[Code of Federal Regulations] [Title 29, Volume 9] [Revised as of July 1, 2006] From the U.S. Government Printing Office via GPO Access [CITE: 29CFR2520.103-5] [Page 428-431] TITLE 29--LABOR CHAPTER XXV--EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR PART 2520_RULES AND REGULATIONS FOR REPORTING AND DISCLOSURE--Table of Contents Subpart C_Annual Report Requirements Sec. 2520.103-5 Transmittal and certification of information to plan administrator for annual reporting purposes. (a) General. In accordance with section 103(a)(2) of the Act, an insurance carrier or other organization which provides benefits under the plan or [[Page 429]] holds plan assets, a bank or similar institution which holds plan assets, or a plan sponsor shall transmit and certifty such information as needed by the administrator to file the annual report under section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6: (1) Within 9 months after the close of the plan year which begins in 1975 or September 30, 1976, whichever is later, and (2) Within 120 days after the close of any plan year which begins after December 31, 1975. (b) Application. This requirement applies with respect to-- (1) An insurance carrier or other organization which: (i) Provides from its general asset account funds for the payment of benefits under a plan, or (ii) Holds assets of a plan in a separate account; (2) A bank, trust company, or similar institution which holds assets of a plan in a common or collective trust, separate trust, or custodial account; and (3) A plan sponsor as defined in section 3(16)(B) of the Act. (c) Contents. The information required to be provided to the administrator shall include-- (1) In the case of an insurance carrier or other organization which: (i) Provides funds from its general asset account for the payment of benefits under a plan, upon request of the plan administrator, such information as is contained within the ordinary business records of the insurance carrier or other organization and is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6; (ii) Holds assets of a plan in a pooled separate account and files a Form 5500 report pursuant to Sec. 2520.103-9 for the participating plan's plan year-- (A) A copy of the annual statement of assets and liabilities of the separate account for the fiscal year of such account ending with or within the plan year for which the participating plan's annual report is made, (B) A statement of the value of the plan's units of participation in the separate account, (C) The Employer Identification Number (EIN) of the separate account, entity number required for purposes of completing the Form 5500 and any other identifying number assigned by the insurance carrier to the separate account, (D) A statement that a filing pursuant to Sec. 2520.103-9(c) will be made for the separate account (for its fiscal year ending with or within the participating plan's plan year) on or before the filing due date for such account in accordance with the Form 5500 instructions, and (E) Upon request of the plan administrator, any other information that can be obtained from the ordinary business records of the insurance carrier and that is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6; (iii) Holds assets of a plan in a pooled separate account and does not file a Form 5500 report pursuant to Sec. 2520.103-9 for the participating plan's plan year-- (A) A copy of the annual statement of assets and liabilities of the separate account for the fiscal year of such account that ends with or within the plan year for which the participating plan's annual report is made, (B) A statement of the value of the plan's units of participation in the separate account, (C) The EIN of the separate account and any other identifying number assigned by the insurance carrier to the separate account, (D) A statement that a filing pursuant to Sec. 2520.103-9(c) will not be made for the separate account for its fiscal year ending with or within the participating plan's plan year, and (E) Upon request of the plan administrator, any other information that can be obtained from the ordinary business records of the insurance carrier and that is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6. (iv) Holds assets of a plan in a separate account which is not exempted from certain reporting requirements under Sec. 2520.103-4, a listing of all transactions of the separate account and, [[Page 430]] upon request of the plan administrator, such information as is contained within the ordinary business records of the insurance carrier and is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6. (2) In the case of a bank, trust company, or similar institution holding assets of a plan-- (i) In a common or collective trust that files a Form 5500 report pursuant to Sec. 2520.103-9 for the participating plan's plan year-- (A) A copy of the annual statement of assets and liabilities of the common or collective trust for the fiscal year of such trust ending with or within the plan year for which the participating plan's annual report is made, (B) A statement of the value of the plan's units of participation in the common or collective trust, (C) The EIN of the common or collective trust, entity number assigned for purposes of completing the Form 5500 and any other identifying number assigned by the bank, trust company, or similar institution, (D) A statement that a filing pursuant to Sec. 2520.103-9(c) will be made for the common or collective trust (for its fiscal year ending with or within the participating plan's plan year) on or before the filing due date for such trust in accordance with the Form 5500 instructions, and (E) Upon request of the plan administrator, any other information that can be obtained from the ordinary business records of the bank, trust company or similar institution and that is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. Sec. 2520.104a-5 or 2520.104a-6. (ii) In a common or collective trust that does not file a Form 5500 report pursuant to Sec. 2520.103-9 for the participating plan's plan year-- (A) A copy of the annual statement of assets and liabilities of the common or collective trust for the fiscal year of such account that ends with or within the plan year for which the participating plan's annual report is made, (B) A statement of the value of the plan's units of participation in the common or collective trust, (C) The EIN of the common or collective trust and any other identifying number assigned by the bank, trust company or similar institution, (D) A statement that a filing pursuant to Sec. 2520.103-9(c) will not be made for the common or collective trust for its fiscal year ending with or within the participating plan's plan year, and (E) Upon request of the plan administrator, any other information that can be obtained from the ordinary business records of the bank, trust company or similar institution and that is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. Sec. 2520.104a-5 or 2520.104a-6. (iii) In a trust which is not exempted from certain reporting requirements under Sec. 2520.103-3, a listing of all transactions of the separate trust and, upon request of the plan administrator, such information as is contained within the ordinary business records of the bank, trust company, or similar institution and is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5. (iv) In a custodial account, upon request of the plan administrator, such information as is contained within the ordinary business records of the bank, trust company, or similar institution and is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6. (3) In the case of a plan sponsor, a listing of all transactions directly or indirectly involving plan assets engaged in by the plan sponsor and such information as is needed by the plan administrator to comply with the requirements of section 104(a)(1) of the Act and Sec. 2520.104a-5 or Sec. 2520.104a-6. (d) Certification. (1) An insurance carrier or other organization, a bank, trust company, or similar institution, or plan sponsor, as described in paragraph (b) of this section, shall certify to the accuracy and completeness of the information described in paragraph (c) of this section by a written declaration which is signed by a person authorized to represent the insurance carrier, bank, or plan sponsor. Such [[Page 431]] certification will serve as a written assurance of the truth of the facts stated therein. (2) Example of Certification. The XYZ Bank (Insurance Carrier) hereby certifies that the foregoing statement furnished pursuant to 29 CFR 2520.103-5(c) is complete and accurate. [43 FR 10140, Mar. 10, 1978, as amended at 65 FR 21082, Apr. 19, 2000]