explanation and election of form of benefit

SOUTHERN CALIFORNIA PIPE TRADES RETIREMENT FUND
501 Shatto Place, 5th Floor . Los Angeles, CA 90020 . (800) 595-7473 . (213) 385-6161 . Fax: (213)383 – 6801. www.scptac.org
EXPLANATION AND ELECTION OF FORM OF BENEFIT
EXPLANATION OF BENEFIT
The amount of your monthly pension benefit will vary depending on the form of payment you select. The amounts
provided below are based on the information in your Basic Pension Application, including your age and your martial status,
and the age of your spouse or joint-annuitant, if any. This notice provides an estimate, not a guarantee, of your monthly
benefit under each of the Plan’s payment options. For more information about selecting your form of payment, including
eligibility provisions, consent requirements and the reduction factors used to calculate your benefit, see the “Description of
Types of Pension Benefits and Forms of Payment” section below.
NORMAL FORMS OF PAYMENT
Under the Husband 50% Husband and Wife Pension, you will receive a benefit of $______
<$$$> per month for life and at your
death your spouse will receive 50% of your monthly benefit equal to $______
<$$$> per month for her lifetime. This is the
automatic form of payment for married participants unless it is rejected by the participant and spouse.
Under the Single Life Annuity with 60-Certain Payments, you will receive $______
<$$$> per month for life with a guarantee that
at least 60 monthly payments will be made. If you should die before you receive at least 60 monthly payments, payments
will continue to your designated beneficiary until 60 total monthly payments have been made. This is the automatic form of
payment for participants who are not married unless it is rejected by the participant. It is an optional form of payment for
married participants.
JOINT AND SURVIVOR OPTIONS
The following joint and survivor options are available to both married and single participants. If you are married, the
amounts listed below are those with your spouse as the joint annuitant unless you named someone else as a possible joint
annuitant on your Basic Pension Application. If you are single, no amounts are listed below unless you gave the named a
possible joint annuitant on your Basic Pension Application.
The amounts listed below treat ________________________
<Joint Annuitant Name> as the joint annuitant with a date of birth of ______________.
<Date of Birth>
Under the 100% Joint and Survivor Option, you will receive $______
<$$$> per month for life and at your death your joint
annuitant will receive 100% of your monthly benefit equal to $______
<$$$> per month for his or her lifetime.
Under the 66 ⅔% Joint and Survivor Option, you will receive $______
<$$$> per month for life and at your death your joint
annuitant will receive 662/3% of your monthly benefit equal to $______
<$$$> per month for his or her lifetime.
<$$$> per month for life and at your death your joint
Under the 50% Joint and Survivor Option, you will receive $______
annuitant will receive 50% of your monthly benefit equal to $______
<$$$> per month for his or her lifetime.
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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Description of Forms of Benefit Payment
Normal Forms of Payment
If You are Not Married
Benefits will automatically be paid to you as a Single Life Annuity with 60 Certain Payments unless you elect
otherwise. Under this form of payment, you will receive a monthly payment for the rest of your life with a
guarantee that at least 60 monthly payments will be made. If you should die before you receive at least 60 monthly
payments, payments will continue to your designated beneficiary until 60 total monthly payments have been made.
If You are Married
Benefits will automatically be paid to you in the form of a 50% Husband-and-Wife Pension unless you and your
spouse elect otherwise. This form of payment provides a reduced monthly payment for your life with 50% of that
amount continuing to your surviving spouse if you should die before your spouse. If your spouse dies before you,
your benefit will increase (“pop-up”) to the unreduced monthly benefit you would have received under the Single
Life Annuity.
The reduction is based on the Single Life Annuity that would otherwise be payable to you, and adjusted to account
for the fact that the payment of the pension will be made over two lifetimes. This reduction is taken by adjusting
the amount you are paid as follows:
•
Determine the amount that would be payable to you under the Single Life Annuity,
•
If the benefit is to be paid as other than a Disability Pension, multiply the amount payable as a Single Life
Annuity by 90% plus .4 percentage points for each full year your spouse is older than you or minus .4
percentage points for each full year your spouse is younger than you. If the benefit is payable as a
Disability Pension, multiply the amount payable as a Single Life Annuty by 82% plus .4 percentage points
for each full year your spouse is older than you or minus .4 percentage points for each full year your
spouse is younger than you.
•
You may not receive more than 100% of the Single Life Annuity that otherwise would have been payable
under the above formula.
For the 50% survivor benefit to be payable, you and your spouse must have been married throughout the year
ending on your Pension Effective Date or the date of your death.
If You are Divorced and Your Benefit is Subject to a Qualified Domestic Relations Order
If the Qualified Domestic Relations Order permissibly specifies a form of payment for your benefit, your benefit
will be paid in the form set forth in the order.
Optional Forms of Payment
You may waive the normal form of payment, and elect an optional form. If you are married, you have the option
of electing the Single Life Annuity with 60 Certain Payments. Whether you are married or not, you may elect the
either a 50%, 66 ⅔%, or 100% Joint and Survivor Option. If you are married, spousal consent is required to elect
any optional form.
The Joint and Survivor Options provide a reduce monthly retirement benefit for the life of the Participant with
50%, 66 ⅔%, or 100% of that amount payable to the beneficiary for his or her lifetime upon the death of the
Participant. The beneficiary is called a joint annuitant and he or she may be almost any person that you choose,
including your spouse. If you name a joint annuitant who is not your spouse, you may not elect the 100% Joint
and Survivor Option if the non-spouse joint annuitant is more than 10 years younger than you, and you may not
elect the 66 ⅔% Joint and Survivor Option if the non-spouse joint annuitant is more than 24 years younger than
you. You may not have more than one joint annuitant, and you may not change your joint annuitant once your
payments start.
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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100% Joint and Survivor Option
If you, and your spouse (if applicable), have properly rejected the Normal Form of Payment, you may elect this
optional form, which pays a reduced monthly pension during your lifetime. Upon your death, your spouse or other
joint annuitant will receive 100% of the monthly pension amount that you received. If your spouse or other joint
annuitant dies before you, your benefit will increase (“pop-up”) to the unreduced monthly benefit you would have
received under the Single Life Pension. In order to receive this benefit increase, you must file a copy of the joint
annuitant’s death certificate with the Plan Administrator within the period described in Plan sec. 7.01(e).
The amount you are paid is adjusted as follows for payments of pensions other than a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Single Life Pension by 81.7% plus .7 percentage points for each full year
your spouse or joint annuitant is older than you or minus .4 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
The amount you are paid is adjusted as follows for payments of a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Single Life Pension by 67% plus .5 percentage points for each full year
your spouse or joint annuitant is older than you or minus .5 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
66 ⅔% Joint and Survivor Option
If you, and your spouse (if applicable), have properly rejected the Normal Form of Payment, you may elect this
optional form, which pays a reduced monthly pension during your lifetime. Upon your death, your spouse or other
joint annuitant will receive 66 2/3% of the monthly pension amount that you received. If your spouse or other joint
annuitant dies before you, your benefit will increase (“pop-up”) to the unreduced monthly benefit you would have
received under the Single Life Pension.
The amount you are paid is adjusted as follows for payments of pensions other than a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Straight Life Pension by 87% plus .5 percentage points for each full year
your spouse or joint annuitant is older than you or minus .5 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
The amount you are paid is adjusted as follows for payments of a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Single Life Pension by 77% plus .5 percentage points for each full year
your spouse or joint annuitant is older than you or minus .5 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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50% Joint and Survivor Option
If you, and your spouse (if applicable), have properly rejected the Normal Form of Payment, you may elect this
optional form, which pays a reduced monthly pension during your lifetime. Upon your death, your spouse or other
joint annuitant will receive 50% of the monthly pension amount that you received. If your spouse or other joint
annuitant dies before you, your benefit will increase (“pop-up”) to the unreduced monthly benefit you would have
received under the Single Life Pension.
The amount you are paid is adjusted as follows for payments of pensions other than a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Single Life Pension by 90% plus .4 percentage points for each full year
your spouse or joint annuitant is older than you or minus .4 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
The amount you are paid is adjusted as follows for payments of a Disability Pension:
•
Determine the amount that would be payable to you under the Single Life Pension,
•
Multiply the amount payable as a Single Life Pension by 82% plus .4 percentage points for each full year
your spouse or joint annuitant is older than you or minus .4 percentage points for each full year your
spouse or joint annuitant is younger than you.
•
You may not receive more than 100% of the Single Life Pension that otherwise would have been payable
under the above formula.
COMPARISON OF THE RELATIVE VALUE OF THE NORMAL FORMS OF PAYMENT WITH THE
OPTIONAL FORMS OF PAYMENT
By federal law, the Fund is also required to give you the following additional information about the relative value of each of
the forms of payment discussed above. “Relative value” means the actuarial present value of each optional form of payment
relative to the actuarial present value of the 50% Husband and Wife Pension for married participants and the Single Life
Annuity with 60 Certain Payments for unmarried participants. The Plan’s actuary has determined that the relative values of
all of the Plan’s optional forms of benefit payment are approximately the same as the 50% Husband and Wife Pension and
the Single Life Annuity with 60 Certain Payments.
These values were calculated, for comparison purposes, using a 7.0% interest rate and assuming that, on average,
participants would live as long as predicted under the mortality table. The actual value of payments made under an annuity
optional form will ultimately depend upon actual longevity. Upon your request, the Fund office will provide you with a
more precise relative value calculation based on your specific information.
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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ELECTION OF FORM OF BENEFIT
PATICIPANT’S ELECTION
I have reviewed the information provided by the Fund office about the various forms of benefit payment. I hereby
elect to receive my pension benefit in the following form (check one):
1. ____ 50% Husband and Wife Pension (normal form for married participants)
2. ____ Single Life Annuity with 60 Certain Payments (normal form for participants who are not married)
3. ____ 100% Joint and Survivor Option
4. ____ 66 ⅔% Joint and Survivor Option
5. ____ 50% Joint and Survivor Option
If you are electing the 100%, 66 ⅔%, or 50% Joint and Survivor Options, and if your joint annuitant is someone
other than your spouse, insert the name and date of birth of the joint annuitant:_____________________________.
PATICIPANT’S STATEMENT
I am applying for a pension from the Southern California Pipe Trades Retirement Fund, and I consent to payment in
the form I have elected above. I have read the Explanation of the Normal and Optional Forms of Benefit Payment
supplied to me with this election form. I understand that if I am married and I have elected a benefit form other
than the 50% Husband and Wife Pension, it means that no benefits will be paid to my spouse under the Plan after
my death, unless benefits are payable under other provisions of the Plan. I understand that I have at least 30 days
after the receipt of the Explanation and this Election Form to consider whether to consent to the payment of my
pension and to consider whether to waive the 50% Husband and Wife Pension.
I understand that I may change my election of a benefit form at any time before the effective date of my pension. I
also understand that my election of a benefit form may not be changed after my payments start, although I do have
at least eight days from my receipt of this application to make such a change.
I declare that (check one of the following):
_____ I am not married.
_____ The person co-signing this document is my current legal spouse.
____ I am unable to locate my spouse (complete and submit the enclosed “Unable to Locate Spouse Affidavit”).
_____________________________________________________
Participant’s Signature
________________
Date
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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SPOUSE’S STATEMENT
If you are married and you have not elected the 50% Husband and Wife Pension, your spouse must
complete the section below.
I,________________________________, state that I am the legal spouse of ______________________________.
I understand that the Southern California Pipe Trades Retirement Fund may not pay the retirement benefits of
married participants in a form other than a 50% Husband and Wife Pension without the consent of the spouse. I
have reviewed and consent to my spouse’s election of a benefit form other than the 50% Husband and Wife
Pension. I have reviewed the Explanation of the Normal and Optional Forms of Benefit Payment and the effect of
waiving the 50% Husband and Wife Pension. 0
I understand that as a result of my spouse’s payment selection, the Retirement Fund will not pay a pension to me
after my spouse’s death, unless my spouse has selected a form of payment that pays survivor benefits for which I
am the designated beneficiary at the time of my spouse’s death, or my spouse has selected a joint and survivor
option with me as the joint annuitant. I further recognize that because of this rejection, the pension paid to my
spouse while he or she is living may be higher than it would be if I had the protection of the 50% Husband and
Wife Pension.
I have reviewed my spouse’s designation of a beneficiary or beneficiaries made with this election. I consent to my
spouse’s designation of a beneficiary or beneficiaries, recognizing that in making such designation, my spouse and
I have waived my right to the survivor benefits under the 50% Husband and Wife Pension and any optional forms
of payment under the Plan, unless I am the primary designated beneficiary. I understand that such designation
cannot be changed or revoked without my consent.
_____________________________________________________
Spouse’s Signature
________________
Date
Notary Certification
State of _____________________________
County of ____________________________
On the _____day of ____________20_____, before me came, ________________________________,
Print spouse’s name (not participant)
personally known to me, or proved to me on the basis of satisfactory evidence, to be the person
described herein and who executed the foregoing Spouse’s Statement, and (s)he duly acknowledged to
me that (s)he executed the same.
X
Place Notary Seal Above
Signature of Notary Public
My commission expires on _____________________
Southern California Pipe Trades Retirement Fund Pension Application – Step 2(3): Explanation and Election of Form of Benefit
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