PlanPremier Fee Payment Authorization

Transcription

1 Use this form to authorize or modify payments from plan assets to American Funds, your Third-Party Administrator (TPA) or another third party. This form can also be used to discontinue ongoing payments. To request or discontinue payments to your plan s financial professional, please submit the PlanPremier Financial Professional Fee Payment Authorization form. 1 Plan information Please type or print clearly. Plan name Plan ID Date 2 Payment request type Complete A or B. Please complete a separate form for each payment request. A. Establish fee payment Select one payment type below: Fees invoiced by American Funds Complete Sections or 5 and 7 Third-Party Administrator (TPA) Firm Complete Sections, 4 or 5 and 7 Other plan payment Complete Sections, 4 or 5, 6 and 7 B. Discontinue ongoing fee payment(s) - Select the option(s) below to discontinue a previously established ongoing fee payment. This form must be received prior to the 20 th day of the last month of the calendar quarter for payment to be stopped that quarter. Indicate ongoing payments to discontinue: Fees invoiced by American Funds TPA ongoing fees Other ongoing fees: 1

2 Payments from participant accounts To request a new payment or modify an existing ongoing payment from participant accounts, complete A, B or C. Note: Based on fee disclosure regulations, you are generally required to provide plan participants 0-90 days advance notice prior to initiating and/or modifying fee payments from participant accounts. As a result, this change may require that notice be provided to participants. If you would like American Funds to furnish a participant change notice and update the plan s fee disclosure document, submit the PlanPremier Fee Disclosure Customization Request form. A. Automatic payment of fees invoiced by American Funds. Fees will be systematically recovered from participant accounts on an ongoing calendar quarter basis. To setup your plan for automatic quarterly payments of the American Funds invoice, choose one of the following funding methods (1 or 2): 1. Flat dollar amount per plan (assessed pro rata). Amount specified will be divided proportionally among the participants in the plan on the day of payment based on their average daily balance during the calendar quarter. 2. Flat dollar amount per plan (assessed per capita). Amount specified will be divided equally among participants with a balance in the plan on the day the payment is calculated. If the amount exceeds a participant account balance, the recovery will be limited to the funds available in that account. For 1 or 2 above: Check here to debit forfeiture accounts first. Request will be prorated across all forfeiture money types that can be used to pay plan expenses. If there are insufficient funds in the forfeiture accounts, the remaining amounts will be taken from participant accounts. Note: If the amount requested exceeds available funds, we will process the recovery for the maximum amount available. Any outstanding balance will be carried forward onto your next invoice, and the subsequent automatic payment will be applied to this balance. Payment schedule: Select the calendar quarter you want the first payment to be effective. Check one calendar quarter end date below: Quarter ending /1 Quarter ending 6/0 Quarter ending 9/0 Quarter ending 12/1 2

3 Payments from participant accounts (continued) B. Ongoing payments Fees will be systematically recovered from participant accounts on an ongoing calendar quarter basis. Ongoing payments are sent out within 2 business days following the end of each calendar quarter. Ongoing payment requests are valid until American Funds receives a request to discontinue the payment. Ongoing payments to TPAs are sent out on the 9 th business day after quarter end in conjunction with the regularly scheduled monthly payment. Deduct payments from: All participant accounts OR Terminated participant accounts only* *The employer will pay the share of expenses attributable to active participants Fee amount: Indicate the fee amount that should be recovered annually from participant accounts, (Amounts will be converted into quarterly recoveries.) Select one option. 1. Basis points: (per year). Provide basis points in whole numbers (e.g., 50 basis points = 0.50% annually). The adjusted quarterly rate will be multiplied by the average daily balance for the calendar quarter of all participants on the recordkeeping system as of the payment date. 2. Flat dollar amount per plan (assessed pro rata): $ (per year). Amount specified will be divided proportionally among the participants in the plan on the day of the payment based on their average daily account balances during the calendar quarter. Check here to debit forfeiture accounts first. Request will be prorated across all forfeiture money types that can be used to pay plan expenses. If there are insufficient funds in the forfeiture accounts, the remaining amounts will be taken from participant accounts.. Flat dollar amount per plan (assessed per capita): $ (per year). Amount specified will be divided equally among participants with a balance in the plan on the day the payment is calculated. If the amount exceeds a participant account balance, the recovery will be limited to the funds available in that account. Check here to debit forfeiture accounts first. Request will be prorated across all forfeiture money types that can be used to pay plan expenses. If there are insufficient funds in the forfeiture accounts, the remaining amounts will be taken from participant accounts. 4. Flat dollar amount per participant: $ (per year). Amount specified will be taken from each participant with a balance in the plan on the day the payment is calculated. If the amount exceeds a participant account balance, the recovery will be limited to the funds available in that account. Payment schedule: Select the calendar quarter you want the first payment to be effective. Check one calendar quarter end date below: Quarter ending /1 Quarter ending 6/0 Quarter ending 9/0 Quarter ending 12/1 Note: Completed forms for ongoing payments must be submitted by the 15 th day of the last month in the calendar quarter.

4 Payments from participant accounts (continued) C. One-time payment Deduct payments from: All participant accounts OR Terminated participant accounts only* *The employer will pay the share of expenses attributable to active participants One-time payments are processed upon receipt of this form. TPA payment requests will be issued with the next scheduled monthly payment. All other payee requests will be issued within 11 business days. Indicate the amount and method of the requested payment. Select one option. Basis points:. Provide basis points in whole numbers (e.g., 50 basis points = 0.50%). The rate will be multiplied by the balance of each participant s account as of the date the payment is calculated. Flat dollar amount per plan (assessed pro rata): $. Amount specified will be divided proportionally among the participants in the plan based on their account balances on the day the payment is calculated. Flat dollar amount per plan (assessed per capita): $. Amount specified will be divided equally among participants with a balance in the plan on the day the payment is calculated. If the amount exceeds a participant s available account balance, the recovery will be limited to the funds available in that account. Flat dollar amount per participant: $. Amount specified will be taken from each participant with a balance in the plan on the day the payment is calculated. If the amount exceeds a participant s available account balance, the recovery will be limited to the funds available in that account. 4

5 4 Payments from plan recapture account for plans in R-2, R-2E, R- or R-4 share classes only This section should only be completed if the plan has previously established compensation recapture using the PlanPremier-TPA TPA Compensation Recapture Setup form. To request a new payment or to modify an existing ongoing payment, complete A or B. If the amount requested exceeds the available funds in the plan compensation recapture account (UPA4), the remaining amount will be taken from the plan net credit (UPA2) account. If the amount requested exceeds the available funds in UPA4 and UPA2 accounts, we will process the recovery for the maximum amount available. The amounts available for processing in the UPA4 and UPA2 accounts can be found on the Plan Service Center in the Plan Overview tab. A. Ongoing payments Fees will be paid from the plan compensation recapture account on a quarterly basis as indicated below. Ongoing payment requests are valid until American Funds receives instructions to discontinue the payment or if there is a change to the plan s TPA. Ongoing payments to TPAs are sent out on the 9 th business day after quarter end in conjunction with the regularly scheduled monthly payment. Fee amount: Indicate the fee amount that should be recovered annually from the plan compensation recapture account. (Amounts will be converted into quarterly recoveries.) Select one option. Dollar amount: $ (per year). OR Basis points: (per year). Provide basis points in whole numbers (e.g., 50 basis points = 0.50% annually). The adjusted quarterly rate will be multiplied by the average daily balance of each participant s account and all other plan level account balances on the American Funds recordkeeping system during the calendar quarter. Payment schedule: Select when the first ongoing payment should be sent. Check one:: Q1 Form must be received by /1 for May payment Q2 Form must be received by 6/0 for August payment Q Form must be received by 9/0 for November payment Q4 Form must be received by 12/1 for February payment B. One-time payment Indicate the method and amount of the requested payment. Select one option. Dollar amount: $ OR Basis points:. Provide basis points in whole numbers (e.g., 50 basis points = 0.50% annually). Basis points specified will be multiplied by the balance of each participant s account and all other plan level account balances on the American Funds recordkeeping system as of the date the payment is calculated. Note: One-time payments are processed upon receipt of this form. Payment is sent within 11 business days. 5

6 5 One-time payment from other plan-level account(s) To request a payment from plan-level accounts, complete A and B below. The amounts available for processing in the forfeiture accounts or other plan-level accounts can be found on the Plan Sponsor website. A. Specify the account type. Select one: Plan forfeiture account (Fees will be prorated across all available forfeiture money types that can be used to pay plan expenses.) Plan net credit account (UPA2) Other: Account type Money type to debit B. Specify the amount: Dollar amount: $ If the amount requested exceeds the available funds, we will process the payment for the maximum amount available. Note: One-time payments are processed upon receipt of this form. Payment is sent within 11 business days. 6 Payee information Firm/payee name* EIN or TIN: Company: Address: Payee City / State / Zip Note: If you are unsure if your firm has instructions on file, please contact the Service Center at (877) *An initial W-9 form must be completed and provided with this form for each EIN. To access a W-9 form, go to Payments to American Funds American Funds invoices are generated approximately 75 days after quarter end. Deadline for form submission Deadline to cancel / Debited from account(s) discontinue request** Automatic Payment Plan (quarterly) 15 th day of 2 nd month in calendar quarter* Last Day of 2 nd month in calendar quarter By the 15 th day following each calendar quarter Ongoing Payments (quarterly) 15 th day of last month in calendar quarter* 20 th day of last month in calendar quarter By the 15 th day following each calendar quarter One-Time Payments 20 th day of last month in calendar quarter* One business day following form submission Within seven business days following form submission *For example, requests received in good order by May 15 th will ensure automatic payment of your 1 st quarter invoice for the billing period ending March 1 st. **In order to cancel one-time payments or discontinue ongoing payments and automatic payments, an from an authorized signer must be submitted to your TPA Account Manager Team. 6

7 7 Plan Sponsor authorization As plan trustee or authorized signer of the plan, I certify that these payment instructions are in accordance with the terms of the plan and that the recordkeeper is entitled to rely on my authorization and is hereby indemnified from all liability arising from following the instructions provided in this form. All assets held in Employer Stock, Self-Directed Brokerage Accounts and any assets held outside of the recordkeeping system will be excluded from payment calculations. I understand that any ongoing payment instructions requested in this form shall remain in effect until I provide written instructions to modify or discontinue these payments or there is a change to the plan s TPA. If necessary, the plan s participant fee disclosure document will be updated and any required notice provided to participants. (See the PlanPremier Fee Disclosure Customization Request form.) Signature of Authorized Plan Sponsor or Plan Trustee Print name of authorized Plan Sponsor or Plan Trustee Date Daytime phone of primary plan contact address 8 Submission instructions If you have any questions about this form, call American Funds at (877) Please return this request to American Funds for processing by attaching this form to your service request in the Plan Management Portal. 7