amount of any premium 

required to be paid or any premium-related information required to be reported. 

PBGC Audits 

We may audit any premium filing; inspect and copy any records that are relevant to the 

determination of the amount of any premium required to be paid and any premium-related 

information required to be reported; and require disclosure and demonstration of any system used 

to determine any premium required to be paid or premium-related information required to be 

reported, so that PBGC can assess the system’s effectiveness and reliability. 

If we determine upon audit that the full amount of the premium due was not paid, late payment 

interest charges under §4007.7 of the Premium Regulations and late payment penalty charges under 

§4007.8 of the Premium Regulations will apply to the unpaid balance from the premium due date 

to the date of payment (see “Late Payment Charges” section for more information on penalties and 

interest for late payment of premiums). 

 If, in our judgment, the plan’s records fail to establish the number of participants with respect to 

whom premiums were required, we may rely on data we obtain from other sources (including the 

Internal Revenue Service and the Department of Labor) for presumptively establishing the number 

of plan participants for premium computation purposes. Similarly, if, in our judgment, the plan’s 

records fail to establish the unfunded vested benefits amount reported in the premium filing, we 

may rely on data we obtain from other sources for estimating the unfunded vested benefits for 

premium computation purposes. 

In addition to penalties for late payment of premiums, we may assess a penalty under ERISA 

section 4071 for failure to furnish premium-related information by required due dates. 

Page 42
Appendix 1 – Definitions 

The following terms are used throughout the instructions. 

“Alternative Premium Funding Target” – see “Premium Funding Target” 

“Benefit Liabilities” means all liabilities with respect to employees and their beneficiaries under 

the plan (within the meaning of Code section 401(a)(2)). Thus, Benefit Liabilities include 

liabilities for all accrued benefits, whether or not vested. In addition, a plan’s Benefit Liabilities 

include liabilities for ancillary benefits not directly related to retirement benefits, such as 

disability benefits not in excess of the qualified disability benefit, life insurance benefits payable 

as a lump sum, incidental death benefits, or current life insurance protection (see Treasury 

Regulation § 1.411(a)-7(a)(1)). 

 “Consolidation” means a transaction in which two or more plans transfer all of their assets and 

liabilities to a New Plan and, as a result, cease to exist (because the transferor plans become part 

of the new transferee plan). It differs from a Merger because in a Merger, the transferee plan 

existed before the transaction. In a Consolidation, the transferee plan is a New Plan that is created 

in the Consolidation. Thus, the plan that exists after a Consolidation follows the premium filing 

rules for New Plans. 

“Code” means the Internal Revenue Code of 1986, as amended. 

“EIN” means Employer Identification Number. It is always a nine-digit number assigned by the 

Internal Revenue Service for tax purposes. 

“ERISA” means the Employee Retirement Income Security Act of 1974, as amended (29 U.S.C. 

1001 et seq.). 

“Flat-rate Premium” means the portion of the premium determined by multiplying the flat 

premium rate by the number of participants in the plan on the Participant Count Date. The perparticipant flat premium rate for plan years beginning in 2009 is $34 for Single-employer Plans 

and $9 for Multiemployer Plans. 

“Form 5500 Series” means Form 5500, Annual Return/Report of Employee Benefit Plan, jointly 

developed by the Internal Revenue Service, the Department of Labor, and PBGC. 

“Large Plan” – See “Plan Size” 

“Merger” means a transaction in which one or more plans transfer all of their assets and 

liabilities to an existing plan and, as a result, cease to exist (because the transferor plan(s) become 

part of the transferee plan). It differs from a Consolidation because in a Consolidation, the 

transferee plan did not exist before the transaction. In a Merger, the transferee plan is an existing 

plan and follows the rules for preexisting, ongoing plans. 

“Mid-size Plan” – See “Plan Size” 

“Multiemployer Plan” (subject to the provisions of ERISA sections 3(37)(E) and (G) and 4303, 

dealing with elections to be treated or not to be treated as a Multiemployer Plan) means a plan: 

 to which more than one employer is required to contribute, 

 which is maintained pursuant to one or more collective bargaining agreements between one 

or more employee organizations and more than one employer, and 

 which satisfies such other requirements as the Secretary of Labor may prescribe by regulation. 

For purposes of determining whether a plan is a Multiemployer Plan or a Single-employer Plan, 

all trades or businesses (whether or not incorporated) that are under common control are 

considered to be one employer. 

Page 43
Appendix 1 – Definitions 

“Multiple-employer plan” means a plan to which more than one employer contributes that is not 

a Multiemployer Plan. 

“My PAA” means “My Plan Administration Account,” PBGC’s electronic premium filing 

application, available through PBGC’s Web site (www.pbgc.gov). 

“New Plan” means a plan that did not exist before the Premium Payment Year. This includes a 

plan resulting from a Consolidation or Spinoff. A plan that meets this definition is considered to 

be a New Plan even if the plan constitutes a successor plan within the meaning of ERISA section 

4021(a). 

“Newly-covered Plan” means a plan that is not a New Plan and that was not covered by title IV 

of ERISA immediately before the Premium Payment Year. 

“Participant” of a plan means an individual (whether active, inactive, retired, or deceased) with 

respect to whom the plan has Benefit Liabilities. See “How to Count Participants” section for 

more information. 

“Participant Count” means the number of participants on the Participant Count Date. See “How 

to Count Participants” section for more information. 

“Participant Count Date” means the date on which participants are counted for purposes of 

determining the Flat-rate Premium and, if applicable, the cap on the Variable-rate Premium. In 

general, it is the last day of the plan year preceding the Premium Payment Year, but there are 

some exceptions. See “How to Count Participants” section for more information. 

“Plan Administrator” means: 

 the person specifically so designated by the terms of the instrument under which the plan is 

operated; or 

 if an administrator is not so designated, the Plan Sponsor. 

“Plan Adoption Date” means the date on which a plan was formally adopted. 

“Plan Size” refers to the category to which a plan, other than a New or Newly-covered Plan, is 

assigned. Plans are divided into three categories based on the number of participants for whom 

premiums were payable for the plan year preceding the Premium Payment Year: 

 “Small Plan” means a plan that had fewer than 100 such participants. 

 “Mid-size Plan” means a plan that had 100 or more but fewer than 500 such participants. 

 “Large Plan” means a plan that had 500 or more such participants. 

If this is the first Premium Payment Year (i.e., if the plan is a New or Newly-covered Plan), the 

plan is not classified as either a Small, Mid-size or Large Plan. 

“Plan Sponsor” is determined as follows: 

 For a Single-employer Plan with: 

- one contributing sponsor, the Plan Sponsor is the contributing sponsor; 

- two or more contributing sponsors that are all in a single controlled group, the Plan 

Sponsor is the parent of the controlled group or, if there is no parent, the largest member 

of the controlled group (whether or not the parent or largest member is a contributing 

sponsor); 

- two or more contributing sponsors that are not all in a single controlled group, the Plan 

Sponsor is determined as follows: first identify the controlled group, or contributing 

Page 44
Appendix 1 – Definitions 

sponsor that is not in a controlled group, that has the most participants in the plan. If you 

identify a contributing sponsor that is not in a controlled group, the Plan Sponsor is that 

contributing sponsor. But if you identify a controlled group, then the Plan Sponsor is the 

parent of that controlled group or, if there is no parent, the largest member of that 

controlled group (whether or not the parent or largest member is a contributing sponsor). 

 For a Multiemployer Plan, the Plan Sponsor is the association, committee, joint board of 

trustees, or other entity that establishes or maintains the plan. 

“PN” means Plan Number. This is always a three-digit number. The employer maintaining the 

plan assigns this number to distinguish among employee benefit plans established or maintained 

by the same employer. An employer usually starts numbering pension plans at “001” and uses 

consecutive Plan Numbers for each additional plan. Once a PN is assigned, always use it to 

identify the same plan. If a plan is terminated, retire the PN—do not use it for another plan. 

“Premium Funding Target” is the liability measure used to determine the Variable-rate 

Premium. This is similar to the funding target that is used to determine the minimum funding 

requirement for the Premium Payment Year except that only vested benefits are taken into 

account. The assumptions used to determine this amount vary depending on which calculation 

method is used (standard or alternative): 

 “Standard Premium Funding Target” means a Premium Funding Target calculated using 

the same assumptions used for funding purposes except instead of the discount rates used for 

funding purposes, the discount rates are the segment rates for the month preceding the month 

in which the Premium Payment Year begins that are determined in accordance with ERISA 

section 4006(a)(3)(E)(iv). 

 “Alternative Premium Funding Target” means a Premium Funding Target calculated 

using the same assumptions used for funding purposes. See “How to Determine Unfunded 

Vested Benefits” section for additional information related to the election and use of the 

Alternative Premium Funding Target. 

See “How to Determine Unfunded Vested Benefits” section for additional information on how 

the Premium Funding Target is determined. 

“Premium Payment Year” means the plan year for which the premium is being paid. For 

example, since this document relates to premium filings for plan years beginning in 2009, all 

references to “Premium Payment Year” relate to plan years beginning in 2009. 

“Premium Regulations” means PBGC’s regulations on Premium Rates and Payment of 

Premiums (29 CFR Parts 4006 and 4007). The premium filing procedures (including the My PAA 

electronic filing application, paper instructions, and forms) are prescribed under and implement 

the Premium Regulations. 

“Schedule SB” means Schedule SB to the Form 5500 Series. 

“Single-employer Plan” means any plan that is not a Multiemployer Plan. A Single-employer 

Plan includes a Multiple-employer Plan. For purposes of determining whether a plan is a 

Multiemployer Plan or a Single-employer Plan, all trades or businesses (whether or not 

incorporated) that are under common control are considered to be one employer. 

“Small Plan” – See “Plan Size” 

“Spinoff” means a transaction in which the transferor plan transfers only part of its assets and/or 

liabilities to the transferee plan. The transferee plan may be a New Plan that is created in the 

Spinoff, or it may be a preexisting plan that simply receives part of the assets and/or liabilities of 

the transferor plan. 

Page 45
Appendix 1 – Definitions 

Page 46

“Standard Premium Funding Target” – see “Premium Funding Target” 

“UVB Valuation Date” means the plan’s funding valuation date for the Premium Payment Year 

determined in accordance with ERISA section 303(g)(2). 

“Variable-rate Premium” means the portion of the single-employer premium based on a plan’s 

unfunded vested benefits. The Variable-rate Premium is $9 for every $1,000 (or fraction thereof) 

of unfunded vested benefits, subject to a cap for certain plans of small employers. 

“We” or “us” refers to the Pension Benefit Guaranty Corporation. 

“You” or “your” refers to the Plan Administrator.
Appendix 2 – Contact information 

1. PBGC’s Web site (www.pbgc.gov) contains pension plan information of interest to Plan 

Administrators and practitioners, such as electronic premium filing, current and prior 

premium filing booklets, frequently asked questions interest rates, regulations, etc. This 

information can typically be accessed via the Practitioners Page. The “What’s New” section 

of the Practitioners Page provides information on recent events (e.g., disaster relief, etc.) 

2. Submit electronic premium filings (including electronic amended filings) through “My 

Plan Administration Account” (“My PAA”) on PBGC’s Web site. Access My PAA 

information via the Practitioners Page and follow instructions about how to use My PAA 

for submitting premium payments. 

3. For a paper premium filing (if exempt from mandatory e-filing), see Appendix 5 for 

information on where to mail filings. 

4. For all premium-related correspondence (other than submitting a paper filing), 

including requests for exemption from the requirement to file electronically, premium 

filing questions (for electronic or paper filings), requests for instructions, address changes, 

requests for refunds (that are not submitted with premium filings), and requests for penalty 

waivers: 

a. Mail (U.S. Postal Service or private delivery service): Send to the address posted on 

Web site under Premium Filings. 

b. Call: 1-800-736-2444 or 202-326-4242 (Note – requests for exemptions from e-filing 

requirement cannot be made by phone) 

c. Fax: 202-326-4250 

d. E-mail: premiums@pbgc.gov

5. For current interest rate information: 

a. Call: 202-326-4041 

b. See: Interest Rate section in top left corner of the Practitioners Page of PBGC’s Web 

site. 

6. For assistance on coverage determination or plan termination: 

a. Call: 1-800-736-2444 or 202-326-4242 

b. E-mail: standard@pbgc.gov 

c. Write to: 

Pension Benefit Guaranty Corporation 

Standard Termination Compliance Division, Suite 930 

Processing and Technical Assistance Branch

1200 K Street, NW 

Washington, DC 20005-4026 

Page 47
Appendix 2 – Contact information 

Page 48

7. If you have a complaint about the service you have received or still need assistance after 

calling our practitioner telephone numbers listed in item 4 (1-800-736-2444 or 202-326-

4242), please contact the Problem Resolution Officer (Practitioners): 

a. Call: 1-800-736-2444, ext. 4136 or 202-326-4136 

b. E-mail: practitioner.pro@pbgc.gov 

c. Write to: 

Pension Benefit Guaranty Corporation 

Financial Operations Department 

Problem Resolution Officer (Practitioners) 

1200 K Street, NW 

 Washington, DC 20005-4026 

8. For questions about our Premium Compliance Evaluation Program: 

a. Call: 1-800-736-2444, ext. 6855 or 202-326-4161, ext. 6855 

b. E-mail: pce@pbgc.gov 

9. For software developers requesting approval of XML files produced by private-sector 

software for use in My PAA, follow submission instructions on PBGC’s Web site. 

TTY/TDD users may call the Federal relay service toll-free at 1-800-877-8339 and ask to be 

connected to any telephone number. 

Note – We cannot accept collect calls. 
Appendix 3 – Online Premium Filing with My PAA

 

Introduction 

My Plan Administration Account (My PAA) is a secure, Web-based application that enables you to 

electronically submit premium filings and payments to PBGC. Although electronic filing of 

premium information is mandatory, payments may be made either electronically or by paper check. 

Information about how to use My PAA may be accessed through the Practitioners Page of PBGC’s 

Web site (www.pbgc.gov) as well as within the My PAA application itself. 

To use My PAA, you must set up a My PAA account which includes a user ID and password. Each 

My PAA user needs only one account, which can include an unlimited number of plans. 

My PAA offers three e-filing methods: 

 You can use My PAA’s data entry and editing screens to create a filing; route it to others for 

review, editing, and electronic certification; and submit it electronically to PBGC. Each person 

who participates in the electronic processing of the filing must have a My PAA account. 

 You can use private-sector software that is compatible with My PAA to create a filing, and 

then import the filing data into My PAA’s data entry and editing screens for routing, review, 

editing, electronic certification, and electronic submission to PBGC. Each person who 

participates in the electronic processing of the filing must have a My PAA account. 

 You can use private-sector software that is compatible with My PAA to create a filing, and 

then upload the filing to PBGC via the My PAA application. The filing cannot be routed, 

reviewed, or edited in My PAA. In most cases, a paper copy or copies of the filing must be 

certified outside of My PAA and retained in plan records. Only the person who uploads the 

filing must have a My PAA account. 

My PAA’s Data Entry and Editing Screens 

Entering information 

My PAA’s data entry and editing screens walk you through a step-by-step process to create a 

premium filing. For example, in the first step you identify the type of filing to be submitted 

(estimated Flat-rate Premium filing for Large Plans or comprehensive premium filing for all other 

purposes), the type of plan (Single-employer or Multiemployer) for which the filing is being 

submitted, and the plan year. Instructions are provided at each step. 

The information entered in each step determines the content of the successive steps. For example, if 

you indicate that you are preparing a comprehensive premium filing for a Single-employer Plan, 

the later steps will request information needed to determine the amount of the Variable-rate 

Premium (if applicable). However, if you indicate that you are preparing a comprehensive premium 

filing for a Multiemployer Plan, the Variable-Rate Premium screens will be suppressed. 

The required mathematical calculations are automated. For example, My PAA automatically 

multiplies your Participant Count by the applicable flat premium rate to generate the Flat-rate 

Premium. 

Page 49
Appendix 3 – Online Premium Filing with My PAA

 

E-filing team 

Multiple people can contribute to a plan’s filing in My PAA’s data entry and editing screens. For 

example, some information might be entered by the Plan Administrator and other information by 

an actuary. The people authorized to contribute to a plan’s premium filing in My PAA’s data entry 

and editing screens are those who have the plan in their My PAA accounts, and are referred to as 

the plan’s “e-filing team.” 

Routing filings 

Filings in progress can be routed among e-filing team members through My PAA for input, review, 

editing, e-certification of information, authorization of payment, and submission to PBGC. The 

person routing the filing to another member of the e-filing team can provide comments and 

instructions for the person to whom the filing is being routed. My PAA sends that person an e-mail 

notice (with the comments and instructions) stating that the filing has been routed for the 

recipient’s action and that the recipient is now “holding” that filing. After all information has been 

provided and certified, and payment (if any) has been authorized, the filing can be electronically 

submitted to PBGC by the Plan Administrator or Filing Coordinator. 

Using Private-Sector Software with My PAA 

Compatibility with My PAA 

You can use private-sector software to prepare a premium e-filing, but the software you use must 

be compatible with My PAA. That means that the software must be able to place your filing in an 

electronic file that is in “XML” format and meets PBGC specifications. The specifications are 

posted on PBGC’s Web site (www.pbgc.gov). Private-sector software providers and developers 

submit to PBGC sample filings in XML format for PBGC review and assignment of vendor 

numbers; you should check with your software provider or developer to find out whether your 

software is capable of creating an XML file in the proper format for use with My PAA. If your 

compatible private-sector software permits, you can create batch files containing more than one 

premium filing for use with My PAA. 

Importing a filing 

A premium filing that has been prepared with compatible private-sector software can be 

“imported” into My PAA’s data entry and editing screens. That means that the information in the 

filing is placed into the data entry and editing screens and can then be electronically routed, 

reviewed, edited, certified, and submitted to PBGC as described above (see My PAA’s Data Entry 

and Editing Screens). To import a filing for a plan, the plan must be in your My PAA account. My 

PAA provides instructions for importing filings. 

Uploading a filing 

A premium filing that has been prepared with compatible private-sector software can also be 

“uploaded” through My PAA. That means that the fully-completed filing is submitted directly to 

PBGC and, therefore, cannot be reviewed or edited in My PAA before submission to PBGC. My 

PAA’s upload feature also allows multiple filings to be uploaded at the same time (i.e., a batch 

upload). 

To upload a filing for a plan, the plan need not be in your My PAA account, but you must have a 

My PAA account with at least one plan in it. You must electronically certify in My PAA that you 

have authority to submit the filing for the plan, but in most cases the information in the filing must 

be certified on paper outside My PAA, and the certified information must be retained in plan 

records. (The Plan Administrator’s (or enrolled actuary’s) certification can be made on-line if it is 

Page 50
Appendix 3 – Online Premium Filing with My PAA

 

the Plan Administrator (or enrolled actuary) who uploads the filing.) My PAA provides instructions 

for uploading filings and for certifying the information in uploaded filings. 

Filing Coordinator 

A central role in the e-filing process is played by the “filing coordinator,” who is the person 

designated by the plan or Plan Sponsor to be responsible for coordinating the plan’s on-line 

premium filings. The filing coordinator for a plan is the one who adds that plan to the account of 

each other person in the e-filing team and assigns each e-filing team member one or more filing 

roles, such as the authority to certify a filing (e.g., as the Plan Administrator). My PAA provides 

instructions for becoming a plan’s filing coordinator, adding plans, adding e-filing team members, 

assigning roles, etc. 

Payment Options 

Payment within My PAA 

If you owe a premium, you can pay it using My PAA. My PAA offers three electronic payment 

methods: 

 Automated Clearing House (ACH) – This payment method involves the electronic transfer of 

funds from an account that you specify by entering your account number and bank routing 

number. 

 Electronic check – This is the electronic equivalent to writing a paper check to PBGC. It 

involves entering the check number of a (voided) paper check, your account number, and your 

bank routing number. 

 Credit card – My PAA currently accepts Visa and MasterCard as payment options. A 

convenience fee (which is passed on to the credit card processor) of approximately 3.09 percent 

of the total premium amount is added to a premium payment made by credit card. The 

maximum allowable credit card payment is $99,999.99 (including the convenience fee). 

Payment outside My PAA 

Payment outside My PAA is permitted for any filing and is required if multiple filings are uploaded 

at the same time (i.e., a batch upload). However, separate payments must be submitted for each 

plan. Do not combine premiums for two or more plans into one payment. 

The options are: 

 Electronic funds transfer (EFT) via Automated Clearing House (ACH) or Fedwire — You 

arrange for payment to be electronically transferred by providing your bank with PBGC’s EFT 

information as follows: 

JPMorgan Chase Bank, N.A. 

ABA: 071000013 

Account: 656510666 

Beneficiary: PBGC 

Reference: “EIN/PN: XX-XXXXXXX/XXX 

PYC: MM/DD/YY” 

Report the Employer Identification Number and Plan Number (“EIN/PN”) and the date the 

Premium Payment Year commenced (PYC) in the payment ID line of the electronic funds transfer 

in the format “EIN/PN: XX-XXXXXXX/XXX PYC: MM/DD/YY.” Since we process these 

Page 51
Appendix 3 – Online Premium Filing with My PAA

 

Page 52

payments electronically, strict adherence to this format is required for accurate and timely 

application of your payment. Any deviation from the prescribed format (e.g., combining premiums 

for two or more plans into one payment) may result in our sending you a bill for premium, interest, 

and penalty if our automated system cannot apply your payment.

 Paper check – write the Employer Identification Number/Plan Number (EIN/PN) and the 

date the Premium Payment Year commenced (PYC) on the check to help ensure the 

accurate and timely application of your payment. In addition, My PAA provides you with a 

voucher9

 to send in with your check to help PBGC automatically match your check with 

your filing. 

Send the check (and voucher, if provided) to the address posted on Web site under 

Premium Filings. 

Other Important My PAA Features 

Filing receipts 

My PAA gives you a filing receipt. For a filing submitted from My PAA’s data entry and editing 

screens (including a filing imported into My PAA), the filing receipt shows the date and time of 

submission to PBGC, a confirmation number, and all of the information submitted in the filing. For 

an upload, the filing receipt shows the date and time of submission by PBGC, a confirmation 

number, and the name of the uploaded XML file, but does not show any of the filing information in 

the uploaded file. 

Account history 

A member of a plan’s e-filing team may, if authorized by the filing coordinator, view the plan’s 

account history on-line through My PAA. The account history shows the results of PBGC’s 

processing of your premium filings and payments for each plan year. 

Instructions 

My PAA provides full filing instructions and help screens. In addition, PBGC’s Web site 

(www.pbgc.gov) provides information and “demos” about how to get started and how to use My 

PAA. To access the My PAA information, select the Practitioners Page, and then click on “Online 

Premium Filing (My PAA).” 

For More Information 

If you have questions about e-filing with My PAA, please contact us. See Appendix 2 for 

information.

 

9

 My PAA does not provide a voucher when filings for multiple plans are uploaded at the same time (i.e., a 

batch upload). 
Appendix 4 – Business Codes 

 

Agriculture, Forestry, Fishing & Hunting Utilities 

Crop Production 

111100 Oilseed & Grain Farming 

111210 Vegetable & Melon Farming (including potatoes & yams) 

111300 Fruit & Tree Nut Farming 

111400 Greenhouse, Nursery, &Floriculture Production 

111900 Other Crop Farming (including tobacco, cotton, sugarcane, hay, peanut, sugar beet and all other crop farming) 

Animal Production 

112111 Beef Cattle Ranching & Farming 

112112 Cattle Feedlots 

112120 Dairy Cattle & Milk Production 

112210 Hog & Pig Farming 

112300 Poultry & Egg Production 

112400 Sheep & Goat Farming 

112510 Aquaculture (including shellfish and finfish farms & hatcheries) 

112900 Other Animal Production 

Forestry and Logging 

113110 Timber Tract Operations 

113210 Forest Nurseries & Gathering of Forest Products 

113310 Logging 

Fishing, Hunting and Trapping

114110 Fishing 

114210 Hunting & Trapping 

Sport Activities for Agriculture and Forestry 

115110 Support Activities for Crop Production (including cotton ginning, soil preparation, & cultivating) 

115210 Support Activities for Animal Production 

115310 Support Activities for Forestry 

Mining 

211110 Oil & Gas Extraction 

212110 Coal Mining 

212200 Metal Ore Mining 

212310 Stone Mining & Quarrying 

212320 Sand, Gravel, Clay & Ceramic & Refractory Minerals Mining & Quarrying 

212390 Other Nonmetallic Mineral Mining & Quarrying 

213110 Support Activities for Mining 

Utilities 

221100 Electric Power Generation, Transmission & Distribution 

221210 Natural Gas Distribution 

221300 Water, Sewage and Other Systems 

221500 Combination Gas and Electric 

Construction 

Construction of Buildings 

236110 Residential Building Construction 

236200 Nonresidential Building Construction 

Page 53
Appendix 4 – Business Codes 

 

Heavy and Civil Engineering Construction

237100 Utility System Construction 

237210 Land Subdivision 

237310 Highway, Street, & Bridge Construction 

237990 Other Heavy & Civil Engineering Construction 

Specialty Trade Contractors 

238100 Foundation, Structure & Building Exterior Contractors (including framing carpentry, masonry, glass, roofing, & siding) 

238210 Electrical Contractors 

238220 Plumbing, Heating, & Air Conditioning Contractors 

238290 Other Building Equipment Contractors 

238300 Building Finishing Contractors (including drywall, insulation, painting, wall covering, flooring, tile, & finish carpentry) 

238900 Other Specialty Trade Contractors (including site preparation) 

Manufacturing 

Food Manufacturing 

311110 Animal Food Mfg. 

311200 Grain & Oilseed Milling 

311300 Sugar & Confectionery Product Mfg. 

311400 Fruit & Vegetable Preserving & Specialty Food Mfg 

311500 Dairy Product Mfg 

311610 Animal Slaughtering and Processing 

311710 Seafood Product Preparation & Packaging 

311800 Bakeries & Tortilla Mfg. 

311900 Other Food Mfg. (including coffee, tea, flavorings & seasonings) 

Beverage and Tobacco Product Manufacturing 

312110 Soft Drink & Ice Mfg. 

312120 Breweries 

312130 Wineries 

312140 Distilleries 

312200 Tobacco Manufacturing 

Textile Mills and Textile Product Mills 

313000 Textile Mills 

314000 Textile Product Mills 

Apparel Manufacturing 

315100 Apparel Knitting Mills 

315210 Cut & Sew Apparel Contractors 

315220 Men's & Boys' Cut & Sew Apparel Mfg. 

315230 Women's & Girls' Cut & Sew Apparel Mfg 

315290 Other Cut & Sew Apparel Mfg. 

315990 Apparel Accessories & Other Apparel Mfg. 

Leather and Allied Product Manufacturing 

316110 Leather & Hide Tanning & Finishing 

316210 Footwear Mfg. (including rubber & plastics) 

316990 Other Leather & Allied Product Mfg. 

Wood Product Manufacturing 

321110 Sawmills & Wood Preservation 

321210 Veneer, Plywood & Engineered Wood Product Mfg. 

321900 Other Wood Product Mfg. 

Page 54
Appendix 4 – Business Codes 

 

Paper Manufacturing 

322100 Pulp, Paper, & Paperboard Mills 

322200 Converted Paper Product Mfg 

Printing and Related Support Activities 

323100 Printing & Related Support Activities 

Petroleum and Coal Products Manufacturing 

324110 Petroleum Refineries (including integrated) 

324120 Asphalt Paving, Roofing, & Saturated Materials Mfg. 

324190 Other Petroleum & Coal Products Mfg. 

Chemical Manufacturing 

325100 Basic Chemical Mfg. 

325200 Resin, Synthetic Rubber, & Artificial & Synthetic Fibers & Filaments Mfg. 

325300 Pesticide, Fertilizer, & Other Agricultural Chemical Mfg. 

325410 Pharmaceutical & Medicine Mfg. 

325500 Paint, Coating, & Adhesive Mfg. 

325600 Soap, Cleaning Compound, & Toilet Preparation Mfg. 

325900 Other Chemical Product & Preparation Mfg.

Plastics & Rubber Products Manufacturing 

326100 Plastics Product Mfg. 

326200 Rubber Product Mfg. 

Nonmetallic Mineral Product Manufacturing 

327100 Clay Product & Refractory Mfg. 

327210 Glass & Glass Product Mfg. 

327300 Cement & Concrete Product Mfg. 

327400 Lime & Gypsum Product Mfg. 

327900 Other Nonmetallic Mineral Product Mfg. 

Primary Metal Manufacturing 

331110 Iron & Steel Mills & Ferroalloy Mfg. 

331200 Steel Product Mfg. from Purchased Steel 

331310 Alumina & Aluminum Production & Processing 

331400 Nonferrous Metal (except Aluminum) Production & Processing 

331500 Foundries 

Fabricated Metal Product Manufacturing 

332110 Forging & Stamping 

332210 Cutlery & Handtool Mfg. 

332300 Architectural & Structural Metals Mfg. 

332400 Boiler, Tank & Shipping Container Mfg. 

332510 Hardware Mfg. 

332610 Spring & Wire Product Mfg. 

332700 Machine Shops; Turned Product; & Screw, Nut & Bolt Mfg. 

332810 Coating, Engraving, Heat Treating, & Allied Activities 

332900 Other Fabricated Metal Product Mfg. 

Machinery Manufacturing 

333100 Agriculture, Construction, & Mining Machinery Mfg. 

333200 Industrial Machinery Mfg. 

333310 Commercial & Service Industry Machinery Mfg. 

Page 55
Appendix 4 – Business Codes 

 

333410 Ventilation, Heating, Air-Conditioning, & Commercial Refrigeration Equipment Mfg. 

333510 Metalworking Machinery Mfg 

333610 Engine, Turbine & Power Transmission Equipment Mfg. 

333900 Other General Purpose Machinery Mfg. 

Computer and Electronic Product Manufacturing 

334110 Computer & Peripheral Equipment Mfg. 

334200 Communications Equipment Mfg. 

334310 Audio & Video Equipment Mfg. 

334410 Semiconductor & Other Electronic Component Mfg. 

334500 Navigational, Measuring, Electrometrical, & Control Instruments Mfg. 

334610 Manufacturing & Reproducing Magnetic & Optical Media 

Electrical Equipment, Appliance, and Component Manufacturing 

335100 Electric Lighting Equipment Mfg. 

335200 Household Appliance Mfg. 

335310 Electrical Equipment Mfg. 

335900 Other Electrical Equipment & Component Mfg. 

Transportation Equipment Manufacturing 

336100 Motor Vehicle Mfg. 

336210 Motor Vehicle Body & Trailer Mfg. 

336300 Motor Vehicle Parts Mfg. 

336410 Aerospace Product & Parts Mfg. 

336510 Railroad Rolling Stock Mfg. 

336610 Ship & Boat Building 

336990 Other Transportation Equipment Mfg. 

Furniture and Related Product Manufacturing 

337000 Furniture & Related Product Manufacturing

Miscellaneous Manufacturing 

339110 Medical Equipment & Supplies Mfg. 

339900 Other Miscellaneous Manufacturing 

Wholesale Trade 

Merchant Wholesalers, Durable Goods 

423100 Motor Vehicle & Motor Vehicle Parts & Supplies 

423200 Furniture & Home Furnishings 

423300 Lumber & Other Construction Materials 

423400 Professional & Commercial Equipment & Supplies 

423500 Metals & Minerals (except Petroleum) 

423600 Electrical & Electronic Goods 

423700 Hardware, Plumbing & Heating Equipment & Supplies 

423800 Machinery, Equipment, & Supplies 

423910 Sporting & Recreational Goods & Supplies 

423920 Toy & Hobby Goods & Supplies 

423930 Recyclable Materials 

423940 Jewelry, Watches, Precious Stones, & Precious Metals 

423990 Other Miscellaneous Durable Goods 

Merchant Wholesalers, Nondurable Goods 

424100 Paper & Paper Products 

424210 Drugs & Druggists’ Sundries 

Page 56
Appendix 4 – Business Codes 

 

424300 Apparel, Piece Goods, & Notions 

424400 Grocery & Related Products 

424500 Farm Product Raw Materials 

424600 Chemical & Allied Products 

424700 Petroleum & Petroleum Products 

424800 Beer, Wine, & Distilled Alcoholic Beverages 

424910 Farm Supplies 

424920 Books, Periodicals, & Newspapers 

424930 Flower, Nursery Stock, & Florists’ Supplies 

424940 Tobacco & Tobacco Products 

424950 Paint, Varnish, & Supplies 

424990 Other Miscellaneous Nondurable Goods 

Wholesale Electronic Markets and Agents and Brokers 

425110 Business to Business Electronic Markets 

425120 Wholesale Trade Agents & Brokers 

Retail Trade 

Motor Vehicle and Parts Dealers 

441110 New Car Dealers 

441120 Used Car Dealers 

441210 Recreational Vehicle Dealers 

441221 Motorcycle Dealers 

441222 Boat Dealers 

441229 All Other Motor Vehicle Dealers 

441300 Automotive Parts, Accessories, & Tire Stores 

Furniture and Home Furnishings Stores 

442110 Furniture Stores 

442210 Floor Covering Stores 

442291 Window Treatment Stores 

442299 All Other Home Furnishings Stores 

Electronics and Appliance Stores 

443111 Household Appliance Stores 

443112 Radio, Television, & Other Electronic Stores 

443120 Computer & Software Stores 

443130 Camera & Photographic Supplies Stores 

Building Material and Garden Equipment and Supplies Dealers 

444110 Home Centers 

444120 Paint & Wallpaper Stores 

444130 Hardware Stores 

444190 Other Building Material Dealers 

444200 Lawn & Garden Equipment & Supplies Stores 

Food and Beverage Stores 

445110 Supermarkets and Other Grocery (except Convenience) Stores 

445120 Convenience Stores 

445210 Meat Markets 

445220 Fish & Seafood Markets 

445230 Fruit & Vegetable Markets 

445291 Baked Goods Stores 

445292 Confectionary & Nut Stores 

Page 57
Appendix 4 – Business Codes 

 

445299 All Other Specialty Food Stores 

445310 Beer, Wine, & Liquor Stores 

Health and Personal Care Stores 

446110 Pharmacies & Drug Stores 

446120 Cosmetics, Beauty Supplies, & Perfume Stores 

446130 Optical Goods Stores 

446190 Other Health & Personal Care Stores 

Gasoline Stations 

447100 Gasoline Stations (including convenience stores with gas) 

Clothing & Clothing Accessories Stores 

448110 Men's Clothing Stores 

448120 Women's Clothing Stores 

448130 Children's & Infants' Clothing Stores 

448140 Family Clothing Stores 

448150 Clothing Accessories Stores 

448190 Other Clothing Stores 

448210 Shoe Stores 

448310 Jewelry Stores 

448320 Luggage & Leather Goods Stores 

Sporting Goods, Hobby, Book, & Music Stores 

451110 Sporting Goods Stores 

451120 Hobby, Toy, & Game Stores 

451130 Sewing, Needlework, & Piece Goods Stores 

451140 Musical Instrument & Supplies Stores 

451211 Book Stores 

451212 News Dealers & Newsstands 

451220 Prerecorded Tape, Compact Disc, & Record Stores 

General Merchandise Stores 

452110 Department Stores 

452900 Other General Merchandise Stores 

Miscellaneous Store Retailers 

453110 Florists 

453210 Office Supplies & Stationery Stores 

453220 Gift, Novelty, & Souvenir Stores 

453310 Used Merchandise Stores 

453910 Pet & Pet Supplies Stores 

453920 Art Dealers 

453930 Manufactured (Mobile) Home Dealers 

453990 All Other Miscellaneous Store Retailers (including tobacco, candle, & trophy shops) 

Nonstore Retailers 

454110 Electronic Shopping & Mail-Order Houses 

454210 Vending Machine Operators 

454311 Heating Oil Dealers 

454312 Liquefied Petroleum Gas (bottled gas) Dealers 

454319 Other Fuel Dealers 

454390 Other Direct Selling Establishments (including door-to-door retailing, frozen food plan providers, party plan 

merchandisers, & coffee-break service providers) 

Page 58
Appendix 4 – Business Codes 

 

Transportation and Warehousing 

Air, Rail, and Water Transportation 

481000 Air Transportation 

482110 Rail Transportation 

483000 Water Transportation 

Truck Transportation 

484110 General Freight Trucking, Local 

484120 General Freight Trucking, Long distance 

484200 Specialized Freight Trucking 

Transit and Ground Passenger Transportation 

485110 Urban Transit Systems 

485210 Interurban & Rural Bus Transportation 

485310 Taxi Service

485320 Limousine Service 

485410 School & Employee Bus Transportation 

485510 Charter Bus Industry 

485990 Other Transit & Ground Passenger Transportation 

Pipeline Transportation 

486000 Pipeline Transportation 

Scenic & Sightseeing Transportation 

487000 Scenic & Sightseeing Transportation 

Support Activities for Transportation 

488100 Support Activities for Air Transportation 

488210 Support Activities for Rail Transportation 

488300 Support Activities for Water Transportation 

488410 Motor Vehicle Towing 

488490 Other Support Activities for Road Transportation 

488510 Freight Transportation Arrangement 

488990 Other Support Activities for Transportation 

Couriers and Messengers 

492110 Couriers 

492210 Local Messengers & Local Delivery 

Warehousing and Storage 

493100 Warehousing & Storage (except lessors of mini warehouses & self storage units) 

Information 

Publishing Industries (except internet) 

511110 Newspaper Publishers 

511120 Periodical Publishers 

511130 Book Publishers 

511140 Directory & Mailing List Publishers 

511190 Other Publishers 

511210 Software Publishers 

Motion Picture and Sound Recording Industries 

512100 Motion Picture & Video Industries (except video rental) 

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Appendix 4 – Business Codes 

 

512200 Sound Recording Industries 

Broadcasting (except internet) 

515100 Radio & Television Broadcasting 

515210 Cable & Other Subscription Programming 

Telecommunications 

517000 Telecommunications (including paging, cellular, satellite, cable & other program distribution, resellers, other 

telecommunications, and internet service providers) 

Data Processing Services 

518210 Data Processing, Hosting, & Related Services 

Other Information Services 

519100 Other Information Services (including news syndicates, libraries, and internet publishing & broadcasting) 

Finance and Insurance 

Depository Credit Intermediation 

522110 Commercial Banking 

522120 Savings Institutions 

522130 Credit Unions 

522190 Other Depository Credit Intermediation 

Nondepository Credit Intermediation 

522210 Credit Card Issuing 

522220 Sales Financing 

522291 Consumer Lending 

522292 Real Estate Credit (including mortgage bankers & originators) 

522293 International Trade Financing 

522294 Secondary Market Financing 

522298 All Other Nondepository Credit Intermediation 

Activities Related to Credit Intermediation 

522300 Activities Related to Credit Intermediation (including loan brokers, check clearing, & money transmitting) 

Securities, Commodity Contracts, and Other Financial Investments and Related Activities 

523110 Investment Banking & Securities Dealing 

523120 Securities Brokerage 

523130 Commodity Contracts Dealing 

523140 Commodity Contracts Brokerage 

523210 Securities & Commodity Exchanges 

523900 Other Financial Investment Activities (including portfolio management & investment advice) 

Insurance Carriers and Related Activities 

524140 Direct Life, Health, & Medical Insurance & Reinsurance Carriers 

524150 Direct Insurance & Reinsurance (except Life, Health & Medical) Carriers 

524210 Insurance Agencies & Brokerages 

524290 Other Insurance Related Activities (including third-party administration of insurance and pension funds) 

Funds, Trusts, and Other Financial Vehicles 

525100 Insurance & Employee Benefit Funds 

525910 Open-End Investment Funds (form 1120-RIC) 

525920 Trusts, Estates, & Agency Accounts 

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Appendix 4 – Business Codes 

 

525990 Other Financial Vehicles (including mortgage REITs and closed-end investment funds) 

Note – “Offices of Bank Holding Companies” and “Offices of Other Holding Companies,” are located under Management of 

Companies (Holding Companies)

Real Estate and Rental and Leasing 

Real Estate 

531110 Lessors of Residential Buildings & Dwellings (including equity REITs) 

531114 Cooperative Housing (including equity REITs) 

531120 Lessors of Nonresidential Buildings (except Mini warehouses) (including equity REITs) 

531130 Lessors of Mini warehouses & Self-Storage Units (including equity REITs) 

531190 Lessors of Other Real Estate Property (including equity REITs) 

531210 Offices of Real Estate Agents & Brokers 

531310 Real Estate Property Managers 

531320 Offices of Real Estate Appraisers 

531390 Other Activities Related to Real Estate 

Rental and Leasing Services 

532100 Automotive Equipment Rental & Leasing 

532210 Consumer Electronics & Appliances Rental 

532220 Formal Wear & Costume Rental 

532230 Video Tape & Disc Rental 

532290 Other Consumer Goods Rental 

532310 General Rental Centers 

532400 Commercial & Industrial Machinery & Equipment Rental & Leasing 

Lessors of Nonfinancial Intangible Assets (except copyrighted works) 

533110 Lessors of Nonfinancial Intangible Assets (except copyrighted works) 

Professional, Scientific, & Technical Services 

Legal Services 

541110 Offices of Lawyers 

541190 Other Legal Services 

Accounting, Tax Preparation, Bookkeeping, and Payroll Services 

541211 Offices of Certified Public Accountants 

541213 Tax Preparation Services 

541214 Payroll Services 

541219 Other Accounting Services 

Architectural, Engineering, & Related Services 

541310 Architectural Services 

541320 Landscape Architecture Services 

541330 Engineering Services 

541340 Drafting Services 

541350 Building Inspection Services 

541360 Geophysical Surveying & Mapping Services 

541370 Surveying & Mapping (except Geophysical) Services 

541380 Testing Laboratories 

Specialized Design Services 

541400 Specialized Design Services (including interior, industrial, graphic, & fashion design) 

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Appendix 4 – Business Codes 

 

Computer Systems Design and Related Services 

541511 Custom Computer Programming Services 

541512 Computer Systems Design Services 

541513 Computer Facilities Management Services 

541519 Other Computer Related Services 

Other Professional, Scientific, and Technical Services 

541600 Management, Scientific, & Technical Consulting Services 

541700 Scientific Research & Development Services 

541800 Advertising & Related Services 

541910 Marketing Research & Public Opinion Polling 

541920 Photographic Services 

541930 Translation & Interpretation Services 

541940 Veterinary Services 

541990 All Other Professional, Scientific, & Technical Services 

Management of Companies (Holding Companies)

551111 Offices of Bank Holding Companies 

551112 Offices of Other Holding Companies 

Administrative and Support and Waste Management and Remediation Services 

Administrative and Support Services 

561110 Office Administrative Services 

561210 Facilities Support Services 

561300 Employment Services 

561410 Document Preparation Services 

561420 Telephone Call Centers 

561430 Business Service Centers (including private mail centers & copy shops) 

561440 Collection Agencies 

561450 Credit Bureaus 

561490 Other Business Support Services (including repossession services, court reporting, & stenotype services) 

561500 Travel Arrangement & Reservation Services 

561600 Investigation & Security Services 

561710 Exterminating & Pest Control Services 

561720 Janitorial Services 

561730 Landscaping Services 

561740 Carpet & Upholstery Cleaning Services 

561790 Other Services to Buildings & Dwellings 

561900 Other Support Services (including packaging & labeling services, & convention & trade show organizers) 

Waste Management and Remediation Services 

562000 Waste Management & Remediation Services 

Educational Services 

611000 Educational Services (including schools, colleges, & universities) 

Health Care and Social Assistance 

Offices of Physicians and Dentists 

621111 Offices of Physicians (except mental health specialists) 

621112 Offices of Physicians, Mental Health Specialists 

621210 Offices of Dentists 

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Appendix 4 – Business Codes 

 

Offices of Other Health Practitioners 

621310 Offices of Chiropractors 

621320 Offices of Optometrists 

621330 Offices of Mental Health Practitioners (except Physicians) 

621340 Offices of Physical, Occupational & Speech Therapists, & Audiologists 

621391 Offices of Podiatrists 

621399 Offices of All Other Miscellaneous Practitioners 

Outpatient Care Centers 

621410 Family Planning Centers 

621420 Outpatient Mental Health & Substance Abuse Centers 

621491 HMO Medical Centers 

621492 Kidney Dialysis Centers 

621493 Freestanding Ambulatory Surgical & Emergency Centers 

621498 All Other Outpatient Care Centers 

Medical and Diagnostic Laboratories 

621510 Medical & Diagnostic Laboratories 

Home Health Care Services 

621610 Home Health Care Services 

Other Ambulatory Health Care Services 

621900 Other Ambulatory Health Care Services (including ambulance services & blood & organ banks) 

Hospitals 

622000 Hospitals 

Nursing and Residential Care Facilities 

623000 Nursing & Residential Care Facilities 

Social Assistance 

624100 Individual & Family Services 

624200 Community Food & Housing, & Emergency & Other Relief Services 

624310 Vocational Rehabilitation Services 

624410 Child Day Care Services 

Arts, Entertainment, and Recreation 

Performing Arts, Spectator Sports, and Related Industries 

711100 Performing Arts Companies 

711210 Spectator Sports (including sports clubs & racetracks) 

711300 Promoters of Performing Arts, Sports, & Similar Events 

711410 Agents & Managers for Artists, Athletes, Entertainers, & Other Public Figures 

711510 Independent Artists, Writers, & Performers 

Museums, Historical Sites, and Similar Institutions 

712100 Museums, Historical Sites, & Similar Institutions 

Amusement, Gambling, and Recreation Industries 

713100 Amusement Parks & Arcades 

713200 Gambling Industries 

713900 Other Amusement & Recreation Industries (including golf courses, skiing facilities, marinas, fitness centers, & bowling

centers) 

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Appendix 4 – Business Codes 

 

Page 64

Accommodation and Food Services 

Accommodation 

721110 Hotels (except Casino Hotels) & Motels 

721120 Casino Hotels 

721191 Bed & Breakfast Inns 

721199 All Other Traveler Accommodation 

721210 RV (Recreational Vehicle) Parks & Recreational Camps 

721310 Rooming & Boarding Houses 

Food Services and Drinking Places 

722110 Full-Service Restaurants 

722210 Limited-Service Eating Places 

722300 Special Food Services (including food service contractors & caterers) 

722410 Drinking Places (Alcoholic Beverages) 

Other Services 

Repair and Maintenance 

811110 Automotive Mechanical & Electrical Repair & Maintenance 

811120 Automotive Body, Paint, Interior, & Glass Repair 

811190 Other Automotive Repair & Maintenance (including oil change & lubrication shops & car washes) 

811210 Electronic & Precision Equipment Repair & Maintenance 

811310 Commercial & Industrial Machinery & Equipment (except Automotive & Electronic) Repair & Maintenance 

811410 Home & Garden Equipment & Appliance Repair & Maintenance 

811420 Reupholstery & Furniture Repair 

811430 Footwear & Leather Goods Repair 

811490 Other Personal & Household Goods Repair & Maintenance 

Personal and Laundry Services 

812111 Barber Shops 

812112 Beauty Shops 

812113 Nail Salons 

812190 Other Personal Care Services (including diet & weight reducing centers) 

812210 Funeral Homes & Funeral Services 

812220 Cemeteries & Crematories 

812310 Coin-Operated Laundries & Drycleaners 

812320 Drycleaning & Laundry Services (except Coin-Operated) 

812330 Linen & Uniform Supply 

812910 Pet Care (except Veterinary) Services 

812920 Photofinishing 

812930 Parking Lots & Garages 

812990 All Other Personal Services 

Religious, Grantmaking, Civic, Professional, and Similar Organizations 

813000 Religious, Grantmaking, Civic, Professional, & Similar Organizations (including condominium and homeowner 

associations) 

813930 Labor Unions and Similar Labor Organizations 

921000 Governmental Instrumentality or Agency 
Appendix 5 — Additional Information for Paper Filers 

Requesting an exemption from e-filing 

PBGC may grant an exemption from the electronic filing requirement for good cause in 

appropriate circumstances. PBGC will weigh each request for exemption on the basis of the 

particular facts and circumstances presented. To provide PBGC adequate time to review and 

respond to an exemption request, the request should be submitted as early as possible, preferably 

at least 60 days before the filing due date. 

Requests for an exemption from the electronic filing requirement must be made in writing (e-mail, 

letter or fax). See Appendix 2 for information on where to send requests. Questions regarding 

exemption requests may be made in writing or by phone. 

What to file 

If PBGC has granted you an exemption from making a 2009 premium filing electronically, you 

must file using an approved PBGC form. PBGC will provide a form for this purpose when an 

exemption is granted. 

Note that if you do not receive the anticipated exemption, a paper filing will not satisfy the 

electronic filing requirement. Failure to comply with the electronic filing requirement without an 

exemption is subject to penalty under ERISA section 4071. 

Certifications 

Be sure to complete the Plan Administrator certification on the form. Also, if you are filing for a 

Single-employer Plan be sure to have the enrolled actuary complete the enrolled actuary 

certification on the form unless such certification is not required (see “Description of Data 

Elements” section). 

Information About Attachments 

Be sure to report that additional information is attached to the filing (see item 20 in the 

“Description of Data Elements” section). Show the EIN/PN and the first day of the plan year 

(identified as “PYC”) for this filing at the top of each attachment to your filing. 

Page 65
Appendix 5 — Additional Information for Paper Filers 

Page 66

Where to file 

If you have received an exemption from e-filing, you may submit a paper premium filing by hand, 

mail, or commercial delivery service. Mail your paper premium filing (and check, if payment is 

by check) to the address posted on Web site under Premium Filings. This address will also be 

noted in the letter we send you informing you that your request for an exemption from e-filing 

has been granted. 

Paying your premium 

If you are paying by check, write the EIN/PN and the date the Premium Payment Year 

commenced (PYC) on the check and include your check with the paper filing. 

If you are paying by electronic funds transfers (ACH or Fedwire)—make the transfer to: 

JPMorgan Chase Bank, N.A. 

ABA: 071000013 

Account: 656510666 

Beneficiary: PBGC 

Reference: “EIN/PN: XX-XXXXXXX/XXX 

PYC: MM/DD/YY” 

Report the EIN/PN and the date the Premium Payment Year commenced (PYC) in the payment 

ID line of the electronic funds transfer in the format “EIN/PN: XX-XXXXXXX/XXX PYC: 

MM/DD/YY.” Since we process these payments electronically, strict adherence to this format is 

required for accurate and timely application of your payment. Any deviation from the prescribed 

format may result in our sending you a bill for premium, interest, and penalty if our automated 

system cannot apply your payment. 
Appendix 6 — Paperwork Reduction Act Notice 

Page - 67 -

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

We need this information to determine the amount of premium due to PBGC under Title IV of 

ERISA. You are required to give us this information. An agency may not conduct or sponsor, and 

a person is not required to respond to, a collection of information unless it displays a currently 

valid OMB control number. OMB has approved this collection of information under control 

number 1212-0009. 

Confidentiality is that provided by the Privacy Act and the Freedom of Information Act. 

Shown below is the estimated burden associated with the preparation and submission of premium 

filings (both estimated flat-rate filings for Large Plans and comprehensive filings for all plans). 

The burden estimates are expressed in hours and are averages for the plans in each of the listed 

categories. These times will vary depending on the circumstances of a given plan. 

Plan Type Average 

Burden

Single-Employer Plans 

 Small Plans (prior year Participant Count - fewer than 100) 6.00 hours 

 Mid-size Plans (prior year Participant Count - 100 or more but fewer than 500) 6.50 hours 

 Large Plans (prior year Participant Count - 500 or more) 8.25 hours 

Multiemployer Plans 4.25 hours 

If you have comments concerning the accuracy of these burden estimates or suggestions for 

making the forms or the electronic filing process simpler, please send your comments to Pension 

Benefit Guaranty Corporation, Legislative & Regulatory Department, 1200 K Street, NW, 

Washington, DC 20005-4026.