Instructions for SAR checklist and Regulations Relating to the Summary Annual Report

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Line items Sec. 2520.104b-10 The Summary Annual Report (SAR)
Sec. 2520.104-46 Waiver of examination and report of an independent qualified public accountant for employee benefit plans with fewer than 100 participants.

1a. Plan Name. Top

Indicate the plan name. This entry will be pre-populated from the 5500 form at the time the SAR checklist is added. If you change the name in the 5500 after the SAR has been added, you can delete and re-add the SAR checklist to see your changes.

1b. Plan Type. Top

Indicate the plan type. This entry will determine whether the SAR for a pension plan or a welfare plan will be used.

2a. SAR Instructions. Top

Indicate whether an instruction page will appear as the first page of the SAR.

2b. SAR Instructions. Top

If 2a is 'Custom', insert text to appear as the first page of the SAR. The page will include a heading of 'SUMMARY ANNUAL REPORT INSTRUCTIONS' above your custom instructions.

3a. Include Admin contact name. Top

The administrator's name will be used from Line 2a or 3a of the Form 5500 if 3b is left blank and 3a is "Yes". If "No" is selected, the SAR will read: "If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact the plan administrator at [address] and phone number, [phone number]."

3b. Admin contact name. Top

This item only applies if 3a is "Yes". Indicate the contact name for the plan sponsor that will appear in the SAR. You may leave this blank and the administrator's name will be used from Line 2a or 3a of the Form 5500 will be the contact listed in the SAR as shown below:

"If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact _____, who is a representative of the plan administrator at [address] and phone number, [phone number]."

3c. Pull Contact info from Line 1 - 6 on Select Plan screen. Top

If you do not want the plan administrator's information to pull into the SAR from the Form 5500/SF, you may select 'Yes' to have it pull in the data listed on the "Select Plan" screen, lines 1 - 6. This information will update the final SAR under "Your Rights for Additional Information".

4. Select Schedule H/I/SF. Top

If 1b is not "Welfare - Unfunded", indicate the source of financial information that will appear in the SAR.

5. Participants rights to benefits. Top

Indicate whether all participants have earned the right to receive benefits. If no is selected, the following phrase in bold will appear in the SAR:

"A total of ___ persons were participants in or beneficiaries of the plan at the end of the plan year, although not all of these persons had yet earned the right to receive benefits."

10a. Copy costs full report. Top

Enter the copying charges that will appear in the SAR for the full report. You can leave blank or enter 0 (zero) if there are no fees. You can also enter this information for all plans within the WK Logo > Administrative Tasks > Defaults > SAR/AFN 8955-SSA Defaults.

10b. Copy costs per page. Top

Enter the copying charges that will appear in the SAR per page of the report. You can leave blank or enter 0 (zero) if there are no fees. You can also enter this information for all plans within the WK Logo > Administrative Tasks > Defaults > SAR/AFN 8955-SSA Defaults.

15a-c. Pension - allocated insurance contracts. Top

If Item 1b indicates a pension plan and if "Yes" is selected in 15a, the following language will appear in the SAR:

The plan has (a) contract(s) with [name of insurance carrier(s) from Schedule A or from 15c if 5500SF] which allocate(s) funds toward [entry from Item 15b]. The total premiums paid for the plan year ending [date from 5500] were [amount from Schedule A].

Note that 15c is only applicable if the plan is reporting on a 5500 SF since this information is normally taken from a Schedule A.

16a. Pension - audit waiver Top

If Item 1b and 4 indicate a small pension plan, indicate whether the plan is eligible for waiver of the audit requirement (small plan audit addendum will be used).

More Frequently Asked Questions regarding the Small Pension Plan Audit Waiver Regulation may be found by clicking here, which will direct you to the DOL's site.

If 16a is "Yes", the following will be added to the SAR:

Information Regarding Plan Assets
The U.S. Department of Labor's regulations require that an independent qualified public accountant audit the plan's financial statements unless certain conditions are met for the audit requirement to be waived. This plan met the audit waiver conditions for the plan year beginning [information from 5500] and therefore has not had an audit performed. [If 16b and 16c are not blank] Instead, the following information is provided to assist you in verifying that the assets reported on the Form 5500 were actually held by the plan.

16b. Pension - audit waiver surety Top

If Item 16a is "Yes" (eligible for the audit waiver), then you should enter the name(s) of the surety company issuing enhanced fidelity bonding, if the plan has more than five percent of its assets in "non-qualifying plan assets."

More Frequently Asked Questions regarding the Small Pension Plan Audit Waiver Regulation may be found by clicking here, which will direct you to the DOL's site.

If 16b is not blank and 16c is blank, the following will be added to the SAR:
The remainder of the plan's assets were other assets covered by a fidelity bond at least equal to the value of the assets issued by [Name(s) of Surety], an approved surety company.

If 16b is blank and 16c is blank, the following will be added to the SAR:
The plan's assets were [pulled from return/report].

If 16b is blank and 16c is not blank, the following will be added to the SAR:
The remainder of the plan's assets were [pulled from the return/report].

If 16b is not blank and 16c is not blank, the following will be added to the SAR:
The remainder of the plan's assets were [pulled from the return/report] and other assets covered by a fidelity bond at least equal to the value of the assets issued by [Name(s) of Surety], an approved surety company.

16c. Pension - audit waiver financial information Top

If 16c is not blank, the following will be added to the SAR:
At the end of the plan year, the plan had qualifying plan assets at the following institution(s):

[16c] (Note that the name of each regulated financial institution holding (or issuing) qualifying plan assets and the amount of such assets reported by the institution as of the end of the plan year should be entered in item 16c).

The plan receives year-end statements from these regulated financial institutions that confirm the above information.

The following information will also appear if at least one of the assets types are used in the plan.

The remainder of the plan's assets were []:

16d. Pension - Include Additional Model Language Top

If 16b and 16c are blank and 16d is Yes, the following will be added to the SAR:

Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements and evidence of the fidelity bond. If you want to examine or get copies of the financial institution year-end statements or evidence of the fidelity bond, please contact [pulled from return/report], who is a representative of the plan administrator, at [pulled from return/report] and phone number, [pulled from return/report].

If you are unable to obtain or examine copies of the evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor's Employee Benefit Security Administration (EBSA) for assistance by calling toll-free 866-444-EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions."

If 16b is not blank and 16c is blank, the following will be added to the SAR:
Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the fidelity bond. If you want to examine or get copies of the evidence of the fidelity bond, please contact [pulled from return/report], who is a representative of the plan administrator, at [pulled from return/report] and phone number, [pulled from return/report].

If you are unable to obtain or examine copies of the evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor's Employee Benefit Security Administration (EBSA) for assistance by calling toll-free 866-444-EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions.

If 16b is blank and 16c is not blank, the following will be added to the SAR:
Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements. If you want to examine or get copies of the financial institution year-end statements, please contact [pulled from return/report], who is a representative of the plan administrator, at [pulled from return/report] and phone number, [pulled from return/report].

If you are unable to obtain or examine copies of the evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor's Employee Benefit Security Administration (EBSA) for assistance by calling toll-free 866-444-EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions.

If 16b is not blank, 16c is not blank the following will be added to the SAR:
Plan participants and beneficiaries have a right, on request and free of charge, to get copies of the financial institution year-end statements and the fidelity bond. If you want to examine or get copies of the financial institution year-end statements, please contact [pulled from return/report], who is a representative of the plan administrator, at [pulled from return/report] and phone number, [pulled from return/report].

If you are unable to obtain or examine copies of the evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor's Employee Benefit Security Administration (EBSA) for assistance by calling toll-free 866-444-EBSA (3272). A listing of EBSA regional offices can be found at http://www.dol.gov/ebsa.

General information regarding the audit waiver conditions applicable to the plan can be found on the U.S. Department of Labor Web site at http://www.dol.gov/ebsa under the heading "Frequently Asked Questions.

16e. Pension - audit waiver participant directed accounts. Top

If 16a is "Yes" and pension codes 2G or 2H are used on the 5500 form (line 8a of the 5500 and 9a of the 5500SF), are the assets held in individual participant accounts with investments directed by participants and beneficiaries and with account statements from regulated financial institutions furnished to the participant or beneficiary at least annually?

Note that if this item is "No" - you generally should be entering financial information in item 16c and/or surety information in line 16b in order to qualify for the audit waiver.

See sample SAR language above and the audit waiver regulation below for more information.

17. Pension - deemed/corrective distributions. Top

Indicate whether the SAR should include deemed/corrective distributions in the SAR. The model SAR provided by the DOL lacks this information (see Pension Plan 5500 Cross Reference) and can cause numbers not to add up on the SAR. If yes is selected, the following phrase in bold will appear in the SAR:

"Plan expenses were ___. These expenses included ___ in administrative expenses and ___ in benefits paid to participants and beneficiaries, __ in certain deemed and/or corrective distributions, and ___ in other expenses."

18. Pension - other/rollover contributions and other income. Top

Indicate whether the SAR should include other/rollover contributions and other income in the SAR. The model SAR provided by the DOL (see Pension Plan 5500 Cross Reference) lacks this information from schedules I and H and can cause numbers not to add up on the SAR (not applicable to the SF). If yes is selected, the following phrase in bold will appear in the SAR:

"During the plan year the plan experienced a change in its net assets of ___. This change includes unrealized appreciation or depreciation in the value of plan assets; that is, the difference between the value of the plan's assets at the end of the year and the value of the assets at the beginning of the year or the cost of assets acquired during the year. The plan had total income of ___, including employer contributions of ___, employee contributions of ___, other contributions/other income of ___, gains/(losses) of ____ from the sale of assets, and earnings from investments of _____."

Note that this item is not applicable to a 5500SF since the Pension Plan 5500 Cross Reference does include rollover information from a 5500 SF.

25a/b. Welfare - uninsured. Top

If Item 1b indicates a welfare plan and if 'Yes' is selected in this 25a, the following language will appear in the SAR:

[sponsor name from line 2a of Form 5500] has committed itself to pay all/certain [text entry from Item 25a] claims incurred under the terms of the plan.

25c. Welfare - all or certain claims. Top

If Item 1b indicates a welfare plan and if 'Yes' is selected in 25a, select whether the plan sponsor will pay all or certain claims. We recommend selecting 'certain' - as we assume the plan has some limits on claims it will pay (copays, deductibles, etc.). The following language will appear in the SAR depending upon your response:

[sponsor name from line 2a of Form 5500] has committed itself to pay [all/certain] [text entry from Item 25a] claims incurred under the terms of the plan.

26a/b/d. Welfare - insured. Top

If Item 1b indicates a welfare plan and if "Yes" is selected in 26a, the following language will appear in the SAR:

The plan has contracts with [name of insurance carrier(s) from Schedule A or 26d if 5500SF] to pay all/certain [text entry from Item 26b] claims incurred under the terms of the plan. The total premiums paid for the plan year ending [date from 5500] were [amount from Schedule A].

Note that 26d is only applicable if the plan is reporting on a 5500 SF since this information is normally taken from a Schedule A.

[If applicable add:]

Because they are so called "experience-rated" contracts, the premium costs are affected by, among other things, the number and size of claims. Of the total insurance premiums paid for the plan year ending [date from 5500], the premiums paid under such "experience-rated" contracts were [amount from Schedule A] and the total of all benefit claims paid under these "experience-rated" contracts during the plan year was [amount from Schedule A].

26c/d. Welfare - all or certain claims. Top

If Item 1b indicates a welfare plan and if 'Yes' is selected in 26a, select whether the insurance carrier will pay all or certain claims. We recommend selecting 'certain' - as we assume the plan has some limits on claims it will pay (copays, deductibles, etc.). The following language will appear in the SAR depending upon your response:

The plan has contracts with [name of insurance carrier(s) from Schedule A or 26d if 5500SF] to pay [all/certain] [text entry from Item 26b] claims incurred under the terms of the plan. The total premiums paid for the plan year ending [date from 5500] were [amount from Schedule A].

Note that 26d is only applicable if the plan is reporting on a 5500 SF since this information is normally taken from a Schedule A.

27a. Welfare - Include the type of welfare plan Top

Please note that welfare plan type is included in the DOL's model Form for Summary Annual Report Relating to Welfare Plans. If "Yes" is selected, the welfare plan types entered on the 5500 form will be used to complete the sentence. If "Custom" is selected, the text from 27b will be used. If "No" is selected, the SAR will not include a welfare plan type description. You can also enter this information for all plans within the WK Logo > Administrative Tasks > Defaults > SAR/AFN 8955-SSA Defaults.

27b. Welfare - Custom welfare plan type Top

This item will only apply if 27a is "Custom". Instead of using the welfare plan codes from the 5500, you can insert a plan type description for use in the first sentence of the SAR. You can also enter this information for all plans within the WK Logo > Administrative Tasks > Defaults > SAR/AFN 8955-SSA Defaults.

50. Custom Language. Top

Enter any custom language you would like to appear at the end of the SAR. This item is optional. The custom language entered will appear under the heading "Additional Explanation" at the end of the SAR (as is required by 2520.104b-10(d)(2)).

60. Font type. Top

Select the font type to use for this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

61. Font size. Top

Select the font size to use for this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

62. Line spacing. Top

Select the line spacing for use in this SAR

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

63. Left Margin size. Top

Select the left margin in inches for this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

64. Right margin size. Top

Select the right margin size in inches for this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

65. Top margin size. Top

Select the top margin in inches for use with this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

66. Bottom margin size. Top

Select the bottom margin in inches for use with this SAR.

To update the default SAR font type, size, margins and line-spacing, go to the top of the SAR Checklist and click on SAR/AFN Print Settings. Be sure to click 'Save & Close' in the lower right-hand side of the screen once you have made your changes.

Sec. 2520.104b-10 The Summary Annual Report (SAR) Return to top
(a) Obligation to furnish. Except as otherwise provided in paragraph (g) of this section, the administrator of any employee benefit plan shall furnish annually to each participant of such plan and to each beneficiary receiving benefits under such plan (other than beneficiaries under a welfare plan) a summary annual report conforming to the requirements of this section. Such furnishing of the summary annual report shall take place in accordance with the requirements of sec. 2520.104b-1 of this part.
(b) [Reserved]
(c) When to furnish. Except as otherwise provided in this paragraph (c), the summary annual report required by paragraph (a) of this section shall be furnished within nine months after the close of the plan year.
(1) In the case of a welfare plan described in sec. 2520.104-43 of this part, such furnishing shall take place within 9 months after the close of the fiscal year of the trust or other entity which files the annual report under sec. 2520.104a-6 of this part.
(2) When an extension of time in which to file an annual report has been granted by the Internal Revenue Service, such furnishing shall take place within 2 months after the close of the period for which the extension was granted.
(d) Contents, style and format. Except as otherwise provided in this paragraph (d), the summary annual report furnished to participants and beneficiaries of an employee pension benefit plan pursuant to this section shall consist of a completed copy of the form prescribed in paragraph (d)(3) of this section, and the summary annual report furnished to participants and beneficiaries of an employee welfare benefit plan pursuant to this section shall consist of a completed copy of the form prescribed in paragraph (d)(4) of this section. The information used to complete the form shall be based upon information contained in the most recent annual report of the plan which is required to be filed in accordance with section 104(a)(1) of the Act.
(1) Any portion of the forms set forth in this paragraph (d) which is not applicable to the plan to which the summary annual report relates, or which would require information which is not required to be reported on the annual report of that plan, may be omitted.
(2) Where the plan administrator determines that additional explanation of any information furnished pursuant to this paragraph (d) is necessary to fairly summarize the annual report, such explanation shall be set forth following the completed form required by this paragraph (d) and shall be headed, "Additional Explanation."
(3) Form for Summary Annual Report Relating to Pension Plans. Return to top

Summary Annual Report for (name of plan)

This is a summary of the annual report for (name of plan and EIN) for (period covered by this report). The annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Basic Financial Statement

Benefits under the plan are provided by (indicate funding arrangements). Plan expenses were ($ ). These expenses included ($ ) in administrative expenses and ($ ) in benefits paid to participants and beneficiaries, and ($ ) in other expenses. A total of ( ) persons were participants in or beneficiaries of the plan at the end of the plan year, although not all of these persons had yet earned the right to receive benefits.

[If the plan is funded other than solely by allocated insurance contracts:]

The value of plan assets, after subtracting liabilities of the plan, was ($ ) as of (the end of the plan year), compared to ($ ) as of (the beginning of the plan year). During the plan year the plan experienced an (increase) (decrease) in its net assets of ($ ). This (increase) (decrease) includes unrealized appreciation or depreciation in the value of plan assets; that is, the difference between the value of the plan's assets at the end of the year and the value of the assets at the beginning of the year or the cost of assets acquired during the year. The plan had total income of ($ ), including employer contributions of ($ ), employee contributions of ($ ), (gains) (losses) of ($ ), from the sale of assets, and earnings from investments of ($ ).

[If any funds are used to purchase allocated insurance contracts:]

The plan has (a) contract(s) with (name of insurance carrier(s)) which allocate(s) funds toward (state whether individual policies, group deferred annuities or other). The total premiums paid for the plan year ending (date) were ($ ).

Minimum Funding Standards

[If the plan is a defined benefit plan:]

An actuary's statement shows that (enough money was contributed to the plan to keep it funded in accordance with the minimum funding standards of ERISA) (not enough money was contributed to the plan to keep it funded in accordance with the minimum funding standards of ERISA. The amount of the deficit was $ ).

[If the plan is a defined contribution plan covered by funding requirements:]

(Enough money was contributed to the plan to keep it funded in accordance with the minimum funding standards of ERISA) (Not enough money was contributed to the plan to keep it funded in accordance with the minimum funding standards of ERISA. The amount of the deficit was $ ).

Your Rights to Additional Information

You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report: [Note-list only those items which are actually included in the latest annual report.]

1. an accountant's report;

2. financial information and information on payments to service providers;

3. assets held for investment;

4. fiduciary information, including non-exempt transactions between the plan and parties-in-interest (that is, persons who have certain relationships with the plan);

5. loans or other obligations in default or classified as uncollectible;

6. leases in default or classified as uncollectible;

7. transactions in excess of 5 percent of the plan assets;

8. insurance information including sales commissions paid by insurance carriers;

9. information regarding any common or collective trusts, pooled separate accounts, master trusts or 103-12 investment entities in which the plan participates; and

10. actuarial information regarding the funding of the plan.

To obtain a copy of the full annual report, or any part thereof, write or call the office of (name), who is (state title: e.g., the plan administrator), (business address and telephone number). The charge to cover copying costs will be ($ ) for the full annual report, or ($ ) per page for any part thereof.

You also have the right to receive from the plan administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or a statement of income and expenses of the plan and accompanying notes, or both. If you request a copy of the full annual report from the plan administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge.

You also have the legally protected right to examine the annual report at the main office of the plan ( address ), (at any other location where the report is available for examination), and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N-1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

(4) Form for Summary Annual Report Relating to Welfare Plans. Return to top

Summary Annual Report for (name of plan)

This is a summary of the annual report of the (name of plan, EIN and type of welfare plan) for (period covered by this report). The annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

[If any benefits under the plan are provided on an uninsured basis:]

(Name of sponsor) has committed itself to pay (all, certain) (state type of) claims incurred under the terms of the plan.

[If any of the funds are used to purchase insurance contracts:]

Insurance Information

The plan has (a) contract(s) with (name of insurance carrier(s)) to pay (all, certain) (state type of) claims incurred under the terms of the plan. The total premiums paid for the plan year ending (date) were ($____).

[If applicable add:]

Because (it is a) (they are) so called "experience-rated" contract(s), the premium costs are affected by, among other things, the number and size of claims. Of the total insurance premiums paid for the plan year ending (date), the premiums paid under such "experience-rated" contract(s) were ($ ) and the total of all benefit claims paid under the(se) experience-rated contract(s) during the plan year was ($ ).

[If any funds of the plan are held in trust or in a separately maintained fund:]

Basic financial statement

The value of plan assets, after subtracting liabilities of the plan, was ($ ) as of (the end of plan year), compared to ($ ) as of (the beginning of the plan year). During the plan year the plan experienced an (increase) (decrease) in its net assets of ($ ). This (increase) (decrease) includes unrealized appreciation and depreciation in the value of plan assets; that is, the difference between the value of the plan's assets at the end of the year and the value of the assets at the beginning of the year or the cost of assets acquired during the year. During the plan year, the plan had total income of ($ ) including employer contributions of ($ ), employee contributions of ($ ), realized (gains) (losses) of ($ ) from the sale of assets, and earnings from investments of ($ ). Plan expenses were ($ ). These expenses included ($ ) in administrative expenses, ($ ) in benefits paid to participants and beneficiaries, and ($ ) in other expenses.

Your Rights to Additional Information

You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report: [Note-list only those items which are actually included in the latest annual report].

1. an accountant's report;

2. financial information and information on payments to service providers;

3. assets held for investment;

4. fiduciary information, including non-exempt transactions between the plan and parties-in-interest (that is, persons who have certain relationships with the plan);

5. loans or other obligations in default or classified as uncollectible;

6. leases in default or classified as uncollectible;

7. transactions in excess of 5 percent of the plan assets;

8. insurance information including sales commissions paid by insurance carriers; and

9. information regarding any common or collective trusts, pooled separate accounts, master trusts or 103-12 investment entities in which the plan participates.

To obtain a copy of the full annual report, or any part thereof, write or call the office of (name), who is (state title: e.g., the plan administrator), (business address and telephone number). The charge to cover copying costs will be ($ ) for the full annual report, or ($ ) per page for any part thereof.

You also have the right to receive from the plan administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or a statement of income and expenses of the plan and accompanying notes, or both. If you request a copy of the full annual report from the plan administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge.

You also have the legally protected right to examine the annual report at the main office of the plan (address), (at any other location where the report is available for examination), and at the U.S. Department of Labor in Washington, D.C. or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N-1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

(e) Foreign languages. In the case of either- Return to top
(1) A plan which covers fewer than 100 participants at the beginning of a plan year in which 25 percent or more of all plan participants are literate only in the same non-English language; or
(2) A plan which covers 100 or more participants in which 500 or more participants or 10 percent or more of all plan participants, whichever is less, are literate only in the same non-English language-
The plan administrator for such plan shall provide these participants with an English-language summary annual report which prominently displays a notice, in the non-English language common to these participants, offering them assistance. The assistance provided need not involve written materials, but shall be given in the non-English language common to these participants. The notice offering assistance shall clearly set forth any procedures participants must follow to obtain such assistance.
(f) Furnishing of additional documents to participants and beneficiaries. A plan administrator shall promptly comply with any request by a participant or beneficiary for additional documents made in accordance with the procedures or rights described in paragraph (d) of this section.
(g) Exemptions. Notwithstanding the provisions of this section, a summary annual report is not required to be furnished with respect to the following:
(1) A totally unfunded welfare plan described in 29 CFR 2520.104-44(b)(1)(i);
(2) a welfare plan which meets the requirements of 29 CFR 2520.104-20(b);
(3) An apprenticeship or other training plan which meets the requirements of 29 CFR 2520.104-22;
(4) A pension plan for selected employees which meets the requirements of 29 CFR 2520.104-23;
(5) A welfare plan for selected employees which meets the requirements of 29 CFR 2520.104-24;
(6) A day care center referred to in 29 CFR 2520.104-25;
(7) A dues financed welfare plan which meets the requirements of 29 CFR 2520.104-26; and
(8) A dues financed pension plan which meets the requirements of 29 CFR 2520.104-27.

Appendix to Sec. 2520.104b-10 The Summary Annual Report (SAR) Under ERISA: A Cross-Reference to the Annual Report
A. PENSION PLAN Return to top
SAR Item Form 5500 Large Plan Filer Line Items Form 5500 Small Plan Filer Line Items Form 5500-SF Filer Line Items
1. Funding arrangement Form 5500-9a Same. Not applicable.
2. Total plan expenses Sch. H--2j Sch. I--2j Line 8h
3. Administrative expenses Sch. H--2i(5) Sch. I - 2h Line 8f
4. Benefits paid Sch. H--2e(4) Sch. I--2e. Line 8d
5. Other expenses Sch. H--Subtract the sum of 2e(4) & 2i(5) from 2j Sch. I--2i Line 8g
6. Total participants Form 5500--6f Same Line 5b
7. Value of plan assets (net):
a. End of plan year Sch. H--1l [Col. (b)] Sch. I--1c [Col. (b)] Line 7c [Col. (b)]
b. Beginning of plan year Sch. H--1l [Col. (a)] Sch. I--1c [Col. (a)] Line 7c [Col. (a)]
8. Change in net assets Sch. H--Subtract 1l [Col. (a)] from 1l [Col. (b)] Sch. I--Subtract 1c [Col. (a) from 1c [Col. (b)] Line 7c--Subtract Col. (a) from Col. (b)
9. Total income Sch. H--2d Sch. I--2d Line 8c
a. Employer contributions Sch. H--2a(1)(A) & 2a(2) if applicable Sch. I--2a(1) & 2b if applicable Line 8a(1) if applicable
b. Employee contributions Sch. H--2a(1)(B) & 2a(2) if applicable Sch. I--2a(2) & 2b if applicable Line 8a(2) & 8a(3) if applicable
c. Gains (losses) from sale of assets Sch. H--2b(4)(C) Not applicable Not applicable
d. Earnings from investments Sch. H--Subtract the sum of 2a(3), 2b(4)(C) and 2c from 2d Sch. I-2c Line 8b
10. Total insurance premiums Total of all Schs. A--6b Total of all Schs. A--6b Not applicable
11. Unpaid minimum required contribution (S-E plans) or Funding deficiency (ME plans):
a. S-E Defined benefit plans Sch. SB--39 Same Same
b. ME Defined benefit plans Sch. MB--10 Same Not applicable
c. Defined contribution plans Sch. R--6c, if more than zero Same Line 12d

B. WELFARE PLAN Return to top
SAR Item Form 5500 Large Plan Filer Line Items Form 5500 Small Plan Filer Line Items Form 5500-SF Filer Line Items
1. Name of insurance carrier All Schs. A--1(a) Same Not applicable
2. Total (experience rated and non-experienced rated)
insurance premiums		 All Schs. A--Sum of 9a(1) and 10a Same Not applicable
3. Experience rated premiums All Schs. A--9a(1) Same Not applicable
4. Experience rated claims All Schs. A--9b(4) Same Not applicable
5. Value of plan assets (net):
a. End of plan year Sch. H--1l [Col. (b)] Sch. I--1c [Col. (b)] Line 7c [Col. (b)]
b. Beginning of plan year Sch. H--1l [Col. (a)] Sch. I--1c [Col. (a)] Line 7c [Col. (a)]
6. Change in net assets Sch. H--Subtract 1l [Col. (a)] from 1l [Col. (b)] Sch. I--Subtract 1c [Col. (a)] from 1c [Col. (b)] Line 7c--Subtract [Col. (a)] from 7c [Col. b]
7. Total income Sch. H--2d Sch. I--2d Line 8c
a. Employer contributions Sch. H--2a(1)(A) & 2a(2) if applicable Sch. I--2a(1) & 2b if applicable Line 8a(1) if applicable
b. Employee contributions Sch. H--2a(1)(B) & 2a(2) if applicable Sch. I--2a(2) & 2b if applicable Line 8a(2) if applicable
c. Gains (losses) from sale of assets Sch. H--2b(4)(C) Not applicable Not applicable
d. Earnings from investments Sch. H--Subtract the sum of 2a(3), 2b(4)(C) and 2c from 2d Sch. I -2c. Line 8b
8. Total plan expenses Sch. H--2j Sch. I--2j Line 8h
9. Administrative expenses Sch. H--2i(5) Sch. I--2h Line 8f
10. Benefits paid Sch. H--2e(4) Sch. I--2e Line 8d
11. Other expenses Sch. H--Subtract the sum of 2e(4) & 2i(5) from 2j Sch. I--2i Line 8g

Sec. 2520.104-46 Waiver of examination and report of an independent qualified public accountant for employee benefit plans with fewer than 100 participants. Return to top
(a) General. Return to top
(1) Under the authority of section 103(a)(3)(A) of the Act, the Secretary may waive the requirements of section 103(a)(3)(A) in the case of a plan for which simplified annual reporting has been prescribed in accordance with section 104(a)(2) of the Act.
(2) Under the authority of section 104(a)(3) of the Act the Secretary may exempt any employee welfare benefit plan from certain annual reporting requirements.
(b) Application. Return to top
(1)
(i) The administrator of an employee pension benefit plan for which simplified annual reporting has been prescribed in accordance with section 104(a)(2)(A) of the Act and sec. 2520.104-41 is not required to comply with the annual reporting requirements described in paragraph (c) of this section, provided that with respect to each plan year for which the waiver is claimed-
(A) Return to top
(1) At least 95 percent of the assets of the plan constitute qualifying plan assets within the meaning of paragraph (b)(1)(ii) of this section, or
(2) Any person who handles assets of the plan that do not constitute qualifying plan assets is bonded in accordance with the requirements of section 412 of the Act and the regulations issued thereunder, except that the amount of the bond shall not be less than the value of such assets;
(B) The summary annual report, described in sec. 2520.104b-10, includes, in addition to any other required information: Return to top
(1) Except for qualifying plan assets described in paragraph (b)(1)(ii)(A), (B) and (F) of this section, the name of each regulated financial institution holding (or issuing) qualifying plan assets and the amount of such assets reported by the institution as of the end of the plan year;
(2) The name of the surety company issuing the bond, if the plan has more than 5% of its assets in non-qualifying plan assets;
(3) A notice indicating that participants and beneficiaries may, upon request and without charge, examine, or receive copies of, evidence of the required bond and statements received from the regulated financial institutions describing the qualifying plan assets; and
(4) A notice stating that participants and beneficiaries should contact the Regional Office of the U.S. Department of Labor's Employee Benefits Security Administration if they are unable to examine or obtain copies of the regulated financial institution statements or evidence of the required bond, if applicable; and
(C) in response to a request from any participant or beneficiary, the administrator, without charge to the participant or beneficiary, makes available for examination, or upon request furnishes copies of, each regulated financial institution statement and evidence of any bond required by paragraph (b)(1)(i)(A)(2).
(ii) For purposes of paragraph (b)(1), the term "qualifying plan assets" means: Return to top
(A) Qualifying employer securities, as defined in section 407(d)(5) of the Act and the regulations issued thereunder;
(B) Any loan meeting the requirements of section 408(b)(1) of the Act and the regulations issued thereunder;
(C) Any assets held by any of the following institutions (1) A bank or similar financial institution as defined in sec. 2550.408b-4(c); (2) An insurance company qualified to do business under the laws of a state; (3) An organization registered as a broker-dealer under the Securities Exchange Act of 1934; or (4) Any other organization authorized to act as a trustee for individual retirement accounts under section 408 of the Internal Revenue Code.
(D) Shares issued by an investment company registered under the Investment Company Act of 1940;
(E) Investment and annuity contracts issued by any insurance company qualified to do business under the laws of a state; and,
(F) In the case of an individual account plan, any assets in the individual account of a participant or beneficiary over which the participant or beneficiary has the opportunity to exercise control and with respect to which the participant or beneficiary is furnished, at least annually, a statement from a regulated financial institution referred to in paragraphs (b)(1)(ii)(C), (D) or (E) of this section describing the assets held (or issued) by such institution and the amount of such assets.
(iii)
(A) For purposes of this paragraph (b)(1), the determination of the percentage of all plan assets consisting of qualifying plan assets with respect to a given plan year shall be made in the same manner as the amount of the bond is determined pursuant to secs. 2580.412-11, 2580.412-14, and 2580.412-15.
(B) Examples. Plan A, which reports on a calendar year basis, has total assets of $600,000 as of the end of the 1999 plan year. Plan A's assets, as of the end of year, include: investments in various bank, insurance company and mutual fund products of $520,000; investments in qualifying employer securities of $40,000; participant loans, meeting the requirements of ERISA section 408(b)(1), totaling $20,000; and a $20,000 investment in a real estate limited partnership. Because the only asset of the plan that does not constitute a "qualifying plan asset" is the $20,000 real estate investment and that investment represents less than 5% of the plan's total assets, no bond would be required under the proposal as a condition for the waiver for the 2000 plan year. By contrast, Plan B also has total assets of $600,000 as of the end of the 1999 plan year, of which $558,000 constitutes "qualifying plan assets" and $42,000 constitutes non-qualifying plan assets. Because 7%-more than 5%-of Plan B's assets do not constitute "qualifying plan assets," Plan B, as a condition to electing the waiver for the 2000 plan year, must ensure that it has a fidelity bond in an amount equal to at least $42,000 covering persons handling non- qualifying plan assets. Inasmuch as compliance with section 412 requires the amount of bonds to be not less than 10% of the amount of all the plan's funds or other property handled, the bond acquired for section 412 purposes may be adequate to cover the non-qualifying plan assets without an increase (i.e., if the amount of the bond determined to be needed for the relevant persons for section 412 purposes is at least $42,000). As demonstrated by the foregoing example, where a plan has more than 5% of its assets in non-qualifying plan assets, the bond required by the proposal is for the total amount of the non-qualifying plan assets, not just the amount in excess of 5%.
(2) The administrator of an employee welfare benefit plan that covers fewer than 100 participants at the beginning of the plan year is not required to comply with annual reporting requirements described in paragraph (c) of this section.
(c) Waiver. The administrator of a plan described in paragraph (b) (1) or (2) of this section is not required to: Return to top
(1) Engage an independent qualified public accountant to conduct an examination of the financial statements of the plan;
(2) Include within the annual report the financial statements and schedules prescribed in section 103(b) of the Act and secs. 2520.103-1, 2520.103-2, and 2520.103-10; and
(3) Include within the annual report a report of an independent qualified public accountant as prescribed in section 103(a)(3)(A) of the Act and sec. 2520.103-1.
(d) Limitations. Return to top
(1) The waiver described in this section does not affect the obligation of a plan described in paragraph (b)(1) or (2) of this section to file a Form 5500 "Annual Return/Report of Employee Benefit Plan," including any required schedules or statements prescribed by the instructions to the form. See sec. 2520.104-41.
(2) For purposes of this section, an employee pension benefit plan for which simplified annual reporting has been prescribed includes an employee pension benefit plan which elects to file a Form 5500 as a small plan pursuant to sec. 2520.103-1(d) with respect to the plan year for which the waiver is claimed. See sec. 2520.104-41.
(3) For purposes of this section, an employee welfare benefit plan that covers fewer than 100 participants at the beginning of the plan year includes an employee welfare benefit plan which elects to file a Form 5500 as a small plan pursuant to sec. 2520.103-1(d) with respect to the plan year for which the waiver is claimed. See sec. 2520.104-41.
(4) A plan that elects to file a Form 5500 as a large plan pursuant to sec. 2520.103-1(d) may not claim a waiver under this section.