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Schedule SSA (Form 5500) 1998

Page

1. Is paid some or all of the deferred vested

report those participants who are

General Instructions

retirement benefit (see the Caution below), or

already receiving benefits as

previously reported.

Note: Type or print all information and submit

2. Returns to service covered by the plan

original only.

and/or accrues additional retirement benefits

Line 3, column (b).—Enter the exact social

under the plan, or

security number (SSN) of each participant listed.

Purpose of form.—Use Schedule SSA to report

If the participant is a foreign national employed

all participants with deferred vested benefit

3. Forfeits all the deferred vested retirement

outside the United States who does not have an

rights who separated from your company during

benefit.

SSN, enter the word “FOREIGN.”

the plan year. Also use Schedule SSA to correct

Caution: If payment of the deferred vested

information previously reported concerning

Line 3, column (c).—Enter each participant’s

retirement benefit ceases before ALL of the

participants with deferred vested benefits. The

name exactly as it appears on the participant’s

benefit to which the participant is entitled is paid

information reported on this schedule is given to

social security card.

to the participant, information relating to the

the Social Security Administration which in turn

deferred vested retirement benefit to which the

Line 3, column (d).—From the following list,

provides it to participants when they file for

participant remains entitled shall be filed on the

select the code that describes the type of

Social Security benefits.

Schedule SSA filed for the year following the

annuity that will be provided for the participant.

Who must file.—The plan administrator is

last plan year within which a portion of the

Enter the code that describes the type of annuity

responsible for filing Schedule SSA. Plans that

benefit is paid to the participant.

that normally accrues under the plan at the time

cover only owners and their spouses do not

of the participant’s separation from service

Separation of a re-employed employee.—If the

have to file this schedule.

covered by the plan (or for a plan to which more

deferred vested benefit of a separated employee

than one employer contributes at the time the

Note: Government, church, or other plans that

is different from that previously reported, you

participant incurs the second consecutive 1-year

elect to voluntarily file the Schedule SSA must

may use code B (see below) to report that

break in service under the plan).

check the appropriate box on the schedule and

employee’s total vested benefit.

complete lines 4 through 5c.

Revising prior report.—Report on a current

Type of Annuity Code

What to file.—File this schedule and complete

Schedule SSA any revisions to pension

A A single sum

all line items. All attachments to Schedule SSA

information for a participant you reported on a

should have entries only on the front of the

previous Schedule SSA (e.g., changes in pension

B Annuity payable over fixed number of years

page. If you need more space, use either: (1)

amounts, plan number, etc.). This will ensure that

C Life annuity

additional copies of Schedule SSA, or (2)

SSA’s records are correct. This is important

D Life annuity with period certain

additional sheets the same size as the schedule

since SSA provides Schedule SSA information it

E Cash refund life annuity

containing all the information requested on the

has on file to participants when they file for

schedule. The information required in line 3

Social Security benefits. If this information is not

F Modified cash refund life annuity

columns (a) through (j) should be listed in the

up-to-date, the participant may contact the plan

G Joint and last survivor life annuity

administrator to resolve the differences.

same format as line 3 on Schedule SSA.

M Other

You may send a machine-generated computer

Split plan mergers.—There are conditions where

Line 3, column (e).—From the following list,

listing showing the information required on line 3

some employees covered by an existing plan are

select the code that describes the benefit

instead of completing line 3 on the schedule.

transferred to a different plan, or all of the

payment frequency during a 12-month period.

Use the same format as line 3 on Schedule SSA.

employees of an existing plan are split between

Complete lines 1 and 2 on Schedule SSA and

two or more different plans. The new

Type of Payment Code

enter on line 3 a statement that a list is attached.

administrator for each group of employees

On each page of the computer listing, enter all

should complete a code C entry (see below) for

A Lump sum

each employee previously reported on a

the information from lines 1a through 2b.

B Annually

Schedule SSA for the other plan.

When to Report a Separated Participant.—In

C Semiannually

general, for a plan to which only one employer

Where and how to file.—File as an attachment

D Quarterly

contributes, a participant must be reported on

to Form 5500 or Form 5500-C/R.

E Monthly

Schedule SSA if:

Caution: A penalty may be assessed if Schedule

M Other

1. The participant separates from service

SSA (Form 5500) is not timely filed.

covered by the plan in a plan year, and

Line 3, column (f).—For a defined benefit plan,

Specific Instructions

enter the amount of the periodic payment that a

2. The participant is entitled to a deferred

participant is entitled to receive under line 3,

vested benefit under the plan.

Line 1b.—Enter the sponsor’s employer

column (f).

The separated participant must be reported no

identification number (EIN) shown on line 1b of

For a plan to which more than one employer

later than on the Schedule SSA filed for the plan

the 5500-series form used.

contributes, if the amount of the periodic

year following the plan year in which separation

Line 3, column (a).—From the following list,

payment cannot be accurately determined

occurred. However, you can report the

select the code that applies and enter that code

because the plan administrator does not

separation in the plan year in which it occurs, if

in column (a).

maintain complete records of covered service,

you want to report earlier. Do not report a

enter an estimated amount.

participant more than once unless you wish to

Code A — Use this code for a participant not

revise or update a prior Schedule SSA (see

previously reported. Also complete

Line 3, column (g).—For a defined contribution

instructions for line 3, column (a), under codes

columns (b) through (h).

plan, if the plan states that a participant’s share

B, C, or D).

of the fund will be determined on the basis of

Code B — Use this code for a participant

units, enter the number of units credited to the

In general, for a plan to which more than

previously reported under the plan

participant.

one employer contributes, a participant must

number shown on this schedule to

be reported on Schedule SSA if:

modify some of the previously

If, under the plan, participation is determined

reported information. Enter all the

on the basis of shares of stock of the employer,

1. The participant incurs two successive

current information for columns (b)

enter the number of shares and add the letters

1-year breaks in service (as defined in the plan

through (h).

“SH” to indicate shares. A number without the

for vesting purposes), and

“SH” will be interpreted to mean units.

Code C — Use this code for a participant

2. The participant is (or may be) entitled to a

previously reported under another

Line 3, column (h).—For defined contribution

deferred vested benefit under the plan.

plan number who will now be

plans, enter the value of the participant’s

The participant must be reported no later than

receiving his/her future benefit from

account at the time of separation.

on the Schedule SSA filed for the plan year in

the plan reported on this schedule.

Line 3, columns (i) and (j).—Show the EIN and

which the participant completed the second of

Also complete columns (b), (c), (i),

plan number of the plan under which the

the two consecutive 1-year breaks in service.

and (j).

participant was previously reported.

The participant may be reported earlier (i.e., on

Code D — Use this code for a participant

the Schedule SSA filed for the plan year in which

Line 4.—If the Post Office does not deliver mail

previously reported under the plan

he or she separated from service or completed

to the street address and you have a P.O. box,

number shown on this schedule who

the first 1-year break in service.)

enter the box number instead of the street

is no longer entitled to those

address.

When NOT To Report a Participant.— A

deferred vested benefits. Also

participant is not required to be reported on

Signature.—This form must be signed by the

complete columns (b) and (c). If you

Schedule SSA if, before the date the Schedule

plan administrator. If more than one Schedule

wish, you may also use this code to

SSA is required to be filed (including any

SSA is filed for one plan, only page one should

extension of time for filing), the participant:

be signed.

Instructions For Form 5500 (Schedule Ssa) - Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits - 1998

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