Contents 

2015

Premium Payment Instructions 
Contents 

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

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

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

How to File ....................................................................................................................... 8

How to Count Participants ................................................................................................ 9

How to Determine Unfunded Vested Benefits ................................................................... 13

Data to be Submitted ........................................................................................................ 21

Description of Data Elements ............................................................................................ 25

Late Payment Charges ....................................................................................................... 39

Correcting Filings, Credit Balances and Reconciling Estimates ............................................. 42

Recordkeeping Requirements and PBGC Audits ................................................................. 45

Appendices

 Appendix 1 – Definitions..................................................................................................... 46

 Appendix 2 – Contact information...................................................................................... 50

 Appendix 3 – Online Premium Filing with My PAA............................................................. 52

 Appendix 4 – Paperwork Reduction Act Notice.................................................................. 56
Introduction and What’s New

Page 1

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 clicking on the “Laws and Regulations” link on the 

home page (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 are 

described in the “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.

This document provides information for plans paying premiums for plan years beginning in 2015, including 

instructions for each data element that must be reported. If you are filing for a previous year, you must follow 

the instructions for that year (available from the “Premium Payment Instructions and Addresses” section of the 

Practitioners Page at www.pbgc.gov). 

If you are amending a filing for a plan year that did not begin in 2015, 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 at www.pbgc.gov) should be used instead 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 

“Premium Payment Instructions and Addresses” section of the Practitioners Page at 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. 
Introduction and What’s New

Page 2

What’s New 

The filing requirements for 2015 are almost identical to the filing requirements for 2014. Here are the key items 

to note for 2015: 

 Changes in premium rates

o Flat-rate Premiums —The per-participant flat-rate premium rate for single-employer plans is $57 up 

from $49. For multiemployer plans that rate is $26, up from $12.

o Variable-rate Premium — The rate per $1,000 of unfunded vested benefits is $24, up from $14.

o Cap on Variable-rate Premium — The MAP-21 Cap on the Variable-Rate Premium cap is $418 times the 

number of participants, up from $412 times the number of participants.

 New due date for Small Plans — The due date transition rule for Small Plans is now fully phased-in. That 

means Small Plans are now subject to the same due dates as other plans. In general, the 2015 due date for a 

calendar year plan is October 15, 2015. See “When to File” section.

 New (optional) contact information – Plans that prefer the phone number shown on PBGC’s Is my Pension 

Insured web page be a number other than that of the Plan Administrator, may now provide an alternative 

phone number for that purpose.

 New questions on risk transfer activities — Information about the number of former employees involved in 

certain recent risk transfer activities (i.e., annuity purchases and lump sum windows) is now required to be 

reported. Because the reporting requirement for 2015 applies to a much longer period than for subsequent years, 

reasonable estimates may be reported instead of exact counts. See Miscellaneous Information under the “Data to 

be submitted” and “Description of Data Elements” sections and a new definition (Lump Sum Window) in 

Appendix 1.

 Change in certification procedures for uploaded filings

o In prior years, the person responsible for uploading was permitted to do so before the Plan 

Administrator had manually signed a hard copy of the premium data generated by the private sector 

software. Starting with 2015 filings, to ensure the filing has, in fact, been certified by the Plan 

Administrator, the uploader must wait until the manual certification has been done. If the Enrolled 

Actuary is also certifying manually, the same rule applies with respect to the actuarial certification.

o After the filing is uploaded, the My PAA generated confirmation number must be written on the 

certified paper copy (to be retained in plan records).

o The detailed information about certifying uploaded premium filings in the My PAA Users Manual has 

been modified accordingly.

 Additional guidance re: Small Plan Lookback Rule — PBGC approval is required to start using the Lookback 

Rule in 2015 after opting out in 2014, and, with limited exceptions, to opt out of the Lookback Rule starting 

with 2015. The instructions have been expanded to clarify the exceptions and provide information on how 

to request approval. See “How to Determine UVBs” section.
Who Must File

Page 3

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 Multipleemployer 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 29, 

2014. On April 6, 2015, assets are distributed in satisfaction of all Benefit Liabilities. The Plan Administrator must 

file and make the premium payments for the 2014 and 2015 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 27, 2015. On July 6, 2015, 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 2014 and 2015 plan 

years, because a trustee was not appointed until after the beginning of the 2015 plan year. 
When to File

Page 4

Introduction

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.

Normal Premium Due Date

The Normal Premium Due Date applies unless:

 The plan is a New or Newly Covered Plan, 

 The plan year changed since last year, or

 All assets are distributed during the Premium Payment Year pursuant to a standard termination.

The Normal Premium Due Date is the 15th day of the 10th full calendar month in the plan year (e.g., generally 

October 15th for calendar-year plans).1 If the Normal Premium Due Date falls on a Saturday, Sunday or Federal 

Holiday, the due date is automatically extended to the next business day2. 

Transition Rule for Small Plan fully phased in

Before 2014, the due date for small plans was the last day of the 16th full calendar month following the end of 

the plan year preceding the Premium Payment Year (e.g., April 30th after year-end for small calendar-year plans). 

For plans that were considered small for 2013, the revised Normal Premium Due Date meant premiums were

due 61⁄2 months earlier than they would have been absent the 2014 amendments to our premium regulations. 

To give such plans time to adjust to the new rules and to spread out the time between the 2013 and 2014 

premium due dates, the Normal Premium Due Date for plans that were considered small for 2013 was

automatically extended to the 15th day of the 14th full calendar month beginning on or after the first day of the 

plan year (e.g., generally February 15, 2015 for calendar-year Small Plans). Starting in 2015, Small Plans are

subject to the same Normal Due Date rules as other plans.

The following table shows the Normal Premium Due Dates for plan years beginning in 2015:

 

1

The due date is the 15th day of the 10th full calendar month that begins on or after the first day of the Premium Payment Year. In 

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

2 See “Late Payment Charges” section for information on how late charges are determined if payment is made after an automatically 

extended due date.
When to File

Page 5

2015 Normal Premium Due Dates 

Premium Payment

Year Begins

Premium Due 

Date

Premium Payment

Year Begins

Premium 

Due Date

1/1/2015 10/15/2015

01/02 - 02/01/2015 11/16/2015*07/02 - 08/01/2015 05/16/2016*

02/02 - 03/01/2015 12/15/2015 08/02 - 09/01/2015 06/15/2016

03/02 - 04/01/2015 01/15/2016 09/02 - 10/01/2015 07/15/2016

04/02 - 05/01/2015 02/16/2016*10/02 - 11/01/2015 08/15/2016

05/02 - 06/01/2015 03/15/2016 11/02 - 12/01/2015 09/15/2016

06/02 - 07/01/2015 04/15/2016 12/02 - 12/31/2015 10/17/2016*

*

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.

Due Date for Special Situations

In the situations noted below, premiums may be due on a date other than the Normal Premium Due Date:

 The plan is a New or Newly Covered Plan, 

 The plan year changed since last year, or

 All assets are distributed during the Premium Payment Year pursuant to a standard termination.

The due dates for these situations are described below. For all of these situations, if the adjusted due date falls 

on a Saturday, Sunday or Federal Holiday, the due date is automatically extended to the next business day. 

New and Newly Covered Plans

In some cases, these first time filers cannot have their filings ready by the Normal Due Date. For example, 

consider a calendar year plan that is adopted November 1st with an effective date retroactive to January 1. 

Because the plan was adopted after the Normal Premium Due Date (October 15

th

), a later due date is warranted.

To accommodate such plans, the due date for New and Newly Covered Plans is the latest of:

 The Normal Due Date,

 90 days after the date of the plan’s adoption,

 90 days after the date on which the plan became covered by title IV of ERISA, or

 In the case of a Small Plan that is also a Continuation Plan, 90 days after the UVB Valuation Date.
When to File

Page 6

These rules are illustrated in the following examples:

Example 1 – Plan A, a calendar-year plan was adopted August 1, 2015 with a retroactive effective date of 

January 1, 2015. Plan A is not a Continuation Plan or a Small Plan. The due date for Plan A’s first premium filing 

is October 30, 2015 (90 days after August 1, 2015) because that date is later than the Normal Premium Due Date 

(October 15, 2015).

Example 2 – The situation for Plan B is identical to Plan A (see Example 1) except that the plan was adopted one 

month earlier, July 1, 2015. The due date for Plan B’s first premium filing is October 15, 2015, the Normal 

Premium Due Date because that date is later than 90 days after the adoption date.

Example 3 – A professional service employer maintains Plan C, a calendar plan year plan. From plan inception

through September 30, 2015, Plan C never had more than 25 active participants, and thus was not a covered 

plan under ERISA section 4021. On October 1, 2015, a few employees were hired and became covered by the 

plan resulting in a total active participant count of 26 and therefore, the plan became a covered plan on that 

date. Plan C 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, 2015, even though the plan did not become 

covered until after that date. The due date for the plan’s first premium filing is December 30, 2015 (90 days 

after October 1, 2015) because the date is later than the Normal Premium Due Date (October 15, 2015).

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. However, for the first plan year under the new cycle, the due date is whichever is later:

 The Normal Premium Due Date, or

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

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

Example 1 – By plan amendment adopted on December 1, 2015, a 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, 2015, and ending 

May 31, 2015. Premiums for the short plan year are due October 15, 2015, the Normal Premium Due Date.

For the plan year beginning June 1, 2015, the premiums are due by the Normal Premium Due Date (March 15,

2016) because that is later than 30 days after the date the plan amendment changing the plan year was adopted 

(December 31, 2015).

Example 2 – By plan amendment adopted on January 6, 2016, and made retroactively effective to April 1, 2015, 

a plan changes from a plan year beginning on March 1 to a plan year beginning on April 1. For the March 1, 2015

- March 31, 2015 short plan year, the premium is due December 15, 2015. For the new plan year beginning April 

1, 2015, the due date is 30 days after the adoption of the plan amendment changing the plan year (February 5, 

2016) because that is later than the Normal Premium Due Date (January 15, 2016).

Assets Distributed Pursuant to a Standard Termination

For the Premium Payment Year in which all plan assets are distributed pursuant to standard termination, it’s 

possible that the employer will be out of business or plan records and personnel will not be available by the 

Normal Premium Due Date. To streamline the final premium payment with the other activities related to a 

standard termination, the due date for a plan in this situation is the earlier of: 
When to File

Page 7

 The Normal Premium Due Date (i.e., the date premiums would have been due had the plan not been 

terminated), or

 The date when the post-distribution certification3is filed with us. 

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). If such relief is granted, a 

Disaster Relief Announcement explaining what relief has been granted and how to claim the relief will be posted 

on the Practitioners Page at www.pbgc.gov.

Additional Information

You can find detailed rules about filing due dates in PBGC’s premium payment regulation (29 CFR Part 4007). 

You can access this regulation on the “Laws and Regulations” page, accessible from the Practitioners Page or the 

“Open Government” section of the Home Page at www.pbgc.gov.

 

3 The post-distribution certification (Form 501) is a document required to be submitted to PBGC as part the standard termination process 

See § 4041.29 for additional information.
How to File

Page 8

General

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

payment by completing and submitting a comprehensive premium filing.

A list of the data that must be reported 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” is to provide a 

comprehensive list of data that must be submitted electronically. These instructions are written as if they 

related to the illustrative form (see “Description of Data Elements” section). The “form” is for illustrative 

purposes only.

Filing Method

Electronic premium filing is mandatory4. Electronic filing is done through PBGC’s e-filing application, My Plan 

Administration Account (My PAA), which you access through the “Online Premium Filing (My PAA)” section of 

the Practitioners Page at www.pbgc.gov. 

You may prepare the filing directly using My PAA’s data entry screens. Alternatively, you may use approved 

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. Approved private sector-software is able to place your filing in an electronic file that is in 

“XML” format and meets PBGC specifications. 

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 forms. In addition, 

in some cases, the software may perform certain calculations instead of requiring that you manually enter each 

required data element. If you use My PAA’s data entry and editing screens, instructions are available on-line.

Appendix 3 provides an introduction to My PAA. PBGC’s Web site (www.pbgc.gov) provides detailed, and often 

more up to date, information about My PAA. 

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) or by electronic check. If you pay outside of 

My PAA, you may pay by electronic funds transfer (ACH or Fedwire), paper check or on-line via www.pay.gov, a 

free, and user-friendly Federal website from which you can make secure electronic payments direct to many 

Federal Agencies, including PBGC. We recommend using Pay.gov to minimize the potential for errors (e.g., 

incorrect account numbers). Additional information on payment options is included in Appendix 3.

 

4

PBGC may grant a request for an exemption from the electronic filing requirement for good cause in appropriate circumstances. Such 

a request must be made in writing (e-mail, letter or fax). See Appendix 2 for information on where to send requests. 
How to Count Participants

Page 9

General

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

as are both caps on the Variable-rate Premium (MAP-21 Cap and Small Employer Cap). In addition, the 

number of participants affects whether variable-rate premiums are based on current or prior (i.e., 

“lookback”) year measurements. 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 wasn’t covered under ERISA section 4021 on that 

date.

 If the plan is the transferee plan in a Merger (i.e., the continuing plan) or the transferor plan in a 

Spinoff 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 is covered by this rule if:

- a Merger is effective on the first day of the transferee plan’s premium payment year, or a 

Spinoff is effective on the first day of the transferor plan’s premium payment 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, 2015. The Participant Count Date for the:

 January 1, 2015 – May 31, 2015 plan year is December 31, 2014, 

 June 1, 2015 – May 31, 2016 plan year is May 31, 2015.

Example 2 – A new calendar-year plan is adopted February 18, 2015, retroactively effective as of January 

1, 2015. The Participant Count Date is January 1, 2015.

Example 3 – A new calendar-year plan is adopted January 1, 2015, effective April 1, 2015. The 

Participant Count Date is April 1, 2015.

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

1, 2015, 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 2015 plan year, Plan A’s Participant Count Date for the 2015 Flat-rate Premium is 

January 1, 2015. Note that the Participant Count includes Plan A participants that used to be covered by 

Plan B. 
How to Count Participants

Page 10

Example 5 – Plan A has a calendar plan year. Effective January 1, 2015, 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, 2015. (Plan B’s Participant Count Date also is January 1, 2015, since it is a New Plan that 

became effective on that date.)

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

covered on May 31, 2015. The first day of the Premium Payment Year is January 1, 2015, and the 

Participant Count Date is January 1, 2015.

Participant

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

deceased) with respect to whom the plan has Benefit Liabilities as of the Participant Count Date. 

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 $5,000 or less), 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. 
How to Count Participants

Page 11

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

participant’s vested benefit has a value of $5,000 or less, 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, 2014, the participant will be included in the Participant Count as of 

December 31, 2014 (because the cashout is deemed to occur on January 1, 2015, the first of the month 

following termination of employment). If, as is typically the case for a calendar-year plan, the plan’s 

Participant Count Date for 2015 is December 31, 2014, a Flat-rate Premium must be paid for this 

participant for 2015. 

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. 

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.

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, 2010, and terminates employment on February 1, 2014. Further assume that this 

participant does not perform more than 500 hours of service during the December 1, 2013 – November 

30, 2014 computation period. This participant incurs a one-year break in service on November 30, 2014. 

Since the break occurred before December 31, 2014 (the Participant Count Date for the 2015 premium), 

the individual would not be included in the Participant Count for 2015.

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 

2014 calendar-year computation period. This participant incurs a one-year break in service on December 

31, 2014. Although the break occurs on the Participant Count Date for the 2015 premium, the individual 

would not be included in the Participant Count for 2015.

Comparison to Form 5500 

The Participant Count for the Premium Payment Year and the number of participants reported for 

item 6 of Form 5500 for the plan year preceding the Premium Payment Year (e.g., the 2015 premium 

filing and the 2014 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 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 6 of the 

Form 5500, even if the plan has no Benefit Liabilities with respect to them. 
How to Count Participants

Page 12

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

purposes and for purposes of item 6 of Form 5500. For purposes of item 6 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 6 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 nonvested 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

Page 13

General

“Unfunded vested benefits” (UVBs) 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 and when the Premium Funding Target and fair market value of plan assets are 

determined for this calculation. 

Which year’s UVBs

In general, Variable-rate Premiums are based on UVBs for the Premium Payment Year. However, Small 

Plans are subject to a Lookback Rule, under which the Variable-rate Premium for the Premium Payment 

Year is based on UVBs for the plan year preceding the Premium Payment Year - for example, under the 

Lookback Rule, the 2015 Variable-rate Premium is based on UVBs for 2014 (the Lookback Year).

Opting out of the Lookback Rule – general rule

Small Plans5 may, subject to certain conditions, opt out of the Lookback Rule and instead use UVBs 

measured as of the UVB Valuation Date for the current year to determine the 2015 Variable-rate 

Premium. Once a Small Plan opts out of the Lookback Rule, it is required to continue to use current 

year UVBs to determine the Variable-rate Premium for all subsequent years unless and until the plan 

seeks and receives permission from PBGC to start using the Lookback Rule in the future (or unless the 

plan ceases to be a Small Plan). 

For 2015, a Small Plan is subject to the Lookback Rule unless:

 The plan is a New and Newly Covered Small Plan - The Lookback Rule doesn’t apply to New and 

Newly Covered Small Plans because such plans don’t have a covered prior year to look back to. So, 

special rules apply. If a New or Newly Covered Plan is Small and:

– Was created as the result of a non de minimis spinoff6 or consolidation (i.e., “Continuation 

Plans”), the Variable-rate Premium for the Premium Payment Year is based on UVBs for that 

same year. These plans do, however, get more time to complete their filings (see “When to File” 

section). 

– Is not a Continuation Plan, the plan is exempt from the Variable-rate Premium for its first year 

of filing. Note that such a plan could be either a newly established plan or a plan resulting from 

a de minimis spinoff. The exception applies in either case.

 The plan opted out of the Lookback Rule in 2014, unless the plan requested and received 

permission from PBGC to use the Lookback Rule starting with the 2015 plan year (see below).

Requesting to use the Lookback Rule after opting out in a prior year

If a plan that opted out of the Lookback Rule for 2014 wants to request permission to use the Lookback 

Rule for 2015 (and all subsequent years), an email with “Request re: Lookback Rule” in the subject line 

must be sent to premiums@pbgc.gov at least 60 days before the due date. In the email, you must 

identify the plan and explain the reason for the requested change. PBGC will reply to acknowledge 

 

5

In 2014, the criteria for being considered a Small Plan were modified. Please see Definition in Appendix 1.

6

See the regulations under section 414(l) of the Code with respect to Single-employer Plans.
How to Determine Unfunded Vested Benefits

Page 14

receipt of such requests. If you do not receive an acknowledgement within two business days, please 

call PBGC at 1 (800) 736-2444 to confirm that your request was received. 

PBGC will review such requests based on the facts and circumstances and will grant such requests only 

for good cause in appropriate circumstances. If you do not receive a determination within 30 days of 

making the request, please call us at the 800 number shown above, as you will need the determination 

to make a timely premium filing.

Opting out of the Lookback Rule starting with the 2015 plan year 

If a Small Plan had the opportunity to opt out of the Lookback Rule in the past but chose not to, PBGC 

permission is required to opt out. To request permission, send an email with “Request re: Lookback 

Rule” in the subject line to premiums@pbgc.gov at least 60 days before the due date. In the email, you 

must identify the plan and explain the reason the plan wants to opt out for the 2015 plan year, but did 

not do so for 2014 (when approval was automatic). PBGC will reply to acknowledge receipt of such 

requests. If you do not receive an acknowledgement within two business days, please call PBGC at 

1 (800) 736-2444 to confirm that your request was received. 

PBGC will review such requests based on the facts and circumstances and will grant such requests only 

for good cause in appropriate circumstances. If you do not receive a determination within 30 days of 

making the request, please call us at the 800 number listed above, as you will need the determination to 

make a timely premium filing.

If the 2015 plan year is the first year for which a plan has the opportunity to opt out of the Lookback 

Rule, the plan may do so without first seeking permission from PBGC. For example, permission is not 

required if, for the 2014 plan year:

 The plan was not a Small Plan, but because of a decrease in Participant Count, is Small Plan for 2015;

 The plan was a New or Newly Covered Small Plan that was also a Continuation Plan and was thus, 

required to use current year UVBs to determine its 2014 Variable-rate Premium;

 The plan did not have to calculate nor report UVBs because it was:

– Exempt from the VRP, or 

– Eligible for the Small-employer Cap and chose to pay the cap and not report UVBs. 

Small Plans reporting UVBs for the first time are cautioned to be careful to ensure the data reported 

in the Variable-rate Premium section of the filing are entered correctly because if the reported UVB 

Valuation Date7is within the Premium Payment Year, we will expect all future filings to be 

completed using current year UVBs to determine the Variable-rate Premium.

Note for small plans with year-end valuation dates – It is not practical for a small plan with a year-end 

valuation date to opt out of the Lookback Rule. For example, consider a small plan with a calendar year 

plan year. Opting out of the Lookback Rule would mean measuring UVBs on December31st, two and 

half months after the October 15th due date.

 

7

See (line (7)(c)(3) of the illustrative form in the “Data to be submitted” section.
How to Determine Unfunded Vested Benefits

Page 15

Measurement date

Unfunded Vested Benefits are measured on the funding valuation date (i.e., the measurement date for 

determining the minimum required contribution) for the applicable plan year (i.e. either the Premium 

Payment Year or the Lookback Year, depending on whether the Lookback Rule applies). Regardless of 

whether the Lookback Rule applies, this date is called the UVB Valuation Date to distinguish it from the 

Participant Count Date (see “How to Count Participants” section). So, for plans using the Lookback Rule, 

the UVB Valuation Date is the valuation date used to determine the minimum required contribution (i.e., 

“the funding valuation date”) for the Lookback Year. For all other plans, the UVB Valuation Date is the 

funding valuation date for the Premium Payment Year.

Examples

The following examples illustrate these rules:

Example 1 – Plan A, a calendar year plan, is not a Small Plan and therefore, in accordance with ERISA 303 

must have a beginning of year valuation date. Plan A’s Variable-Rate Premium for 2015 is based on 

UVBs for 2015 (i.e., the Premium Payment Year) measured as of 1/1/2015. This result is not dependent 

on whether the plan is a Continuation Plan.

Example 2 – Plan B is a pre-existing Small Plan and is therefore is subject to the Lookback Rule. Plan B 

has a calendar year plan year and a beginning of year valuation date. Plan B did not submit a request a 

PBGC regarding the Lookback Rule. If Plan B did not opt out of the Lookback Rule for 2014, its Variablerate Premium for 2015 is based on UVBs for the plan year beginning in 2014 measured as of 1/1/2014. 

If Plan B opted out of the Lookback Rule for 2014, its Variable-rate Premium for 2015 is based on UVBs 

for the plan year beginning in 2015 measured as of 1/1/2015. 

Example 3 – Plan C is a New Small Plan with a calendar year plan year and a beginning of year valuation 

date. Plan C was created as the result of a non de minimis spin-off on 1/1/2015 and is therefore 

considered a Continuation Plan for 2015. As a Continuation Plan, Plan C is not subject to the Lookback 

Rule for 2015 (because there is no prior year to look back to). That means UVBs are measured as 

1/1/20158. 

Example 4 – Plan D is a pre-existing Plan which has a calendar year plan year and a beginning of year 

valuation date. Plan D had a participant count of 102 for 2014, but due to attrition, its 2015 participant 

count is 98. Thus, Plan D is now subject to the Lookback Rule. That means Plan D’s Variable-rate 

Premium for 2015 is based on UVBs for the plan year beginning in 2014 (i.e., the “Lookback Year” 

measured as of 1/1/2014), the same UVBs that were used to determine the 2014 VRP. Alternatively, 

Plan D may opt out of the Lookback Rule, in which case, its Variable-rate Premium for 2015 will be based 

on UVBs for the plan year beginning in 2015 measured as of 1/1/2015. 

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. 

 

8

Assuming the participant count remains below 100, Plan D will be subject to the Lookback Rule for 2016. That means that 

Plan D’s Variable-rate Premium for 2016 will also be based on UVBs for 2015 measured as of 1/1/2015. But, Plan D can opt 

out of the Lookback Rule starting with 2016.
How to Determine Unfunded Vested Benefits

Page 16

With the exception of the discount rate, all other assumptions must be identical to those used to 

determine the minimum required contribution under ERISA section 303. In lieu of using the special 

premium discount rates, you may make an election (irrevocable for five years) to use smoothed 

discount rates, similar to, and in some cases identical to, the rates used to determine the minimum 

required contribution. 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 ERISA section 4006(a)(3)(E)(iv)) segment rates for:

- In the case of a Small Plan using the Lookback Rule, the month before the month in which the 

Lookback Year begins.

- In the case of any other plan, the month before the month in which the Premium Payment Year

begins.

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, unlike ERISA 303 

segment rates which are averaged over 24 months, the segment rates used to determine the 

Standard Premium Funding Target are not averaged. These “spot” segment rates are published by 

IRS each month and are also posted on the “Interest Rates and Factors” section of the Practitioners 

Page at www.pbgc.gov.

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

election described above is in effect. The Alternative Premium Funding Target is determined using 

the discount rates that would have been used to determine the ERISA section 303 funding target9

for the Premium Payment Year (or, for a plan using the Lookback Rule, the Lookback Year) if not for 

the HATFA Stabilization Rules. Thus, if an election is made under:

- 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; or

- 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, determined without regard to the HATFA

Stabilization Rules, are used to determine the Alternative Premium Funding Target.

Until an election is officially revoked, it remains in place. An election to use the Alternative Premium 

Funding Target cannot be revoked for five calendar years. Similarly, once an election is revoked, the 

plan cannot make another election to use the Alternative Premium Funding Target for five full years. 

The following example illustrates the rules on making and revoking an election to use the Alternative 

Premium Funding Target.

 

9

Note that this will not be the case if the plan is not yet subject to PPA for funding purposes, or if an election is made under 

PPA 2006 section 402, to use an 8.25% discount rate to determine the funding target for funding purposes. See “Plans Subject 

to Special Funding Rules” later in this section.
How to Determine Unfunded Vested Benefits

Page 17

Example – Plan A first makes an election to use the Alternative Premium Funding Target for a plan year 

that begins on April 1, 2015. In this case, the Alternative Premium Funding Target must be used to 

determine unfunded vested benefits for all plan years beginning before April 1, 2020. The plan may 

revoke the election first effective for any plan year beginning on or after April 1, 2020, but unless the 

election is revoked, it will remain in place. 

This is the case even if the plan year subsequently changes. For example, if the plan year is changed to 

the calendar year first effective January 1, 2020, the Alternative Premium Funding Target must be used 

for the short plan year April 1, 2019 – December 31, 2019 and for the January 1, 2020 – December 31, 

2020 plan year. The first plan year for which the Plan Administrator may revoke the election is the 2021 

plan year. 

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. If an election (or revocation) is not made as part of the comprehensive filing, it may be 

made as part of an amended filing only if the amended filing is made on or before the due date.

Vested Benefits

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 qualified social 

security supplement (QSUPP) 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.
How to Determine Unfunded Vested Benefits

Page 18

Estimated Premium Funding Target

If the Premium Funding Target is not known by the due date, an estimated Variable-rate Premium may 

be paid on the due date. Doing so triggers a requirement to submit an amended filing at a later date to 

reconcile the actual Variable-rate Premium with the estimate. In the event the actual Variable-rate 

Premium is greater than the estimate, penalties for late payment will be waived if the estimate meets 

certain criteria and the reconciliation filing is made by the end of the sixth calendar month that begins 

on or after the premium filing due date (generally April 30th after year end for calendar year plans). For 

additional information, see “Automatic Penalty Waiver for Certain Late Variable-Rate Premiums” in the 

“Late Payment Charges” section.

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 without regard to any averaging method. 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 plan year prior to the Premium Payment Year (or, in the case of a plan using the 

Lookback Rule, the plan year preceding the Lookback Year) are made after the UVB Valuation Date, the 

market value is increased to reflect the value of such contributions discounted to the UVB Valuation 

Date. The discount rate for this purpose is the ERISA section 303(h)(2)(A) effective interest rate for the 

plan year for which the contributions were made (as reported in item 5 of Schedule SB). For example, 

consider a calendar year plan with a January 1, 2015 UVB valuation date. 

Contributions made in 2015 for the 2014 plan year are included in the January 1, 2015 asset value. 

Such contributions are discounted from the date made to January 1, 2015 using the 2014 effective 

interest rate. Such contributions are included only to the extent made by the date of the premium filing.

Adjustments for current year contributions 

If contributions for the Premium Payment Year (or, in the case of a plan using the Lookback Rule, the 

Lookback 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, such are increased to the UVB 

Valuation Date using the ERISA section 303(h)(2)(A) effective interest rate for the plan year for which 

they were made. 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 the case of:

 a Small Plan using the Lookback Rule, the asset value reported is generally the same as the market 

value of assets required to be reported in the Schedule SB for the Lookback Year (item 2a). 

 any other plan, the asset value reported here is generally the same as the market value of assets 

required to be reported in the Schedule SB for the Premium Payment Year (item 2a). 

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

contributions are made after the premium filing is made (and thus not included in assets).
How to Determine Unfunded Vested Benefits

Page 19

Summary 

The following table summarizes the various dates and assumptions that are used to determine Variablerate premiums for 2015. Although Participant Count Date is not used to determine the Variable-rate 

premium, it is included in the table so that all of the variables affecting premium calculations are

contained in one summary. Please review the column that relates to your plan. 

Summary10

If Lookback Rule Applies If Lookback Rule Does Not Apply

Standard Premium 

Funding Target

Alternative Premium Funding 

Target

Standard Premium 

Funding Target

Alternative Premium 

Funding Target

Participant Count 

Date 

Last day of 

2014 plan year

Last day of

2014 plan year

Last day of 

2014 plan year

Last day of 

2014 plan year

UVB Valuation 

Date

Funding valuation

date for 2014

Funding valuation

date for 2014

Funding valuation

date for 2015

Funding valuation

date for 2015

Benefits reflected 

in Premium 

Funding Target

Vested portion of

benefits included in

2014 funding target

Vested portion of

benefits included in

2014 funding target

Vested portion of

benefits included in

2015 funding target

Vested portion of

benefits included in

2015 funding target

Assumptions

 Discount rates December 2013

spot segment rates

Whatever would have been

used for funding purposes for 

2014 if HATFA stabilization 

rules had not applied11

December 2014

spot segment rates

Whatever would be used 

for funding purposes for 

2015 if HATFA stabilization 

rules did not apply11

 All other 

assumptions

Whatever was used

for funding purposes

for 2014

Whatever was used

for funding purposes

for 2014

Whatever is used

for funding purposes

for 2015

Whatever is used 

for funding purposes

for 2015

At-risk status Whatever status was

in effect for funding 

purposes for 2014

Whatever status was

in effect for funding

purposes for 2014

Whatever status is

in effect for funding 

purposes for 2015

Whatever status is

in effect for funding 

purposes for 2015

At-risk load 

 4% of liability 

portion of load

If the plan was at-risk for 

2014 for funding 

purposes, 4% of what

the Standard Premium 

Funding Target would be

if the plan wasn’t at-risk. 

Otherwise, N/A.

If the plan was at-risk for

2014 for funding

purposes, 4% of what

the Alternative Premium 

Funding Target would be

if the plan wasn’t at-risk. 

Otherwise, N/A.

If the plan is at-risk for 

2015 for funding

purposes, 4% of what

the Standard Premium

Funding Target would be

if the plan wasn’t at-risk. 

Otherwise, N/A.

If the plan is at-risk for

2015 for funding

purposes, 4% of what

the Alternative Premium 

Funding Target would be

if the plan wasn’t at-risk. 

Otherwise, N/A.

 Per-participant 

portion of load

The same amount

included in the liability

for funding purposes

for 2014

The same amount

included in the liability

for funding purposes

for 2014

The same amount

included in the liability

for funding purposes

for 2015

The same amount

included in the liability

for funding purposes

for 2015

 

10

 Table entries assume plan is not a New or Newly Covered Small Plan. The terms “funding” or “for funding purposes” in this table 

mean amounts determined under ERISA Section 303. References to 2014 or 2015 relate to the plan year beginning in such year.

11

 This is not the case for plan that are not subject to PPA for funding purposes or plans made elections under section 402 of PPA 

which the funding target is determined using an 8.25% discount rate. See “Plans Subject to Special Funding Rules” on next page.
How to Determine Unfunded Vested Benefits

Page 20

Plans Subject to Special Funding Rules 

Sections 104 and 105 of PPA 2006 delay the effective date of the PPA funding rules for certain plans of 

cooperatives, charity plans, and plans affected by settlement agreements with PBGC. 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 21

Form is for Illustrative Purpose Only

Amended filing 2015 PBGC Comprehensive Premium Filing Disaster Relief (enter code) _ _ - _ _ 

Part I – General Plan Information

1 Plan sponsor information

a Name ___________________________________________________________________________________________________

b Six-digit business code _ _ _ _ _ _ _ c First six digits of CUSIP number _ _ _ _ _ _ 

2 Plan administrator information 

a Name ___________________________________________________________________________________________________________

b Address line 1 _____________________________________________________________________________________________________

c Address line 2 _____________________________________________________________________________________________________

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

h Contact person 

(1) Name (for “attention” line of mailings) ______________________________________________________________ 

(2) e-mail address ___________________________________________________ (3) Phone number: _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ 

i Alternative phone number for Insured Plans List on pbgc.gov: _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ 

3 Additional plan contact (optional)

(1) Name ___________________________________________________________________________________ 

(2) e-mail address ___________________________________________________ (3) Phone number: _ _ _ -_ _ _ - _ _ _ _ ext _ _ _ _ _ 

4 Plan information

a Plan name _____________________________________________________________________________________________________

b Premium payment year information: 

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

(2) For the premium payment year, is the plan a “small plan” (see definitions section of instructions)? Yes No

(3) 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 _ _/_ _/_ _ _ _ .

(4) 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 4c(3). 

(3) If the EIN and PN are not both the same as on the 2014 Form 5500, enter EIN and PN from 2014 Form 5500 and provide explanation: Otherwise, skip to 

item 4d. EIN _ _ _ _ _ _ _ _ _ PN _ _ _. Explanation _____________________________________________________________________________________ 

d Plan effective date _ _ /_ _ / _ _ _ _ 

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

f Check box if plan is a new or newly covered plan and provide the following information: 

(1) Adoption date _ _ /_ _ / _ _ _ _ (2) Date coverage began on _ _ /_ _ / _ _ _ _. 

(3) Is the plan a “continuation plan” (see definitions section of instructions)? Yes No
Data to be Submitted 

Page 22

Part III – Variable-rate Premium Information

Multiemployer plans — Skip to Part IV

Complete item 6 only if the plan is electing, or revoking an election, to use the Alternative Premium Funding Target instead of the Standard Premium Funding Target; 

otherwise skip to item 7.

6 Alternative Premium Funding Target Election or Revocation

a Election - Check box to elect to use the Alternative Premium Funding Target instead of the Standard Premium Funding Target. The election will be effective —

and the plan will be required to use the Alternative Premium Funding Target — beginning with this premium payment year and for all subsequent plan years 

unless and until the election is subsequently revoked.

b Revocation - Check box to revoke a prior election to use the Alternative Premium Funding Target. The revocation will be effective — and the plan will be 

required to use the Standard Premium Funding Target — beginning with this premium payment year and for all subsequent plan years unless and until a new 

election is subsequently made.

Note — Elections or Revocations must remain in place for at least five years.

7 Variable-rate premium (VRP)

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

 New or newly covered small plan other than a continuation plan No vested participants 

 Standard termination with a final distribution during the premium payment year 412(e)(3) plan 

 Standard termination with a proposed termination date in a prior year (proposed termination date: _ _ /_ _ /_ _ _ _)

b VRP small employer cap qualification – Check box if this plan qualifies for the small employer cap applicable to certain plans of small employers (those with 

25 or fewer employees). If box is checked, items 7c through 7g may, but need not, be omitted. 

c Assumptions and methods used to determine premium funding target 

(1) Premium funding target method: Standard Alternative 

(2) Discount rate(s): 1

st segment ____% 2nd segment ____% 3rd segment ____% N/A, full yield curve used

(3) UVB valuation date: Month ___ Day ___ Year ____

d Premium funding target as of UVB valuation date – Check box if the reported premium funding target information is an estimate. 

(1) Attributable to active participants _____________

(2) Attributable to terminated vested participants _____________

(3) Attributable to retirees and beneficiaries receiving payment _____________

(4) Total premium funding target (item 7d(1) + item 7d(2) + item 7d(3)) _____________

e Market value of assets as of UVB valuation date _____________

f Unfunded vested benefits (excess, if any, of item 7d(4) over item 7e, rounded up to the next $1,000) _____________

g Uncapped variable-rate premium (item 7f x 0.024) _____________

h Maximum VRP

(1) MAP-21 cap ($418 x item 5b(2)) _____________

(2) Small employer cap, if applicable ($5 x item 5b(2) x item 5b(2)) – Omit this item if plan is not eligible for this cap _____________

(3) Maximum variable-rate premium — If the plan qualifies for the small employer cap, the lesser of item 7h(1) and 7h(2). Otherwise, 

item 7h(1). _____________

i Variable-rate premium — If the plan qualifies for the small employer cap and item 7g was omitted, item 7h(3). Otherwise, the lesser 

of item 7g and item 7h(3). _____________

Part II – Flat-Rate Premium Information

5 Flat-rate premium 

a Participant count date: Month ___ Day ___ Year ____

b Flat-rate premium calculation

(1) Applicable rate (Single-employer plans enter $57; Multiemployer plans, enter $26) ______________

(2) Participant count as of participant count date

Active: ___________ Terminated vested _____________ Retirees and beneficiaries: _______________ Total: ______________

(3) Flat-rate premium (item 5b(1) x item 5b(2)) ______________
Data to be Submitted 

Page 23

Part IV – Total Premium Information

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 5b(3) + item 7i, if applicable) ______________

9 Total premium — If the plan does not qualify for premium proration, item 5b(3) + item 7i, if applicable. If the plan qualifies for premium 

proration, item 8b x item 8a ÷ 12. ______________

Part V – Payment Information

10 Premium credit 

a Payments made previously for this premium payment year ______________

b Outstanding credit from the plan year immediately preceding the premium payment year ______________

c Total (item 10a + item 10b) ______________

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

12 Treatment of overpayment 

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

b Treatment of balance (select one): Credit towards next year’s premium Refund by check

 Refund by electronic funds transfer (EFT). If you select this option, complete item 12c.

c Information for EFT refund: Type of account Checking Savings Bank routing number _______________________

 Account number ___________________ Sub-account number (if any) _________________

Part VI – Miscellaneous Information

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

Merger/Consolidation Trusteeship Distribution pursuant to termination Cessation of covered status 

14 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

15 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

16 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 _ _/_ _/_ _ _ _ . 

17 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)________________________________________________________________________________
Data to be Submitted 

Page 24

18 Risk transfer activity – Do not complete this item if this is the last filing for this plan

a Lump Sum Windows: If the plan provided one or more Lump Sum Windows during the time period described in the instructions, report the 

number of persons eligible to elect a lump sum under any such window and the number who elected a lump sum:

(1) Persons not in pay status when lump sum was offered: Eligible to elect lump sum _______ Elected lump sum _______

(2) Persons in pay status when lump sum was offered: Eligible to elect lump sum _______ Elected lump sum _______

b Annuity purchases: If, during the time period described in the instructions, the plan purchased annuities for a group of people, report the 

number of persons for whom an annuity was purchased:

(1) Persons not in pay status when annuity was purchased: _______

(2) Persons in pay status when annuity was purchased : _______

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 4b(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 4c(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:

_____________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________

Part VII – Certifications

20 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 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

21 Certification of Enrolled Actuary – An enrolled actuary must sign and complete this item unless the plan is (1) a multiemployer plan, (2) exempt from the variablerate premium, or (3) eligible for the small employer cap, 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 

Page 25

Overview 

This section provides a description of each required data element presented in the same order as the “form” 

used to illustrate the data elements (see “Data to be Submitted” 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 2014 or 2015: 

References in these instructions to the 2014 plan year (and to filings for the 2014 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 2015. When such a plan makes its premium filing(s) for its 

second 2015 plan year, the references in these instructions to the 2014 plan year (and to filings for the 2014 

plan year) should be considered to refer to the plan’s first 2015 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 2014, the references in these instructions to the 2014 plan year (and to filings for the 2014 plan year) 

should be considered to refer to the plan’s second 2014 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 2015 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 reported in the filing that is being amended, 

you must provide an explanation of the specific circumstances or events that caused the reduction. See the 

“Correcting Filings, Credit Balances and Reconciling Estimates” section for more information.

Note – If you are amending a filing for a plan year that did not begin in 2015, 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 through the Practitioners Page at

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. 
Description of Data Elements

Page 26

Instructions for Part I – General Plan Information

1 Plan sponsor information

a Report the name of the Plan Sponsor. 

b 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 can be found in the instructions to Form 5500 and in the “Premium 

Filings” section of the Practitioners Page at www.pbgc.gov. Because codes for the Premium Payment Year 

may not be available at the time you submit this filing, you may report the relevant code for either the 

Premium Payment Year or the prior year. 

c 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 

a-g 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). 

h Report the name, e-mail address, and phone number of the person we should contact if we have any 

questions concerning this filing. We will send official correspondence to the “attention of” this person at 

the address reported in (b)-(g). In addition, unless a different phone number is provided in item 2i, the 

phone number reported in 2h will be posted on PBGC’s Is my Pension Insured list as the number plan 

participants should call if they have questions about their plan.

i If you would prefer plan participants with questions about their plan call a phone number other than the 

one reported in item 2h, report the phone number you would like them to use. If this item is left blank, 

the Insured Plans List on PBGC’s website will show the phone number reported in item 2h.

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.

3 Additional plan contact (optional)

Although official correspondence related to premium filings is directed to the Plan Administrator (see item 2), 

some plans choose to provide contact information for another individual as well. In general, the contact 

person identified in this section will be used for questions that aren’t important enough for official 

correspondence. PBGC may also contact this individual if official inquiries to the Plan Administrator go 

unanswered.
Description of Data Elements

Page 27

4 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 be the plan 

effective date.

(2) Check the appropriate box to indicate whether the plan is a Small Plan for the Premium Payment Year

(See definition of Small Plan in Appendix 1). 

(3) 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. 

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

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

 is a short first year of a New Plan;

 is 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); 

- distribution of plan assets pursuant to plan termination; or

- the appointment of a trustee for a Single-employer Plan under ERISA section 4042;

 includes a portion of time in which the plan was not covered by PBGC, unless such period of noncoverage began after the first day of the plan year12

.

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:

 

12

 A Newly Covered Plan with a coverage date after the first day of the Premium Payment Year qualifies to pay a prorated premium. A 

plan ceases to be a covered plan before the end of the plan year does not. 
Description of Data Elements

Page 28

 If item 4c(2) was reported incorrectly in the original filing (i.e., the filing that is being amended), 

provide the correct information in the amended filing.

 If item 4c(2) was reported correctly in the original filing, provide the same information in the 

amended filing.

(3) If the EIN and PN for this filing do not both match exactly the EIN and PN reported in the 2014 Form 

5500, report both the EIN and PN that were reported in the 2014 Form 5500, and attach an explanation. 

If a 2014 Form 5500 was not required, leave this item blank.

d Plan effective date – Report the date the plan became effective.

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

f Information for New or Newly Covered Plans – If this is a New or Newly Covered Plan, check the box and 

complete the rest of item 4f.

(1) Adoption date – Enter the date the plan was adopted

(2) Coverage date – Enter the date the plan became covered under Title IV. If the plan has had one or more 

periods of coverage, 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 liabilities to this New or Newly Covered Plan, be sure to complete the “Transfers from other 

plans” item (see item 14).

(3) Continuation Plan – Check the box to indicate whether this New or Newly Covered Plan meets the 

definition of a Continuation Plan (see definition).

Instructions for Part II – Premium Information

5 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 2015, the rate is $57 for Singleemployer Plans and $26 for Multiemployer Plans. 

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

separately for active participants, terminated vested participants, retirees and beneficiaries receiving 

payment, and in total. 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 you must make a premium filing even if the Flat-rate 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.
Description of Data Elements

Page 29

Instructions for Part III – Alternative Premium Funding Target Election/Revocation

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

To be valid, an election must be made in accordance with these instructions and must be filed with PBGC on or 

before the deadline. 

6 Alternative Premium Funding Target Election / Revocation

a Election - Check this box to make an election to use the Alternative Premium Funding Target first effective 

for this Premium Payment Year.

b Revocation - Check this box to revoke a prior election to use the Alternative Premium Funding Target that 

was in effect for the plan year immediately preceding the Premium Payment Year.

You may elect to use the Alternative Premium Funding Target to determine unfunded vested benefits instead of 

the Standard Premium Funding Target. Once an election is made, it remains in effect for all subsequent plan 

years unless and until it is subsequently revoked. You may revoke a prior election only if the Premium Payment 

Year begins at least five years after the beginning of the plan year for which the election was first applicable. For 

example, if your plan is a calendar-year plan and you first elected to use the Alternative Premium Funding 

Target:

 for a plan year beginning 2008 - 2010, you may revoke the election first effective for this 2015 filing. If you 

revoke the election for 2015, you cannot make another election to use the Alternative Premium Funding 

Target until 2020.

 for a plan year beginning 2011 - 2014, the election is still in effect; you must use it for 2015.

 for this plan year, 2015, you must also use it for 2016 - 2019. You may first revoke the election for 2020.

Similarly, if you revoke an election, you may not make a new election to use the Alternative Premium Funding 

Target until five years have passed.

If you are not sure if an election is in effect or when an election first took effect, you find it by viewing your 

account history in My PAA.

See “How to Determine Unfunded Vested Benefits” section for more information on elections and revocations.

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 $24 per $1,000, or fraction thereof, of unfunded vested benefits as of 

the UVB Valuation Date, but no more than $418 times the number of participants (i.e., the MAP-21 Cap). For 

certain plans of small employers, the Variable-rate Premium may be capped at an amount lower than the 

MAP-21 CAP (see item 7b). 

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 if it meets 

the requirements for any of the exemptions described below: 
Description of Data Elements

Page 30

 New or Newly Covered Small Plans other than Continuation Plans – Your plan qualifies for this 

exemption if it is a New or Newly Covered Plan and a Small Plan, but not a Continuation Plan. See 

Definitions section for more information about these terms.

 Standard termination — closing out in current year – Your plan qualifies for this exemption if it makes a 

final distribution of assets in a standard termination during the Premium Payment Year.

You may claim this exception in anticipation of a full distribution by plan year-end even if that hasn’t 

happened by the time you submit the filing. However, if you fail to complete the final distribution by 

the end of the year, the exemption will not apply. In that case, you will need to amend the filing 

accordingly and late payment charges will be assessed on any Variable-rate Premium owed and paid 

after the applicable due date. 

 Standard termination — proposed termination date in a prior year — 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 before the beginning of the 

Premium Payment Year.

To qualify for this exemption, it is not necessary that the plan make a final distribution of assets during 

the Premium Payment Year. However, this exemption is conditioned on the plan’s ultimately making a 

final distribution of assets in full satisfaction of its obligations under the standard termination. If that 

doesn’t happen, the premium that would otherwise have been required will be due retroactive to the 

applicable due date.

 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.

If an exemption applies, check the applicable box to indicate which exemption applies and skip to item 8. If 

more than one exemption applies, check all applicable boxes. 

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

may be capped at an amount lower than the MAP-21 Cap.

Determining whether a plan qualifies for the Small-Employer 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 Small-Employer 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.
Description of Data Elements

Page 31

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 calculating and reporting both the uncapped Variable-rate 

Premium and the maximum Variable-rate Premium and then paying the lesser of the two amounts, you may

report and pay only the maximum Variable-rate Premium.

If you choose to not report the uncapped Variable-rate Premium, omit all items 7c through 7g and go 

directly to item 7h. 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 Assumptions and methods used to determine Premium Funding Target

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

or the Alternative Premium Funding Target to determine unfunded vested benefits by checking the 

applicable box (i.e., “Standard” or “Alternative”). Note that:

 The standard method must be used unless an election to use the alternative method is in effect.

 If an election to use the alternative method is in effect, you must use the alternative method. This is 

the case only if a valid election:

– is made as part of a timely filing for the Premium Payment Year by checking the election box in 

item 6 of Part III, or

– that was made in a prior year has not yet been revoked.

 Filers are encouraged to review prior filings or to review the Account History on My PAA to confirm 

whether an election to use the alternative method is in effect.

 Checking the alternative box in item 7(c)(1) does not constitute an election. See item 6 instructions.

For additional information on Premium Funding Target methods, see “How to Determine Unfunded 

Vested Benefits” section.

(2) Discount rates – Report the discount rates used to determine the Premium Funding Target. For 

information on which rates to use, see “How to Determine Unfunded Vested Benefits” section.

(3) UVB Valuation Date – Report the UVB Valuation Date for the Premium Payment Year. In the case of a

Small Plan using the Lookback Rule, this date must be the valuation date for the Lookback Year. For any 

other plan this date must be the valuation date for the Premium Payment Year. Note for Small Plans -

For information about whether you should be using the Lookback Rule, see “How to Determine 

Unfunded Vested Benefits” section.

d Premium Funding Target as of UVB Valuation Date

Report the Premium Funding Target (dollars only) calculated as described in the Premium Funding Target 

part of the “How to Determine Unfunded Vested Benefits” section. Report the amount separately for (1) 
Description of Data Elements

Page 32

active participants, (2) terminated vested participants, (3) retirees and beneficiaries receiving payment, and 

(4) the total premium funding target ((1)+(2)+(3)).

Estimated Premium Funding Targets – If the Premium Funding Target (and thus, the Variable-rate Premium) 

being reported in this filing is an estimate, check the box to report that fact. 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, Credit Balances and Reconciling Estimates” section for more 

information. See also the “Late Payment Charges” section for information on the automatic late payment 

penalty relief that may be available to plans paying estimated Variable-rate Premiums by the due date and 

later reconciling. 

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

Date adjusted to reflect contribution receipts as described in the “How to Determine Unfunded Vested 

Benefits” section.

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. 

g Uncapped Variable-rate Premium – Report the product of 0.024 and the amount of unfunded vested 

benefits.

h Maximum Variable-rate Premium

(1) MAP-21 Cap – Report the product of the Participant Count and $418.

(2) Small Employer Cap – Report the product of $5 and the Participant Count squared. If the plan does not 

qualify for the Small Employer Cap, this item must be left blank.

(3) Maximum Variable-rate Premium – If the plan qualifies for the Small Employer Cap, report the lesser of 

the Small Employer Cap and the MAP-21 Cap. Otherwise, report the MAP-21 Cap.

i Variable-rate Premium – Report the lesser of the maximum Variable-rate Premium and the uncapped 

Variable-rate Premium. If the plan qualifies for the Small Employer Cap and chooses not to report uncapped 

Variable-rate premium data, 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.

Instructions for Part IV – Total Premium Information

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 
Description of Data Elements

Page 33

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 Plans – The short first year of a New Plan is treated as beginning on the 

Participant Count Date (i.e., the plan effective date). 

Counting months for Newly Covered Plans – Although the Premium Payment Year for a Newly Covered Plan 

is, most likely, a full year, premiums are due only for the portion of the year the plan is covered by PBGC. 

Therefore, for purposes of prorating the premium for the first year of coverage, a Newly Covered Plan’s first 

year of coverage is treated as beginning on the date when the plan becomes covered under ERISA section 

4021

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 Variablerate Premium.

9 Total premium

 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.
Description of Data Elements

Page 34

Instructions for Part V – Payment Information

10 Premium credit 

Report the total amount of premium credits available to offset the premium due. Premium credits include:

 Any payments made for 2015 (including an estimated Variable-rate Premium when amending the filing 

to reconcile the estimate; see “Correcting Filings, Credit Balances and Reconciling Estimates” section), 

and

 Any overpayment of the 2014 premium filing for which a refund was not requested and that has not 

been applied to amounts due. A plan account history is available on My PAA. You should review the 

account history to confirm that a 2014 overpayment is available.

If this amount includes cents, report the exact amount (dollars and cents), not a rounded amount.

11 Amount due

If the total premium due 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 this amount includes cents, report the exact amount (dollars and cents), not a rounded amount.

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. If this amount includes cents, report the exact amount (dollars 

and cents), not a rounded amount.

b If you have an overpayment, you must choose whether to have the overpayment credited towards the 

next year’s premium for the plan or refunded (by electronic funds transfer or check). Report your choice 

by checking the appropriate box.

 Credit - If you choose 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.

 Refund - If you choose to have the overpayment refunded, the quickest way to receive your refund is 

to select the electronic funds transfer option, which we strongly recommend. To facilitate an ACH 

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 

prefer your refund by Fedwire funds transfer (available only for refunds of $100,000 or greater), 

please call 1-800-736-2444 or 202-326-4242 and select option 2 (premiums) for instructions. For 

Fedwire funds transfers, you can have the refund credited to a sub-account within the main account if 

you provide the sub-account number to us.
Description of Data Elements

Page 35

Instructions for Part VI – 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; or

 the plan ceased to be covered by Title IV of ERISA, report the date coverage ceased. 

See also “Failure to report a filing as the final premium filing” in the “Correcting Filings, Credit Balances and

Reconciling Estimates” section.

14 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 2015, since the date of

the 2014 “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 this 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, 2015, 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 
Description of Data Elements

Page 36

soon as practicable. The transfer does not actually occur until February 17, 2015. If you are preparing a 

comprehensive premium filing for Plan B for Plan B’s 2015 plan year, report “01/01/2015” 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. 

15 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 2015, since the date of 

the 2014 “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. 

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 14 for more information on what is to be reported for “date of 

transfer.” 

Example – Until November 1, 2014, 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, 2014. If you are preparing a 2015 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 “11/01/2014” as the date of 

transfer.

16 Participation freeze

If, as of the beginning of the Premium Payment Year, 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.
Description of Data Elements

Page 37

17 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. 

18 Risk transfer activity – Do not complete this item if this is the final filing for the plan.

a Lump Sum Windows – If the plan provided one or more Lump Sum Windows during the premium payment 

year or the prior premium payment year, enter the requested information with respect to individuals 

eligible to elect a lump sum under the window. For this purpose:

 Disregard any Lump Sum Window for which the time period for electing a lump sum ends less than 60

days before the premium filing is made.

 Disregard lump sums offered: 

– In the course of routine plan operations,

– In conjunction with a plan termination,

– Upon a participant’s separation from service, or

– As part of an incentive program to encourage active participants to retire early (commonly called an 

early retirement window). 

 Disregard lump sums paid under mandatory cash out provisions.

 A person eligible for a Lump Sum Window whose offer letter is undeliverable may be excluded from the 

“Eligible to elect a lump sum” count.

 If the exact counts are not readily available, reasonable estimates based on readily available plan 

records may be reported. 

b Annuity Purchases - If the plan purchased annuities for a specified group of individuals during the premium 

payment year or the prior premium payment year, enter the requested information with respect to that 

group of individuals. For this purpose:

 Disregard annuities purchases made less than 60 days before the premium filing is made.

 Do not include annuity contracts:

– Purchased in the course of routine plan operations,

– Purchased in conjunction with a plan termination, or

– That remain an asset of the plan (commonly called a “buy-in”).

 If the exact counts are not readily available, reasonable estimates based on readily available plan 

records may be reported. 
Description of Data Elements

Page 38

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 4b(1)) 

differs from what was reported in the original filing (i.e., 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 4c(1)) are not both the same as what was reported 

in the original filing (i.e., the filing that is being amended), report the EIN and PN from the original filing.

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, you must 

provide an explanation of the specific circumstances or events that caused the reduction.

Instructions for Part VII – Certifications

20 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, the telephone number, and the certification date. If the Plan Administrator 

has an e-mail address, that address must also be reported.

21 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 the Small Employer Cap and is paying the maximum Variable-rate Premium (and not 

reporting the regular Variable-rate Premium).

Be sure to provide all of the required information related to the enrolled actuary (i.e., name, firm, telephone 

number, enrollment number, and if the enrolled actuary has an e-mail address, email address). 

The actuary must follow the certification instructions for the electronic filing method that is used to make 

the filing.
Late Payment Charges

Page 39

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 “Interest Rates and Factors” section of the Practitioners Page 

at www.pbgc.gov. 

Late Payment Penalty Charges 

The amount of the late payment penalty charge depends on whether the premium underpayment is 

“self-corrected” and how late the payment is.

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), the penalty rate is 1% of the late premium payment per month capped at 

50% of the unpaid amount.

If the late payment is made after that date, the penalty rate is 5% per month capped at 100% of the unpaid 

amount. 

In both cases, the penalty before reflecting the applicable cap is subject to a $25 minimum.

Minimizing Late Payment Charges 

If you cannot make a 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 filing. If you choose to do this, you must pay outside of My PAA, either via 

www.Pay.gov, or by check or wire transfer. You should then submit your certified filing as soon as possible. 

Additional information on payment options is included in Appendix 3.

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. 
Late Payment Charges

Page 40

Example –The Normal Due Date for a plan with a plan year beginning on February 1, 2015 would normally be 

November 15, 2015. Because that day is a Sunday, the due date is Monday, November 16, 2015. If the filing is 

made after November 16th, late payment charges, if applicable, will be computed from Sunday, November 15, 

2015, not November 16th.

Notices from PBGC

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.

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).

Penalty Waivers

Case-by-Case Waivers

If you receive an SOA (see above) that includes a penalty charge, but you believe there is a reason why all or a 

portion of the penalty should be waived (e.g., reasonable cause), you may request a waiver. Information about 

what constitutes reasonable cause as well as information about other situations where a penalty waiver might 

be warranted can be found in § 21 of the appendix to PBGC’s premium payment regulation, 29 CFR Part 4007, 

available on the “Law and Regulations” page www.pbgc.gov (accessible from the “Open Government” section of 

the Home Page or the Practitioners page).

The instructions and timeframe for requesting a waiver will be provided in the SOA. Be sure to follow the 

instructions carefully. Requests that are submitted past the allotted timeframe will not be granted.

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, 

contact PBGC at least 30 days before the filing due date. Be sure to include specific information and documents 

to demonstrate both that it will be a substantial hardship to make the payment on or before the filing due date 

and that you will have the ability to make the payment within 60 days after the filing due date.
Late Payment Charges

Page 41

Automatic Penalty Waiver for Premiums paid Within Seven Days of Due Date

If the sole reason a late payment penalty charge applies is because a premium was paid after the due date, but 

within seven calendar days of the due date, the late payment penalty charge will automatically be waived. 

Automatic Penalty Waiver for Certain Late Variable-Rate Premiums

As explained in the “When to File” section, in rare circumstances (e.g., a mid-year merger or change in actuary), 

the Premium Funding Target might not be calculated or finalized by the premium due date. PBGC allows plans 

in this situation to file timely and pay an estimated Variable-rate Premium by the due date and then submit an 

amended filing at a later date to reconcile the actual Variable-rate Premium with the estimate. 

Because a plan’s full Variable-rate Premium (not merely an estimate) is due by the due date, if the full amount 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 the actual Variable-rate Premium is greater than the estimate, penalties for late payment will be waived if:

 the reconciliation filing is made and any additional required Variable-rate Premium paid by the end of the 

sixth calendar month that begins on or after the premium due date (generally April 30th after year-end for 

calendar year plans), and

 by the premium due date, you report:

- the fair market value of the plan’s assets, 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

 by the premium due date, 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 this waiver applies only to estimated Premium Funding Targets, not estimated asset values. If the 

asset value reported in the reconciliation filing differs from what was reported in the original (i.e., estimated) 

filing, this automatic 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.

If you know the final Premium Funding Target 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, Credit Balances and Reconciling Estimates

Page 42

Correcting Filings

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.

Failure to report a filing as the final premium filing

If you make a premium filing that is a “Final premium filing” as described in item 13 of the comprehensive 

premium filing instructions, and you do not provide the information required by item 13, you must make an 

amended filing if the event referred to in item 13 occurred before you made your original filing, unless —

 The event was a distribution of assets pursuant to plan termination and was reported on PBGC Form 501, or

 The event was a merger into or consolidation with another plan and was reported on a premium filing for 

the surviving plan.

If you make a premium filing that is a “Final premium filing” as described in item 13 of the comprehensive 

premium filing instructions, and you do not provide the information required by item 13 because the event 

referred to in item 13 has not yet occurred when you make the filing, you are not required to make an 

amended filing. However, to avoid the need for correspondence to establish why you are not making any more 

premium filings, we recommend that you contact us to report the event, unless —

 The event was a distribution of assets pursuant to plan termination and is being reported on PBGC Form 501, 

or

 The event was a merger into or consolidation with another plan and is being reported on a premium filing 

for the surviving plan.

Even if an amended filing is not required, you may want to make one where the plan has made a distribution of 

assets pursuant to plan termination, because that event may enable you to reduce the premium through 

proration and request a refund as part of the amended filing. Alternatively, because our system automatically 

pro-rates premiums for plans in this situation and updates the plan’s statement of account to reflect any 

overpayment, in lieu of submitting an amended filing, you may request a refund of such overpayment simply by 

sending an email to premiums@pbgc.gov.

Amending Filings 

If, after submitting a filing, you discover an error has been made (e.g., 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” sections). 

In the amended filing, report all of the required information, including information that was correct in the 

original filing (i.e., the filing that is being amended). 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.
Correcting Filings, Credit Balances and Reconciling Estimates

Page 43

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. You must indicate whether you want the overpayment refunded or applied to the next year’s 

premium for the plan. We recommend that small credit amounts be carried over to the next plan year. To 

do so, simply enter the relevant amount under “Premium Credits “in the next year’s premium filing. See line 

10b on the illustrative form in the “Data to be Submitted” section. 

If you prefer a refund by electronic funds transfer (EFT), provide the necessary information in the applicable 

section of the amended filing; we will make the transfer through the ACH system or Fedwire (Fedwire 

transfers are available only for refunds of $100,000 or greater). For Fedwire funds transfers, you can have 

the refund credited to a sub-account within the main account if you provide the sub-account number to us. 

With either option, the overpayment will appear as an “Amount Overpaid” on your plan’s account history 

until it is refunded or used to satisfy a future year’s premium. See section below on Premium Credit 

Balances.

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 

comprehensive 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.

Amending a prior year’s filing

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 (EFT) addresses should be used instead of the addresses that 

were included in the instructions for the original filing (i.e., the filing that is being amended). Prior year 

instructions are available in the “Premium Payment Instructions and Addresses” section of the Practitioners 

Page at www.pbgc.gov.

Premium Credit Balances

Premium credit balances, whether resulting from an amended filing or any overpayment, are shown on plans’ 

account histories and can be viewed in My PAA at any time. We recommend you review your plan’s account 

history before you file to ensure that any available credits from the prior plan year have been used. If you have 

a credit from two or more years prior to the Premium Payment year, you will need to contact the Premium 

Customer Service Center in order to use it (See Appendix 2).

Note that an overpayment for one plan cannot be applied to offset an underpayment on another plan. 

A plan administrator may request that a premium credit balance be refunded or be credited against the next 

year’s premium. Requests must be made within the statutory limitation period (generally six years).
Correcting Filings, Credit Balances and Reconciling Estimates

Page 44

Reconciling Estimates

For plans that filed an estimated Variable-rate Premium, the reconciliation is made by amending the filing that 

included the Variable-rate Premium estimate. This reconciliation filing serves to finalize a previously estimated 

Premium Funding Target; it does not afford an opportunity to elect to use the alternative method after the due 

date for such election (or to revoke a prior election after the due date for such revocation). See the instructions 

for item 7d in the “Description of Data Elements” section for additional information on how to reconcile an 

estimated Variable-rate Premium.

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

Page 45

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. For this 

purpose, the term “records” includes, but is 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 premiumrelated information required to be reported.

Records retained 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.

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.
Appendix 1 – Definitions

Page 46

Definitions for terms shown in capital letters throughout the instructions are shown below. New or modified 

terms are highlighted in green for emphasis.

“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)).

“Code” means the Internal Revenue Code of 1986, as amended.

“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.

“Continuation Plan” means a new plan resulting from a consolidation or spinoff that is not de minimis pursuant 

to the regulations under section 414(l) of the Code.

“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. 

“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. 

“HATFA Stabilization Rules” means the provisions of section 2003 of the Highway and Transportation Funding 

Act of 2014 (HATFA) under which the volatility of certain discount rates used for funding purposes is limited by 

constraining them within a specified corridor.

“Lookback Rule” means the provision under which the Variable-rate Premium for the Premium Payment Year is 

determined based on UVBs for the plan year immediately preceding the Premium Payment year instead of the 

Premium Payment Year.

“Lookback Year” means the plan year immediately preceding the Premium Payment Year.

“Lump Sum Window” means a temporary opportunity to elect a lump sum in lieu of future annuity payments 

that is offered to individuals meeting specified criteria who would not otherwise be eligible to elect a lump sum.

“MAP-21 Cap” means the per-participant cap on the Variable-rate Premium as provided in The Moving Ahead 

for Progress in the 21st Century Act.

“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. 
Appendix 1 – Definitions

Page 47

“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.

“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.

“New or Newly Covered Plan” means a plan that is either a New Plan or a Newly Covered Plan. In some cases, 

the term “New and Newly Covered Plan” is used for the same purpose.

“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 becomes covered by title IV of ERISA during the premium payment 

year and that existed as an uncovered plan immediately before the first date in the premium payment year on 

which it was a covered plan.

“Normal Premium Due Date” means the date premiums are due unless some special situation applies (i.e., a 

change in plan year, first time filing, or a standard termination). See “When to File” section.

“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, the MAP-21 CAP on the Variable-rate Premium, whether the plan is a Small Plan, and, if 

applicable, the Small Employer 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.
Appendix 1 – Definitions

Page 48

“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 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 except that only vested 

benefits are taken into account. The discount rates 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 determined using the ERISA section 

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

 “Alternative Premium Funding Target” means a Premium Funding Target determined using ERISA section 

303 (i.e., funding) discount rates, but without regard to the MAP-21 Stabilization Rules. See “How to 

Determine Unfunded Vested Benefits” section for additional information related to the election and use of 

the Alternative Premium Funding Target. 

“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 2015, all references to “Premium Payment Year” 

relate to plan years beginning in 2015.

“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 Singleemployer Plan, all trades or businesses (whether or not incorporated) that are under common control are 

considered to be one employer.
Appendix 1 – Definitions

Page 49

“Small-Employer Cap” means the maximum Variable-rate Premium due for certain plans of small employers, 

generally employers with 25 or fewer employees. For these plans, the maximum Variable-rate Premium is the 

product of $5 and the Participant Count squared.

“Small Plan” means a plan:

 With a Participant Count for the Premium Payment Year of not more than 100, or

 With a funding valuation date for the Premium Payment Year, determined in accordance with ERISA section 

303(g)(2), that is not the first day of the Premium Payment Year.

“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.

“Standard Premium Funding Target” – see “Premium Funding Target”

“UVB Valuation Date” means the date on which UVBs are determined. This date is the plan’s funding valuation 

date determined in accordance with ERISA section 303(g)(2) for:

 In the case of a plan using the Lookback Rule, the Lookback Year, or

 In the case of any other plan, the Premium Payment Year.

”UVBs” means unfunded vested benefits, the term used to describe the underfunding measure on which the 

Variable-rate Premium is based. 

“Variable-rate Premium” means the portion of the single-employer premium based on a plan’s unfunded 

vested benefits. 

“We” or “us” refers to the Pension Benefit Guaranty Corporation.

“You” or “your” refers to the Plan Administrator.
Appendix 2 – Contact information

Page 50

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. Note that you can access or subscribe to “What’s New for Practitioners” that 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) at www.pbgc.gov. Access My PAA information via the “Online Premium Filing (My 

PAA)” section of the Practitioners Page at www.pbgc.gov and follow instructions about how to use My 

PAA for submitting premium payments. 

3. For all premium-related inquiries and requests, including requests for exemption from the requirement 

to file electronically, premium filing questions, 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 and select option 2 (premiums). Note – requests for 

exemptions from e-filing requirement cannot be made by phone.

c. Fax: 202-326-4250

d. E-mail: premiums@pbgc.gov

4. For current interest rate information:

a. Call: 202-326-4041

b. See: “Interest Rates and Factors” section on the Practitioners Page at www.pbgc.gov. 

5. 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
Appendix 2 – Contact information

Page 51

6. 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

Problem Resolution Officer (Practitioners); Suite 610

1200 K Street, NW

Washington, DC 20005-4026

7. 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

8. For software developers requesting approval of XML files produced by private-sector software for use in 

My PAA, follow the submission instructions on the “Software Developer E-filing Resources for Integrating 

with PBGC” webpage. The link to this webpage is found in the section titled “Related Information” on the 

right side of the “Online Premium Filing with My PAA” webpage.

PBGC’s business hours are 8:00 am to 5:00 pm Eastern time, Monday through Friday, except Federal Holidays.

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 – On-line Premium Filing with My PAA

Page 52

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 at www.pbgc.gov as well 

as within the My PAA application itself. Detailed information (e.g., FAQs and Demos) is located in the “Online 

Premium Filing (My PAA)” section of the Practitioners Page at www.pbgc.gov.

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 (before the filing is 

uploaded) 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 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.
Appendix 3 – On-line Premium Filing with My PAA

Page 53

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, ecertification 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 review PBGC’s Web site or 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. My PAA’s import feature also allows 

multiple filings to be imported at the same time.

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 before 

the filing is uploaded, 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 the Plan Administrator (or enrolled actuary) who 
Appendix 3 – On-line Premium Filing with My PAA

Page 54

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.

Premium Payment Options 

If you owe a premium, there are several ways to submit payment:

 Recommended: Online Payment at Pay.gov – This is a website from which you can make secure electronic 

payments direct to many Federal Agencies, including PBGC. It involves entering information about your plan 

(i.e., EIN, plan number, the date the applicable plan year began, information about the account from which 

payment will be made) and then authorizing payment. To pay using this option, go to www.pay.gov and 

select Pension Benefit Guaranty Corporation from the Agency List, and PBGC’s on-line Premium Insurance 

Payments Form will appear.

 Options within My PAA:

– 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. 

– 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.

These options are not available if you are uploading multiple filings at the same time (i.e., batch 

uploads). Additional information about these payment options is available in My PAA.

 Paper Check: You can mail a paper check to our premium lockbox. See the “Premium Payment Instructions 

and Addresses” section of www.pbgc.gov for additional information.

 Federal Wire and ACH: You can direct your bank to send us a payment. See the “Premium Payment 

Instructions and Addresses” section of www.pbgc.gov for more information.

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 that PBGC received the filing, a 

confirmation number, and all of the information submitted in the filing. 

For an uploaded filing, the filing receipt shows the name of the uploaded XML file, the date and time of receipt

by PBGC, and a confirmation number. This confirmation number must be written on the signed paper copy of 

the “form” retained the Plan Administrator’s records. After a filing is uploaded, the uploader can view the 

information submitted in each uploaded filing.
Appendix 3 – On-line Premium Filing with My PAA

Page 55

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, 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.
Appendix 4 — Paperwork Reduction Act Notice

Page - 56 -

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.

PBGC estimates that preparation and submission of a premium filing takes 7 hours if UVBs are reported and 31⁄2 

hours if they are not. PBGC assumes that most of the work (95 percent) is contracted out at a rate of $350 per 

hour. Thus the estimated burden associated with premium filing is about 20 minutes and $2,330 if UVBs are 

reported and about 10 minutes and $1,165 if they are not. The actual time will vary depending on the 

circumstances of each plan.

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.