Attachment 3: Make-Up Plan Questions for Tax Favored Defined Contribution Retirement Plans

Data Effective Date: September 1, 2000 Data Submission Deadline: November 21, 2000

ATTACHMENT 3: MAKE-UP PLAN QUESTIONS FOR TAX FAVORED DEFINED CONTRIBUTION RETIREMENT PLANS

PLEASE SEND US A COPY OF THE MOST RECENT SUMMARY PLAN DESCRIPTION AND A DESCRIPTION OF ANY MATERIAL CHANGES OR ANSWER THE FOLLOWING QUESTIONS

Question

/ 401(a)(17) Make-up Plan / 415 Make-up Plan /
1.  Do you offer this plan? / q  Yes
q  No
q  No, but we provide additional cash to make up for benefits lost because of the 401(a)(17) Limit
(if either “No” box is checked, skip the rest of this column) / q  Yes
q  No
q  No, but we provide additional cash to make up for benefits lost because of the 415 Limit
(if either “No” box is checked, skip the rest of this column)
2. Who is eligible for this plan? / q  All affected tax favored defined contribution retirement plan participants
q  Limited group of tax favored defined contribution retirement plan participants (if checked, describe the limited group below)
Limited group is composed of:
______/ q  All affected tax favored defined contribution retirement plan participants
q  Limited group of tax favored defined contribution retirement plan participants (if checked, describe the limited group below)
Limited group is composed of:
______
3. What is the type of make-up plan? / q  Defined benefit
q  Defined contribution / q  Defined benefit
q  Defined contribution
4. What is the benefit formula in the make-up plan? / q  Same as tax favored defined contribution retirement plan (but without limits)
q  Other type of formula (if checked, describe below)
Other formula is:
______/ q  Same as tax favored defined contribution retirement plan (but without limits)
q  Other type of formula (if checked, describe below)
Other formula is:
______
5. What is the definition of “compensation” in the make-up plan? / q  Same as tax favored defined contribution retirement plan (but without limits)
q  Other definition (if checked, describe below)
Other definition is:
______/ q  Same as tax favored defined contribution retirement plan (but without limits)
q  Other definition (if checked, describe below)
Other definition is:
______
6. What is the source of funds to pay for this benefit? / q  Institution’s general funds
q  Charged to the Department
q  Other source (if checked, describe below)
Other source is: ______/ q  Institution’s general funds
q  Charged to the Department
q  Other source (if checked, describe below)
Other source is: ______
7. Are funds accumulated and set aside for more than one year in advance to pay for this benefit? / q  Yes
q  No / q  Yes
q  No

William M. Mercer, Incorporated University of California Schools of Health Sciences Physician Retirement Benefits Survey

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