[Code of Federal Regulations]
[Title 29, Volume 9]
[Revised as of July 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 29CFR4011.11]

[Page 782-784]
 
                             TITLE 29--LABOR
 
            CHAPTER XL--PENSION BENEFIT GUARANTY CORPORATION
 
PART 4011_DISCLOSURE TO PARTICIPANTS--Table of Contents
 
Sec. 4011.11  OMB control number.

    The collections of information contained in this part have been 
approved by the Office of Management and Budget under OMB control number 
1212-0050.

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            Appendix A to Part 4011--Model Participant Notice

    The following is an example of a Participant Notice that satisfies 
the requirements of Sec. 4011.10 when the required information is 
filled in (subject to Sec. Sec. 4011.10(d)-(e), where applicable).

                  Notice to Participants of [Plan Name]

    The law requires that you receive information on the funding level 
of your defined benefit pension plan and the benefits guaranteed by the 
Pension Benefit Guaranty Corporation (PBGC), a federal insurance agency. 
YOUR PLAN'S FUNDING
    As of [DATE], your plan had [INSERT NOTICE FUNDING PERCENTAGE 
(DETERMINED IN ACCORDANCE WITH Sec. 4011.10(c))] percent of the money 
needed to pay benefits promised to employees and retirees.
    To pay pension benefits, your employer is required to contribute 
money to the pension plan over a period of years. A plan's funding 
percentage does not take into consideration the financial strength of 
the employer. Your employer, by law, must pay for all pension benefits, 
but your benefits may be at risk if your employer faces a severe 
financial crisis or is in bankruptcy.
    [INCLUDE THE FOLLOWING PARAGRAPH ONLY IF, FOR ANY OF THE PREVIOUS 
FIVE PLAN YEARS, THE PLAN HAS BEEN GRANTED AND HAS NOT FULLY REPAID A 
FUNDING WAIVER.]
    Your plan received a funding waiver for [LIST ANY OF THE FIVE 
PREVIOUS PLAN YEARS FOR WHICH A FUNDING WAIVER WAS GRANTED AND HAS NOT 
BEEN FULLY REPAID]. If a company is experiencing temporary financial 
hardship, the Internal Revenue Service may grant a funding waiver that 
permits the company to delay contributions that fund the pension plan.
    [INCLUDE THE FOLLOWING WITH RESPECT TO ANY UNPAID OR LATE PAYMENT 
THAT MUST BE DISCLOSED UNDER Sec. 4011.10(b)(6):]
    Your plan was required to receive a payment from the employer on 
[LIST APPLICABLE DUE DATE(S)]. That payment [has not been made] [was 
made on [LIST APPLICABLE PAYMENT DATE(S)]].

                             PBGC GUARANTEES

    When a pension plan ends without enough money to pay all benefits, 
the PBGC steps in to pay pension benefits. The PBGC pays most people all 
pension benefits, but some people may lose certain benefits that are not 
guaranteed.
    The PBGC pays pension benefits up to certain maximum limits.
     The maximum guaranteed benefit is [INSERT FROM 
TABLE IN APPENDIX B] per month or [INSERT FROM TABLE IN APPENDIX B] per 
year for a 65-year-old person in a plan that terminates in [INSERT 
APPLICABLE YEAR].
     The maximum benefit may be reduced for an 
individual who is younger than age 65. For example, it is [INSERT FROM 
TABLE IN APPENDIX B] per month or [INSERT FROM TABLE IN APPENDIX B] per 
year for an individual who starts receiving benefits at age 55. [IN LIEU 
OF AGE 55, YOU MAY ADD OR SUBSTITUTE ANY AGE(S) RELEVANT UNDER THE PLAN. 
FOR EXAMPLE, YOU MAY ADD OR SUBSTITUTE THE MAXIMUM BENEFIT FOR AGES 62 
OR 60 FROM THE TABLE IN APPENDIX B. IF THE PLAN PROVIDES FOR NORMAL 
RETIREMENT BEFORE AGE 65, YOU MUST INCLUDE THE NORMAL RETIREMENT AGE.]
    [IF THE PLAN DOES NOT PROVIDE FOR COMMENCEMENT OF BENEFITS BEFORE 
AGE 65, YOU MAY OMIT THIS PARAGRAPH.]
     The maximum benefit will also be reduced when a 
benefit is provided for a survivor.
    The PBGC does not guarantee certain types of benefits.
    [INCLUDE THE FOLLOWING GUARANTEE LIMITS THAT APPLY TO THE BENEFITS 
AVAILABLE UNDER YOUR PLAN.]
     The PBGC does not guarantee benefits for which 
you do not have a vested right when a plan ends, usually because you 
have not worked enough years for the company.
     The PBGC does not guarantee benefits for which 
you have not met all age, service, or other requirements at the time the 
plan ends.
     Benefit increases and new benefits that have been 
in place for less than a year are not guaranteed. Those that have been 
in place for less than 5 years are only partly guaranteed.
     Early retirement payments that are greater than 
payments at normal retirement age may not be guaranteed. For example, a 
supplemental benefit that stops when you become eligible for Social 
Security may not be guaranteed.
     Benefits other than pension benefits, such as 
health insurance, life insurance, death benefits, vacation pay, or 
severance pay, are not guaranteed.
     The PBGC generally does not pay lump sum 
exceeding $5,000.

                      WHERE TO GET MORE INFORMATION

    Your plan, [EIN-PN], is sponsored by [CONTRIBUTING SPONSOR(S)]. If 
you would like more information about the funding of your plan, contact 
[INSERT NAME, TITLE, BUSINESS ADDRESS AND PHONE NUMBER OF INDIVIDUAL OR 
ENTITY].
    For more information about the PBGC and the benefits it guarantees, 
you may request

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a free copy of ``Your Guaranteed Pension'' by writing to Consumer 
Information Center, Dept. YGP, Pueblo, Colorado 81009.
    [THE FOLLOWING SENTENCE MAY BE INCLUDED:] ``Your Guaranteed 
Pension'' is also available from the PBGC Homepage on the World Wide Web 
at http://www.pbgc.gov.
    Issued: [INSERT AT LEAST MONTH AND YEAR]

[61 FR 34026, July 1, 1996, as amended at 63 FR 38306, July 16, 1998; 65 
FR 75165, Dec. 1, 2000]

      Appendix B to Part 4011--Table of Maximum Guaranteed Benefits

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                             The maximum guaranteed benefit for an individual starting to receive benefits at the age
                                                                           listed below is the amount (monthly or annual) listed below:
                                                         -----------------------------------------------------------------------------------------------
                If a plan terminates in--                         Age 65                  Age 62                  Age 60                  Age 55
                                                         -----------------------------------------------------------------------------------------------
                                                            Monthly     Annual      Monthly     Annual      Monthly     Annual      Monthly     Annual
--------------------------------------------------------------------------------------------------------------------------------------------------------
1995....................................................   $2,573.86  $30,886.32   $2,033.35  $24,400.20   $1,673.01  $20,076.12   $1,158.24  $13,898.88
1996....................................................   $2,642.05  $31,704.60   $2,087.22  $25,046.64   $1,717.33  $20,607.96   $1,188.92  $14,267.04
1997....................................................   $2,761.36  $33,136.32   $2,181.47  $26,177.64   $1,794.88  $21,538.56   $1,242.61  $14,911.32
1998....................................................   $2,880.68  $34,568.16   $2,275.74  $27,308.88   $1,872.44  $22,469.28   $1,296.31  $15,555.72
1999....................................................   $3,051.14  $36,613.68   $2,410.40  $28,924.80   $1,983.24  $23,798.88   $1,373.01  $16,476.12
2000....................................................   $3,221.59  $38,659.08   $2,545.06  $30,540.72   $2,094.03  $25,128.36   $1,449.72  $17,396.64
2001....................................................   $3,392.05  $40,704.60   $2,679.72  $32,156.64   $2,204.83  $26,457.96   $1,526.42  $18,317.04
2002....................................................   $3,579.55  $42,954.60   $2,827.84  $33,934.08   $2,326.71  $27,920.52   $1,610.80  $19,329.60
2003....................................................   $3,664.77  $43,977.24   $2,895.17  $34,742.04   $2,382.10  $28,585.20   $1,649.15  $19,789.80
2004....................................................   $3,698.86  $44,386.32   $2,922.10  $35,065.20   $2,404.26  $28,851.12   $1,664.49  $19,973.88
2005....................................................   $3,801.14  $45,613.68   $3,002.90  $36,034.80   $2,470.74  $29,648.88   $1,710.51  $20,526.12
--------------------------------------------------------------------------------------------------------------------------------------------------------

    The maximum guaranteed benefit for an individual starting to receive 
benefits at ages other than those listed above can be determined by 
applying the PBGC's regulation on computation of maximum guaranteeable 
benefits (29 CFR 4022.22).

[61 FR 34026, July 1, 1996, as amended at 61 FR 65474, Dec. 13, 1996; 62 
FR 65608, Dec. 15, 1997; 63 FR 63179, Nov. 12, 1998; 64 FR 67164, Dec. 
1, 1999; 65 FR 75165, Dec. 1, 2000; 66 FR 59693, Nov. 30, 2001; 67 FR 
71471, Dec. 2, 2002; 68 FR 67033, Dec. 1, 2003; 69 FR 69821, Dec. 1, 
2004]

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