Plan Provision Checklist

PLAN PROVISION CHECKLIST

Employer Name : Plan #:

Plan Name :

Consultant : Phone :

Instructions: Please complete this document and submit to or fax to 818-883-5475
By checking this box I hereby authorize R-Tech to update plan provisions for this client as indicated below. I understand that R-Tech will prepare kits upon request including the Plan information as furnished in this form. R-Tech is not responsible for the accuracy of and shall have no liability for the accuracy of the information provided above in this form or for any other information about the plan, which is not covered by this form.
Representative Name Date
Notes:
PLAN DESIGN:

Type of Plan

/ 401(k) / Profit Sharing
Safe Harbor 401(k) / Safe Harbor PS
Simple 401(k) / % Of Compensation
Match / Non-integrated
Money Purchase / Integrated
Defined Benefit / Age Weighted
Points Allocation
Age Neutral
New Comparability
/ Principal Office Location (State):
# Of EEs: / # of Eligible EEs:
Future Entry Dates / 401(k) /

PS

MP

Anniversary
Anniversary and Semi-Anniv.
First day of Plan Quarter
First day of Month
Employee’s Date of Hire
Hours of Service:
Actual Hours/1,000 Hours / Days worked
Weeks Worked / Semi-Monthly
Months / Elapsed Time
Plan Year:
Are years of service with a predecessor included? Yes No

Eligibility

/ All employees will be covered

Exclusions

/ Exclusions will apply (below)
Salaried / Hourly
Commissioned / Leased
Non-Resident Alien EE’s
EE’s from stock acquisition/merger
Other, specify ______
Elective Contributions? Yes No
% to % OR $ to $
After-Tax Contributions? Yes No
% to % OR $ to $

Elective Contribution Starting Date:

Catch-up? Yes No Applied after:
Eligibility / 401(k): / None 18 20½ 21 Other:
Age / Match: / None 18 20½ 21 Other:
PS: / None 18 20½ 21 Other:
MP: / None 18 20½ 21 Other:
Change in Elective Contributions
Any business day
First day of month
First day of Plan Quarter
Plan Anniversary
Anniversary and Semi-Anniversary
Eligibility / 401(k) /

Match

PS

MP

Service / None
6 months only
6 mo. & 500 hrs
1 year
2 years
Other:
Automatic Enrollment allowed? Yes No
If yes, % Annually declared%
Employee Group Covered by Automatic Enrollment:
New hires only
Employee not yet eligible
No affirmative election
Initial / 401(k)/Match /

PS

MP

Entry / Open Enroll Date: / / /
Dates / Special Enroll Date: / /

Match contributions? Yes No

Safe Harbor Match:
Basic Match: 100% of the first 3% of and next 50% of the next 2%.
Enhanced Match: Elective Contributions that do not exceed %
of compensation
Plus % of elective contrib. not to exceed %
of compensation not to exceed % of comp. /

Vesting Schedule

Match /

PS

MP

100% Immediate
3 Year Cliff (100% after 3 yrs)
5 Year Cliff (100% after 5 yrs) / -
5 Year Graded
6 Year Graded
7 Year Graded / _
Percentage Match:
% of the First % elective of contributions not to exceed
% or $ compensation.
Will this match be discretionary? Yes No / 5Yr. Graded / 6 Yr. Graded /

7Yr. Graded

<1Year % / <1Year % / <1Year %
1Year % / 1Year % / 1Year %
2Years % / 2Years % / 2Years %
3Years % / 3Years % / 3Years %
4Years % / 4Years % / 4Years %
5Years % / 5Years % / 5Years %
6Years % / 6Years %
7Years 100%
Elective /Elective:
Maximum match is: % or $ of compensation.
Tiered Match:
% of the first % of contributions, plus % of the
next % of contributions, plus % of the next %
contributions up to $ or % of compensation.
Will this match be discretionary? Yes No

Vesting Exclusions

No exclusions

Years prior to Age 18

Years prior to the Plan Effective Date
Additional Match at Plan Year-end? Yes No / Does the plan accept Rollovers? Yes No
If yes, Direct Rollover from / Participant Rollovers from
401(a)/403(b) plan / 401(a)/403(b) plan
403(b) contract / 403(b) contract
457 plan / 457 plan
IRAs
Catch-up contributions matched? Yes No
If yes, after this date:
Hardship withdrawal Allowed for Matching? Yes No
In-service distributions after age 59 ½ of Match? Yes No
Are there Profit Sharing Contributions? Yes No
Discretionary
Profit Sharing Safe Harbor: %
Profit Sharing Percentage of Compensation: %
Other Profit Sharing Contribution / Allocation requirement to receive Contributions:
Match / PS / MP
None
500 hours worked OR employed on the last day of the Plan Year
1,000 hours worked and employed on the last day of the Plan Year
1,000 hours worked in the Plan Year
Employed on last day of Plan Year

Allocation Method

Ration to compensation
Integrated/ Non-Integrated Disparity Tier Allocation.
Classifications:
a)
b)
c)
d)
e)
f)
Are loans allowed? Yes No
If yes, Limited to financial hardship? Yes No
Hardship withdrawal Allowed for Matching? Yes No /

Normal Retirement Age

Attainment of Age
Age and 5th anniversary
Age and anniversary
Anniv of Participation Date nearest age or
the anniversary Of Participation.
In-service distributions after age 59 ½ of Match? Yes No
Change in Investment Mix
Any business day
First day of the Plan Quarter
Plan Anniversary and Semi-Anniversary
Plan Anniversary
Other, specify:

Allocation to Investment Accounts

Participant Directed, all money types
Employer Directed, all money types
Matching and Non-Matching contrib. directed by ER. Other plan
Contrib. directed by Participant.
Participant will direct the following contribution types:
Elective contributions
Matching Contributions
Non-matching contributions
Rollovers
After-tax contributions
and the ER will direct the investment of all other contributions. /

Early Retirement Date

None
Age
First day of Plan Quarter, or;
First day of calendar month, or;
Earlier of the Plan Anniversary or Semi-Anniv

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