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, 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 2014, since the date of the 2013 "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, 2014, and that the obligation to pay benefits to Plan A participants will pass from Plan A to Plan B as of that date. The agreement also provides that Plan A’s assets will be transferred to Plan B’s account as soon as practicable. The transfer does not actually occur until February 17, 2014. If you are preparing a comprehensive premium filing for Plan B for Plan B’s 2014 plan year, report "01/01/2014" 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 2014, since the date of the 2013 "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, 2013, 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, 2013. If you are preparing a 2014 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 "11/01/2013" 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.

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 Amended filings – Complete this item only if this is an amended filing.

1. 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.
2. 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.

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.