(Draft) OSFI 48DB - Application for Registration of a Defined Benefit Pension Plan

Size: px

Start display at page:

Download "(Draft) OSFI 48DB - Application for Registration of a Defined Benefit Pension Plan"

Stephen Harrison
6 years ago
Views:

1 UNCLASSIFIED (Draft) OSFI 48DB - Application for Registration of a Defined Benefit Pension Plan (Please refer to the Instruction Guide for the Application for Registration of a Defined Benefit Pension Plan while completing this form.) PART I Line 001 Official Name of Pension Plan (the Pension Plan): 002 Type of Pension Plan: Defined Benefit (DB) Combination: DB and Defined Contribution (DC) 003 Is the Pension Plan a designated plan under the Income Tax Act? Yes No If Yes, is the plan solely for connected persons as defined in the Income Tax Act? Yes No 004 Effective Date of Pension Plan: Year Month Day 005 Pension Plan Year End: Month Day 006 Number of Participating Employers a) Single Employer pension plan Name of Employer b) Multi-employer pension plan AND Negotiated Contribution Plan c) More than one participating employer but not a multi-employer pension plan If b) or c), please list or attach a list of all participating employers. If (c) please indicate the principal employer. 007 Name of Plan Administrator Plan Administrator (If the administrator is a corporation, pension committee or board, use the name of the corporation, committee or board) Primary Plan contact (The primary plan contact is, for example, the Chair of the pension committee or board. The contact person here is not the same as the 3 rd party administrator) Address City Province/State/Country Postal Code Telephone 008 Indicate whether the Plan Administrator is: Employer(s) Board of Trustees Pension Committee or similar body If administered by a Board of Trustees/Pension Committee please list or attach a list of names and contact numbers. OSFI 48 (March 2012) 1/8

2 Third Party Administrator (if applicable) Name of contact Name of company Address City Province/State/Country Postal Code Telephone 010 How is the pension fund deposited? (check all that apply) Insurance company contract - Fully guaranteed Insurance company contract - Not fully guaranteed Pension Fund Society Single Trust Company - pooled funds Single Trust Company outside pooled funds Trust Agreement (please provide names and addresses of Trustees) Other provide details 011 Name of Pension Fund Custodian (if more than one, please attach a list with the following information) Company Address Policy/Account # Contact Telephone : 012 Does the Pension Plan (for which this Application is being filed) result from a division/spin-off/termination of another plan? Yes No If Yes, please provide the following regarding the other plan : Jurisdiction Province Pension Plan Name OSFI/Provincial Registration Number and Canada Revenue Agency Registration Number Will the other plan be terminated? Yes No Will assets be transferred to this new plan? Yes No OSFI 48 (March 2012) 2/8

3 013 Has the Pension Plan received a Registration Number from the Canada Revenue Agency? Yes No If yes, CRA Registration Number: 014 Is the Pension Plan established pursuant to a collective agreement? Yes No If Yes, please attach a copy of the relevant sections of the collective agreement. Is the Pension Plan contribution level set by the collective agreement? Yes No Expiration Date of current Collective Agreement Collective bargaining agent/union(s) representing the pension plan members 015 Information to Members Have all eligible employees, members and their spouses received a copy of the written explanation of the terms and conditions of the Pension Plan and of their rights and duties thereunder? Yes No If No, please explain 016 Indicate the sections of the Plan text that provide for the use of surplus during the continuation of the Plan and on its termination. 017 Nature of Business - Included Employment Describe the main activity or activities of the Pension Plan sponsor: Indicate the appropriate category on the chart below (select only one): Navigation and Shipping Harbour Operations Rail Transportation Air Transportation Road Transportation Radio and/or Television Telephone and Other Communication First Nations 1 Funding Agency created through Band or Treaty created as separate entity/incorporation Chartered Bank Flour, Feed or Seed Mill Atomic Energy Uranium Mining N.W.T., Nunavut and/or Yukon Interprovincial Pipelines International Bridge Other please describe 018 Type of Organization Trade or Employee Association Crown Corporation Agent Incorporated Company: privately held publicly traded Sole Proprietorship or Partnership Co-operative or Non-Profit Other please describe 1 This does not include private enterprises such as a manufacturing facility. OSFI 48 (March 2012) 3/8

4 019 Pension Plan Membership - as of the effective date of the Pension Plan. Location of Employment Male 001 Female 002 Included Employment 003 Newfoundland Prince Edward Island. Nova Scotia New Brunswick.. Quebec... Ontario... Manitoba Saskatchewan. Alberta British Columbia. Yukon Territory.. Northwest Territories.. Nunavut.. Outside Canada.. Total Male/Female/Included Employment... Total Membership (sum of cols. 001 and 002) Other Beneficiaries Grand Total PART II: INFORMATION CONCERNING PENSION PLAN PROVISIONS 001 Eligibility Class(es) of Employees (multiple entries acceptable, except if All employees has been checked) All employees Salaried Hourly Union Non-union Supervisory Executives (including significant shareholders) Other (describe) 002 Eligibility for membership - new employees Compulsory membership Voluntary membership Closed to new members Other (describe) 003 Type of Plan (Pension Formula for current service): Check only one Final average earning over last years Average best earnings for best years Average best earnings for the best year over the last years Career average earnings specify the year earnings base was last updated Earnings indexed Yes No Flat benefit Profit sharing Hybrid better of defined benefit/defined contribution Composite/combination (for same period of membership) OSFI 48 (March 2012) 4/8

5 Defined benefit/defined contribution (for different periods of membership or different groups of members) Other (describe) Is past service different from current service? No Yes, if yes, describe 004 Employee Contribution rate current service No contributions required % of earnings (not integrated) % of earnings less the required CPP/QPP contributions % of earnings up to YMPE or on which contributions to CPP/QPP are required and % on balance of earnings $. per year cents per hour. Up to 18% of earnings (together with employer contributions), as described by the Income Tax Act. Variable (describe) Other (describe) 005 Employee additional voluntary contributions Yes No 006 Employer contribution rate current service Balance of cost (i.e. defined benefit plan other than modified defined benefit) As specified in a collective agreement (use only for NCDB or MEPP plans, if specific rate is not known) % of earnings (not integrated). % of earning less the required CPP/QPP contributions. % of earnings up to YMPE or on which contributions to CPP/QPP are required and. % on balance of earnings $ per year cents per hour Based on employer profits with minimum of. % of employee s earnings Up to 18% of earnings (together with employee contributions, if any) as prescribed by the Income Tax Act Variable (describe) Other (describe) 007 Current service benefits. % of earnings for each year of service (not integrated). %of earning for each year of service less all or part of CPP/QPP pension. % of earning up to YMPE or on which contributions to CPP/QPP are required and. % on balance of earnings for each year of service $. per month for each year of service $. per month for every hours worked Combination of benefit formulae Variable (describe) Other (describe) 008 Bridging supplement on retirement before age 65 or Pensionable age Yes No Full CPP/OAS (Enter age and service requirement below) Partial CPP/OAS (Enter service requirement and age and service below) Flat Dollar Amount (Enter age and service requirement below) $Amount multiplied by service (Enter amount, age and service requirement below) Bridge Benefit from Plan, actuarially reduced Other (describe) OSFI 48 (March 2012) 5/8

6 009 Disability benefits provided Yes No 010 Normal Retirement (no reduction in pension - based on age). If age is different for different classes of employees, please specify the class and the age. All employees- age Other classes age (specify classes) 011 Pensionable Age/Special Retirement (no reduction in pension based on meeting certain conditions). If the conditions are different for different classes of employees, please specify for which classes. All employees Certain classes (describe) Check all the conditions that apply: Not applicable no special retirement Employer Consent Age (specify) Years of service/membership (specify) Age plus service/membership equals (specify) Age plus points (specify) Other (describe) If more than one of the above is indicated, which conditions must apply: All Either 012 Does the pension plan provide for automatic (contractual) increases to pensions in pay, or deferred pensions (e.g., indexation to Consumer Price Index)? No automatic adjustment provided for in plan Yes (deferred only) Yes (pensions in pay only) Yes (both) If Yes complete below: Based on full consumer price index (CPI) Based on partial CPI Enter % Enter Max % Based on excess interest earnings Percentage increase, % (not based on CPI) Flat dollar annual increase Other (describe) 013 Does the Plan provide for consent benefits? Yes No If yes, check all the conditions that apply Unreduced retirement Age based on age (Enter age) Unreduced retirement Age based on years of service (Enter service) Unreduced retirement Age based on age and service (Enter age and service) Unreduced retirement Age based on age and points (Enter age and points) Unreduced retirement Age based on points (Enter points) Unreduced retirement Age based on Service + Points (Enter service and points) Early Retirement Disability Bridging Supplementary Pension Other (describe) 014 Early Retirement reduced pension payable before Normal Retirement and before Pensionable Age/Special Retirement. Age (specify) OSFI 48 (March 2012) 6/8

7 Years of service/membership (specify) Age plus service/membership equals(specify) Age plus points (specify) Other (describe) 015 Death benefits Pre-retirement 100% of pension benefit credit Other (describe) 016 Normal form of pension for member without spouse or common-law partner Life annuity Pension guaranteed for months Other (describe) 017 Normal form of pension for member with spouse or common-low partner Joint and survivor pension at % of retiree s pension. Is the joint and survivor form of pension actuarially adjusted? Yes No, Other (describe) 018 Miscellaneous Provisions (check all that apply) Plan text reference(s): Flexible Benefits (describe) Other ancillary benefits (describe) Priority Provisions on Plan Termination (describe) 019 Postponed Retirement Yes No 020 Pension benefit limited to Revenue Canada maximum? Yes No PART III 001 Required Documents Attached Pension Plan Text or By-laws Employee Booklet Insurance Contract / Trust Agreement (Individual Trustees or Corporate Trustee) or other custodial instrument Amendments, if any, to any of the accompanying documents Relevant Sections of Collective Agreement (if Pension Plan established pursuant to a collective agreement) Initial Actuarial Report and Actuarial Information Summary (OSFI form T1200) Reciprocal Transfer Agreement (if applicable) If certain documents are not attached, please provide an explanation and timeline for submitting the missing documentation 002 Assessment Assessment enclosed OSFI 48 (March 2012) 7/8

8 PART IV DECLARATION OF COMPLIANCE I,, DECLARE THAT, to the best of my knowledge, the following is true and correct: 1. I am a duly authorized signing officer of the employer or a member of a board of trustees or similar body or pension committee that is the administrator of the (Official name of Pension Plan ) hereinafter referred to as the Plan ; and I hereby apply for registration for the Plan under the Pension Benefits Standards Act, The Plan, including all documents that create or support the Plan or the pension fund, complies with the Pension Benefits Standards Act, 1985, and the Regulations thereto. If the Plan includes members who are not employed in included employment and their benefits are subject to provincial pension legislation, the benefits of those members under the terms of the Plan, including all documents that create or support the Plan or the pension fund, complies with the provisions of the pension legislation of those other jurisdictions; and 3. A Statement of Investment Policies and Procedures was established for the Plan and adopted on and this Statement of Investment Policies and Procedures complies with the requirements of the Pension Benefits Standards Act, 1985, and the Regulations thereto. Signed this day of, 20, in the City of in the Province/State of Authorized officer of Plan Administrator (USE BLOCK LETTERS) Signature Title or Position Would you prefer future correspondence in: English French OSFI 48 (March 2012) 8/8

SPECIMEN Application for Registration of a Pension Plan (Application)

SPECIMEN Application for Registration of a Pension Plan (Application) (Application) All Applications must be submitted to FCAA via the Registration and Licensing System (RLS) The fields found throughout this SPECIMEN Application identify data that you will need to know prior