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 and the telephone number. 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, paying the maximum Variable-rate Premium and not reporting the uncapped Variable-rate Premium.

Be sure to provide the enrolled actuary’s name, firm and telephone number. If the enrolled actuary has an e-mail address, that address must also be reported.

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