SFA 206-A SFA Template 6A

Special Financial Assistance by PBGC

Template 6A v20220701p.xlsx

Application for Special Financial Assistance

OMB: 1212-0074

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Overview

Template 6A Instructions
6A-1 Reconciliation
6A-2 Recon Details
6A-3 Recon Details
6A-4 Recon Details
6A-5 Recon Details


Sheet 1: Template 6A Instructions

TEMPLATE 6A












v20220701p
Reconciliation - for non-MPRA plans using the "basic method", or for MPRA plans for which the requested amount of SFA is determined under the "increasing assets method"















File name: Template 6A Plan Name, where "Plan Name" is an abbreviated version of the plan name.
Instructions for Section C, Item (6) of the Instructions for Filing Requirements for Multiemployer Plans Applying for Special Financial Assistance:















This Template 6A is not required if all assumptions and methods used to determine the requested SFA amount are identical to those used in the most recent actuarial certification of plan status completed before 1/1/2021 ("pre-2021 certification of plan status"), except the non-SFA and SFA interest rates, and except any assumptions changed in accordance with Section III, Acceptable Assumption Changes, in PBGC's SFA assumptions guidance (other than the acceptable assumption change for “missing” terminated vested participants described in Section III.E of PBGC’s SFA assumptions guidance).

This Template 6A is also not required if the requested SFA amount from Template 4A is the same as the SFA amount shown in Template 5A (Baseline).















If the assumptions/methods used to determine the requested SFA amount differ from those in the "Baseline" projection in Template 5A, then provide a reconciliation of the change in the total amount of SFA due to each change in assumption/method from the Baseline to the requested SFA as shown in Template 4A.















For each assumption/method change from the Baseline through the requested SFA amount, provide a deterministic projection using the same calculation methodology used to determine the requested SFA amount, in the same format as Template 4A (either Sheet 4A-4 or Sheet 4A-5).















Additional instructions for each individual worksheet:




























Sheet













6A-1 Reconciliation - Summary for the "basic method", or for MPRA plans for which the requested amount of SFA is determined under the "increasing assets method"
For Item number 1, show the SFA amount determined in Template 5A using the "Baseline" assumptions and methods. If there is only one change in assumptions/methods between the Baseline (Template 5A) and the requested SFA amount (Template 4A), then show on Item number 2 the requested SFA amount, and briefly identify the change in assumptions from the Baseline.

If there is more than one change in assumptions/methods from the Baseline, show each individual change as a separate Item number. Each Item number should reflect all changes already measured in the prior Item number. For example, the difference between the SFA amount shown for Item number 4 and Item number 5 should be the incremental change due to changing the identified single assumption/method. The Item numbers should show assumption/method changes in the order that they were incrementally measured.















6A-2 Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method
For non-MPRA plans, see Template 4A instructions for Sheet 4A-4, except provide the projection used to determine the intermediate Item number 2 SFA amount from Sheet 6A-1 under the "basic method" described in § 4262.4(a)(1). Unlike Sheet 4A-4, it is not necessary to explicitly identify the projected SFA exhaustion year in Sheet 6A-2.

For MPRA plans for which the requested amount of SFA is determined under the "increasing assets method", see Template 4A instructions for Sheet 4A-5, except provide the projection used to determine each intermediate SFA amount from Sheet 6A-1 under the "increasing assets method" described in § 4262.4(a)(2)(i). Unlike Sheet 4A-5, it is not necessary to explicitly identify the projected SFA exhaustion year in Sheet 6A-2.

A Reconciliation Details sheet is not needed for the last Item number shown in the Sheet 6A-1 Reconciliation, since the information should be the same as shown in Template 4A. For example, if there is only one assumption change from the Baseline, then Item number 2 should identify what assumption changed between the Baseline and Item number 2, where Item number 2 is the requested SFA amount. Since details on the determination of the requested SFA amount are shown in Template 4A, a separate Sheet 6A-2 Reconciliation Details is not required here.















6A-3 Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method
See instructions for 6A-2 Reconciliation Details, except for the intermediate Item number 3 SFA amount from Sheet 6A-1.




























6A-4 Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method
See instructions for 6A-2 Reconciliation Details, except for the intermediate Item number 4 SFA amount from Sheet 6A-1.




























6A-5 Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method
See instructions for 6A-2 Reconciliation Details, except for the intermediate Item number 5 SFA amount from Sheet 6A-1.




























Version Updates (newest version at top)













Version Date updated










v20220701p 7/1/2022

Sheet 2: 6A-1 Reconciliation

TEMPLATE 6A - Sheet 6A-1




v20220701p
Reconciliation - Summary for the "basic method", or for MPRA plans for which the requested amount of SFA is determined under the "increasing assets method"












See Template 6A Instructions for Additional Instructions for Sheet 6A-1.











PLAN INFORMATION





Abbreviated
Plan Name:





EIN:





PN:





MPRA Plan?





If a MPRA Plan, which method yields the greatest amount of SFA?












Item number Basis for Assumptions/Methods. For each Item, briefly describe the incremental change reflected in the SFA amount. Change in SFA Amount (from prior Item number) SFA Amount NOTE: A sheet with Recon Details is not required for the last Item
number provided, since that information should be the same as provided
in Template 4A.
1 Baseline N/A
From Template 5A.

2
$0
Show details supporting the SFA amount on Sheet 6A-2.

3
$0
Show details supporting the SFA amount on Sheet 6A-3.

4
$0
Show details supporting the SFA amount on Sheet 6A-4.

5
$0
Show details supporting the SFA amount on Sheet 6A-5.








Create additional rows as needed, and create additional detailed sheets by copying Sheet 6A-5 and re-labeling the header and the sheet name to be 6A-6, 6A-7, etc.






Sheet 3: 6A-2 Recon Details

TEMPLATE 6A - Sheet 6A-2



Item Description (from 6A-1):



v20220701p
Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method



























See Template 4A instructions for Sheet 4A-4 or Sheet 4A-5, except provide the projection used to determine the intermediate SFA amount.





















PLAN INFORMATION












Abbreviated
Plan Name:











EIN:












PN:












MPRA Plan?












If a MPRA Plan, which method yields the greatest amount of SFA?












SFA Measurement Date:












Fair Market Value of Assets as of the SFA Measurement Date:












SFA Amount as of the SFA Measurement Date under the method calculated in this Sheet:












Non-SFA Interest Rate:












SFA Interest Rate:




























On this Sheet, show payments INTO the plan as positive amounts, and payments OUT of the plan as negative amounts.


(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
SFA Measurement Date / Plan Year Start Date Plan Year End Date Contributions Withdrawal Liability Payments Other Payments to Plan (excluding financial assistance and SFA) Benefit Payments Make-up Payments Attributable to Reinstatement of Benefits Suspended through the SFA Measurement Date Administrative Expenses (excluding amount owed PBGC under 4261 of ERISA) Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from SFA Assets SFA Investment Income Based on SFA Interest Rate Projected SFA Assets at End of Plan Year
(prior year assets +
(7) + (8))
Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from Non-SFA Assets Non-SFA Investment Income Based on Non-SFA Interest Rate Projected Non-SFA Assets at End of Plan Year
(prior year assets +
(1) + (2) + (3) +
(10) + (11))

































































































































































































































































































































































































































































Sheet 4: 6A-3 Recon Details

TEMPLATE 6A - Sheet 6A-3



Item Description (from 6A-1):



v20220701p
Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method



























See Template 4A instructions for Sheet 4A-4 or Sheet 4A-5, except provide the projection used to determine the intermediate SFA amount.





















PLAN INFORMATION












Abbreviated
Plan Name:











EIN:












PN:












MPRA Plan?












If a MPRA Plan, which method yields the greatest amount of SFA?












SFA Measurement Date:












Fair Market Value of Assets as of the SFA Measurement Date:












SFA Amount as of the SFA Measurement Date under the method calculated in this Sheet:












Non-SFA Interest Rate:












SFA Interest Rate:




























On this Sheet, show payments INTO the plan as positive amounts, and payments OUT of the plan as negative amounts.


(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
SFA Measurement Date / Plan Year Start Date Plan Year End Date Contributions Withdrawal Liability Payments Other Payments to Plan (excluding financial assistance and SFA) Benefit Payments Make-up Payments Attributable to Reinstatement of Benefits Suspended through the SFA Measurement Date Administrative Expenses (excluding amount owed PBGC under 4261 of ERISA) Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from SFA Assets SFA Investment Income Based on SFA Interest Rate Projected SFA Assets at End of Plan Year
(prior year assets +
(7) + (8))
Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from Non-SFA Assets Non-SFA Investment Income Based on Non-SFA Interest Rate Projected Non-SFA Assets at End of Plan Year
(prior year assets +
(1) + (2) + (3) +
(10) + (11))

































































































































































































































































































































































































































































Sheet 5: 6A-4 Recon Details

TEMPLATE 6A - Sheet 6A-4



Item Description (from 6A-1):



v20220701p
Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method



























See Template 4A instructions for Sheet 4A-4 or Sheet 4A-5, except provide the projection used to determine the intermediate SFA amount.





















PLAN INFORMATION












Abbreviated
Plan Name:











EIN:












PN:












MPRA Plan?












If a MPRA Plan, which method yields the greatest amount of SFA?












SFA Measurement Date:












Fair Market Value of Assets as of the SFA Measurement Date:












SFA Amount as of the SFA Measurement Date under the method calculated in this Sheet:












Non-SFA Interest Rate:












SFA Interest Rate:




























On this Sheet, show payments INTO the plan as positive amounts, and payments OUT of the plan as negative amounts.


(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
SFA Measurement Date / Plan Year Start Date Plan Year End Date Contributions Withdrawal Liability Payments Other Payments to Plan (excluding financial assistance and SFA) Benefit Payments Make-up Payments Attributable to Reinstatement of Benefits Suspended through the SFA Measurement Date Administrative Expenses (excluding amount owed PBGC under 4261 of ERISA) Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from SFA Assets SFA Investment Income Based on SFA Interest Rate Projected SFA Assets at End of Plan Year
(prior year assets +
(7) + (8))
Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from Non-SFA Assets Non-SFA Investment Income Based on Non-SFA Interest Rate Projected Non-SFA Assets at End of Plan Year
(prior year assets +
(1) + (2) + (3) +
(10) + (11))

































































































































































































































































































































































































































































Sheet 6: 6A-5 Recon Details

TEMPLATE 6A - Sheet 6A-5



Item Description (from 6A-1):



v20220701p
Reconciliation - Details for the "basic method" under § 4262.4(a)(1) for non-MPRA plans, or for the "increasing assets method" under
§ 4262.4(a)(2)(i) for MPRA plans for which the requested amount of SFA is determined under that method



























See Template 4A instructions for Sheet 4A-4 or Sheet 4A-5, except provide the projection used to determine the intermediate SFA amount.





















PLAN INFORMATION












Abbreviated
Plan Name:











EIN:












PN:












MPRA Plan?












If a MPRA Plan, which method yields the greatest amount of SFA?












SFA Measurement Date:












Fair Market Value of Assets as of the SFA Measurement Date:












SFA Amount as of the SFA Measurement Date under the method calculated in this Sheet:












Non-SFA Interest Rate:












SFA Interest Rate:




























On this Sheet, show payments INTO the plan as positive amounts, and payments OUT of the plan as negative amounts.


(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
SFA Measurement Date / Plan Year Start Date Plan Year End Date Contributions Withdrawal Liability Payments Other Payments to Plan (excluding financial assistance and SFA) Benefit Payments Make-up Payments Attributable to Reinstatement of Benefits Suspended through the SFA Measurement Date Administrative Expenses (excluding amount owed PBGC under 4261 of ERISA) Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from SFA Assets SFA Investment Income Based on SFA Interest Rate Projected SFA Assets at End of Plan Year
(prior year assets +
(7) + (8))
Benefit Payments (from (4) and (5)) and Administrative Expenses (from (6)) Paid from Non-SFA Assets Non-SFA Investment Income Based on Non-SFA Interest Rate Projected Non-SFA Assets at End of Plan Year
(prior year assets +
(1) + (2) + (3) +
(10) + (11))
































































































































































































































































































































































































































































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