pension plan benefits summary plan description
TRANSCRIPT
Pension Plan Benefits Summary Plan Description
Pipeline Industry Pension Fund
December 2010
e PIPF
PIBF PENSION PLAN BENEFITS Summary Plan Description
Plan Administrator Board of Trustees PIBF amp Fund Office
Physical Address
Pipeline Industry Pension Fund 4845 S 83rd East Avenue Tulsa Oklahoma 74145-6909
Mailing Address Pipeline Industry Pension Fund PO Box 470950 Tulsa Ok 74147-0950
Telephone
(918) 280-4800
Fax Numbers (918) 280-4895 Pension amp Contributions
(918) 280-4899 Health amp Welfare
web site wwwpibforg
Co-Chainnan Board of Trustees DANIEL C HENDRIX Pipe liners Local Union 798 4845 S 83rl1 East Ave Tulsa OK 74145
Co-Chairman Board of Trustees
PAUL G SOMERVILLE Associated Pipe Line Contractors Inc 3535 Briarpark Drive Suite 135 Houston 1X 77042
Union Trustees DAVID L BARNETT
Pipeliners Local Union 798 4823 S 83rd East Ave Tulsa OK 74145
GRANT SAMPLE Pipeliners Local Union 798 4823 S 83rd East Ave Tulsa OK 74145
Contractor Trustees PAUL C GREGORY
Gregory amp Cook Inc 952 Echo Lane Suite 310 Houston 1X 77024
DONW THORN Welded Construction LP 26933 Eckel Rd Perrysburg OH 43551
Director
ROBERT R KIME Pipeline Industry Benefit Fund 4845 S 83rd E Ave Tulsa OK 74145
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Table of Contents BOARD OF TRUSTEES STATEMENT 5
PIBF BOARD OF TRUSTEES 6
CONSULTANTS 7
DIRECTORS STATEMENT 8
INTRODUCTION TO PIPELINE INDUSTRY PENSION PLAN 9
QUESTIONS REGARDING PENSION BENEFIT 11 Who Is Covered By The Pension Plan 11 How Do I Become Eligible 11 What Happens If I Stop Earning Pension Credits 11 Vested Participants 11 Lapsed Participants 11 Terminated Participants 11 What Happens In Case Of Military Service Overseas Employment Or Extended Disability 12 What Is Credited Service 12 How Will I Know My Status As A Participant 12
PAYMENT TO INCAPACITATED PERSONS 12
BREAK IN SERViCE 13
FORMS OF PAYMENT 13 Normal Form - Single Life Annuity 13 Joint amp 50 75 and 100 Survivor Options 13 Guaranteed Period Option 14 Lump Sum 14 Early Retirement 14 Disability Benefits 15 Surviving Spouses Benefit 15
QUALIFIED DOMESTIC RELATIONS ORDER 15
APPLYING FOR BENEFITS 16 Requirements For Making Application For Benefits 16
ADDITIONAL QUESTIONS 17 Where Can I Find Answers To Questions Not Listed In This Booklet 17 How Long Is My Pension Payable 17 May I Change My Form Of Retirement 17 What Happens If I Retum To Work 17
APPEALS PROCEDURE 19 Appeals Procedure 20 Pension Appeal Procedure 20 Amendment of Plan 22
CURRENT PENSION RATES TABLE 23
CURRENT PENSION RATES YEARLY TABLE 25
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION 26
STATEMENT OF ERISA RIGHTS 27
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PENSION BENEFIT GUARANTY CORPORATION (PBGC) 28
THE PENSION PROTECTION ACT (PPA) 28
GENERAL DEFINITIONS 29
PENSION PACKAGE EXAMPLES Message From The Director Example of Application Explanation of Joint and Survivor Benefits 3D-Day Election Waiver Election or Rejection of Lump Sum Direct Rollover Special Tax Notice (Instructions) Assignment and Authorization Request (For Health Insurance) Authorization for Automatic Deposit Alternate Payee or Lien Disclosure
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4
Board of Trustees Statement
THE PIPELINE INDUSTRY PENSION FUND IS AJOINT EFFORT BY THE SIGNATORY CONTRACTORS AND UNION TO PROVIDE PENSION BENEFITS FOR EMPLOYEES PERFORMING WORK UNDER THE UNITED ASSOCIATIONS NATIONAL PIPELINE AGREEMENT
This presentation provides an outline of the Pension Plan arranged for pipeline industry employees and their dependents based on the latest Benefits Claims Procedure Manual and Summary Plan Description
The cost of the program is funded by employer contributions through negotiations with union pipeline contractors as provided by the agreement and declaration of the trust agreement which established the Pipeline Industry Pension Fund
You are asked to read the information in this presentation carefully so that you may know your benefits and understand your eligibility
To download a printable copy of the PIPF Benefits and Summary Plan Description booklet go to our website at wwwoibforg
We the Board of Trustees of the Pipeline Industry Pension Fund declare that this booklet serves as the Summary Plan Description (SPD) The Trustees have discretionary authority to resolve all questions concerning the administration interpretation or application of the plan This includes without limitation discretionary authority to determine eligibility for benefits or to construe the terms of the plan in conducting the review of any appeal
The Plan Documents provide that the Board of Trustees of PIPF may amend revise or terminate the Pension Plan from time to time as they deem necessary
Any changes authorized will take effect on the date specified by the Board and will apply to all affected persons regardless of status illness or injury sustained prior to the effective date Eligibility and benefits are not guaranteed In the event of Plan termination the Board of Trustees will within the limits of the Plans resources adopt a plan to discharge all outstanding obligations and provide that all remaining assets be used in a manner that best carries out the basic purpose for which the Plan was
established or otherwise be disposed of in a manner consistent with applicable law
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Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
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Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
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Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
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Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
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Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
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Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
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Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
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Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
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Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
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Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
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General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
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General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
e PIPF
PIBF PENSION PLAN BENEFITS Summary Plan Description
Plan Administrator Board of Trustees PIBF amp Fund Office
Physical Address
Pipeline Industry Pension Fund 4845 S 83rd East Avenue Tulsa Oklahoma 74145-6909
Mailing Address Pipeline Industry Pension Fund PO Box 470950 Tulsa Ok 74147-0950
Telephone
(918) 280-4800
Fax Numbers (918) 280-4895 Pension amp Contributions
(918) 280-4899 Health amp Welfare
web site wwwpibforg
Co-Chainnan Board of Trustees DANIEL C HENDRIX Pipe liners Local Union 798 4845 S 83rl1 East Ave Tulsa OK 74145
Co-Chairman Board of Trustees
PAUL G SOMERVILLE Associated Pipe Line Contractors Inc 3535 Briarpark Drive Suite 135 Houston 1X 77042
Union Trustees DAVID L BARNETT
Pipeliners Local Union 798 4823 S 83rd East Ave Tulsa OK 74145
GRANT SAMPLE Pipeliners Local Union 798 4823 S 83rd East Ave Tulsa OK 74145
Contractor Trustees PAUL C GREGORY
Gregory amp Cook Inc 952 Echo Lane Suite 310 Houston 1X 77024
DONW THORN Welded Construction LP 26933 Eckel Rd Perrysburg OH 43551
Director
ROBERT R KIME Pipeline Industry Benefit Fund 4845 S 83rd E Ave Tulsa OK 74145
2
Table of Contents BOARD OF TRUSTEES STATEMENT 5
PIBF BOARD OF TRUSTEES 6
CONSULTANTS 7
DIRECTORS STATEMENT 8
INTRODUCTION TO PIPELINE INDUSTRY PENSION PLAN 9
QUESTIONS REGARDING PENSION BENEFIT 11 Who Is Covered By The Pension Plan 11 How Do I Become Eligible 11 What Happens If I Stop Earning Pension Credits 11 Vested Participants 11 Lapsed Participants 11 Terminated Participants 11 What Happens In Case Of Military Service Overseas Employment Or Extended Disability 12 What Is Credited Service 12 How Will I Know My Status As A Participant 12
PAYMENT TO INCAPACITATED PERSONS 12
BREAK IN SERViCE 13
FORMS OF PAYMENT 13 Normal Form - Single Life Annuity 13 Joint amp 50 75 and 100 Survivor Options 13 Guaranteed Period Option 14 Lump Sum 14 Early Retirement 14 Disability Benefits 15 Surviving Spouses Benefit 15
QUALIFIED DOMESTIC RELATIONS ORDER 15
APPLYING FOR BENEFITS 16 Requirements For Making Application For Benefits 16
ADDITIONAL QUESTIONS 17 Where Can I Find Answers To Questions Not Listed In This Booklet 17 How Long Is My Pension Payable 17 May I Change My Form Of Retirement 17 What Happens If I Retum To Work 17
APPEALS PROCEDURE 19 Appeals Procedure 20 Pension Appeal Procedure 20 Amendment of Plan 22
CURRENT PENSION RATES TABLE 23
CURRENT PENSION RATES YEARLY TABLE 25
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION 26
STATEMENT OF ERISA RIGHTS 27
-3
PENSION BENEFIT GUARANTY CORPORATION (PBGC) 28
THE PENSION PROTECTION ACT (PPA) 28
GENERAL DEFINITIONS 29
PENSION PACKAGE EXAMPLES Message From The Director Example of Application Explanation of Joint and Survivor Benefits 3D-Day Election Waiver Election or Rejection of Lump Sum Direct Rollover Special Tax Notice (Instructions) Assignment and Authorization Request (For Health Insurance) Authorization for Automatic Deposit Alternate Payee or Lien Disclosure
35
4
Board of Trustees Statement
THE PIPELINE INDUSTRY PENSION FUND IS AJOINT EFFORT BY THE SIGNATORY CONTRACTORS AND UNION TO PROVIDE PENSION BENEFITS FOR EMPLOYEES PERFORMING WORK UNDER THE UNITED ASSOCIATIONS NATIONAL PIPELINE AGREEMENT
This presentation provides an outline of the Pension Plan arranged for pipeline industry employees and their dependents based on the latest Benefits Claims Procedure Manual and Summary Plan Description
The cost of the program is funded by employer contributions through negotiations with union pipeline contractors as provided by the agreement and declaration of the trust agreement which established the Pipeline Industry Pension Fund
You are asked to read the information in this presentation carefully so that you may know your benefits and understand your eligibility
To download a printable copy of the PIPF Benefits and Summary Plan Description booklet go to our website at wwwoibforg
We the Board of Trustees of the Pipeline Industry Pension Fund declare that this booklet serves as the Summary Plan Description (SPD) The Trustees have discretionary authority to resolve all questions concerning the administration interpretation or application of the plan This includes without limitation discretionary authority to determine eligibility for benefits or to construe the terms of the plan in conducting the review of any appeal
The Plan Documents provide that the Board of Trustees of PIPF may amend revise or terminate the Pension Plan from time to time as they deem necessary
Any changes authorized will take effect on the date specified by the Board and will apply to all affected persons regardless of status illness or injury sustained prior to the effective date Eligibility and benefits are not guaranteed In the event of Plan termination the Board of Trustees will within the limits of the Plans resources adopt a plan to discharge all outstanding obligations and provide that all remaining assets be used in a manner that best carries out the basic purpose for which the Plan was
established or otherwise be disposed of in a manner consistent with applicable law
5
Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
7
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Table of Contents BOARD OF TRUSTEES STATEMENT 5
PIBF BOARD OF TRUSTEES 6
CONSULTANTS 7
DIRECTORS STATEMENT 8
INTRODUCTION TO PIPELINE INDUSTRY PENSION PLAN 9
QUESTIONS REGARDING PENSION BENEFIT 11 Who Is Covered By The Pension Plan 11 How Do I Become Eligible 11 What Happens If I Stop Earning Pension Credits 11 Vested Participants 11 Lapsed Participants 11 Terminated Participants 11 What Happens In Case Of Military Service Overseas Employment Or Extended Disability 12 What Is Credited Service 12 How Will I Know My Status As A Participant 12
PAYMENT TO INCAPACITATED PERSONS 12
BREAK IN SERViCE 13
FORMS OF PAYMENT 13 Normal Form - Single Life Annuity 13 Joint amp 50 75 and 100 Survivor Options 13 Guaranteed Period Option 14 Lump Sum 14 Early Retirement 14 Disability Benefits 15 Surviving Spouses Benefit 15
QUALIFIED DOMESTIC RELATIONS ORDER 15
APPLYING FOR BENEFITS 16 Requirements For Making Application For Benefits 16
ADDITIONAL QUESTIONS 17 Where Can I Find Answers To Questions Not Listed In This Booklet 17 How Long Is My Pension Payable 17 May I Change My Form Of Retirement 17 What Happens If I Retum To Work 17
APPEALS PROCEDURE 19 Appeals Procedure 20 Pension Appeal Procedure 20 Amendment of Plan 22
CURRENT PENSION RATES TABLE 23
CURRENT PENSION RATES YEARLY TABLE 25
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION 26
STATEMENT OF ERISA RIGHTS 27
-3
PENSION BENEFIT GUARANTY CORPORATION (PBGC) 28
THE PENSION PROTECTION ACT (PPA) 28
GENERAL DEFINITIONS 29
PENSION PACKAGE EXAMPLES Message From The Director Example of Application Explanation of Joint and Survivor Benefits 3D-Day Election Waiver Election or Rejection of Lump Sum Direct Rollover Special Tax Notice (Instructions) Assignment and Authorization Request (For Health Insurance) Authorization for Automatic Deposit Alternate Payee or Lien Disclosure
35
4
Board of Trustees Statement
THE PIPELINE INDUSTRY PENSION FUND IS AJOINT EFFORT BY THE SIGNATORY CONTRACTORS AND UNION TO PROVIDE PENSION BENEFITS FOR EMPLOYEES PERFORMING WORK UNDER THE UNITED ASSOCIATIONS NATIONAL PIPELINE AGREEMENT
This presentation provides an outline of the Pension Plan arranged for pipeline industry employees and their dependents based on the latest Benefits Claims Procedure Manual and Summary Plan Description
The cost of the program is funded by employer contributions through negotiations with union pipeline contractors as provided by the agreement and declaration of the trust agreement which established the Pipeline Industry Pension Fund
You are asked to read the information in this presentation carefully so that you may know your benefits and understand your eligibility
To download a printable copy of the PIPF Benefits and Summary Plan Description booklet go to our website at wwwoibforg
We the Board of Trustees of the Pipeline Industry Pension Fund declare that this booklet serves as the Summary Plan Description (SPD) The Trustees have discretionary authority to resolve all questions concerning the administration interpretation or application of the plan This includes without limitation discretionary authority to determine eligibility for benefits or to construe the terms of the plan in conducting the review of any appeal
The Plan Documents provide that the Board of Trustees of PIPF may amend revise or terminate the Pension Plan from time to time as they deem necessary
Any changes authorized will take effect on the date specified by the Board and will apply to all affected persons regardless of status illness or injury sustained prior to the effective date Eligibility and benefits are not guaranteed In the event of Plan termination the Board of Trustees will within the limits of the Plans resources adopt a plan to discharge all outstanding obligations and provide that all remaining assets be used in a manner that best carries out the basic purpose for which the Plan was
established or otherwise be disposed of in a manner consistent with applicable law
5
Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
7
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
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General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
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General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
PENSION BENEFIT GUARANTY CORPORATION (PBGC) 28
THE PENSION PROTECTION ACT (PPA) 28
GENERAL DEFINITIONS 29
PENSION PACKAGE EXAMPLES Message From The Director Example of Application Explanation of Joint and Survivor Benefits 3D-Day Election Waiver Election or Rejection of Lump Sum Direct Rollover Special Tax Notice (Instructions) Assignment and Authorization Request (For Health Insurance) Authorization for Automatic Deposit Alternate Payee or Lien Disclosure
35
4
Board of Trustees Statement
THE PIPELINE INDUSTRY PENSION FUND IS AJOINT EFFORT BY THE SIGNATORY CONTRACTORS AND UNION TO PROVIDE PENSION BENEFITS FOR EMPLOYEES PERFORMING WORK UNDER THE UNITED ASSOCIATIONS NATIONAL PIPELINE AGREEMENT
This presentation provides an outline of the Pension Plan arranged for pipeline industry employees and their dependents based on the latest Benefits Claims Procedure Manual and Summary Plan Description
The cost of the program is funded by employer contributions through negotiations with union pipeline contractors as provided by the agreement and declaration of the trust agreement which established the Pipeline Industry Pension Fund
You are asked to read the information in this presentation carefully so that you may know your benefits and understand your eligibility
To download a printable copy of the PIPF Benefits and Summary Plan Description booklet go to our website at wwwoibforg
We the Board of Trustees of the Pipeline Industry Pension Fund declare that this booklet serves as the Summary Plan Description (SPD) The Trustees have discretionary authority to resolve all questions concerning the administration interpretation or application of the plan This includes without limitation discretionary authority to determine eligibility for benefits or to construe the terms of the plan in conducting the review of any appeal
The Plan Documents provide that the Board of Trustees of PIPF may amend revise or terminate the Pension Plan from time to time as they deem necessary
Any changes authorized will take effect on the date specified by the Board and will apply to all affected persons regardless of status illness or injury sustained prior to the effective date Eligibility and benefits are not guaranteed In the event of Plan termination the Board of Trustees will within the limits of the Plans resources adopt a plan to discharge all outstanding obligations and provide that all remaining assets be used in a manner that best carries out the basic purpose for which the Plan was
established or otherwise be disposed of in a manner consistent with applicable law
5
Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
7
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Board of Trustees Statement
THE PIPELINE INDUSTRY PENSION FUND IS AJOINT EFFORT BY THE SIGNATORY CONTRACTORS AND UNION TO PROVIDE PENSION BENEFITS FOR EMPLOYEES PERFORMING WORK UNDER THE UNITED ASSOCIATIONS NATIONAL PIPELINE AGREEMENT
This presentation provides an outline of the Pension Plan arranged for pipeline industry employees and their dependents based on the latest Benefits Claims Procedure Manual and Summary Plan Description
The cost of the program is funded by employer contributions through negotiations with union pipeline contractors as provided by the agreement and declaration of the trust agreement which established the Pipeline Industry Pension Fund
You are asked to read the information in this presentation carefully so that you may know your benefits and understand your eligibility
To download a printable copy of the PIPF Benefits and Summary Plan Description booklet go to our website at wwwoibforg
We the Board of Trustees of the Pipeline Industry Pension Fund declare that this booklet serves as the Summary Plan Description (SPD) The Trustees have discretionary authority to resolve all questions concerning the administration interpretation or application of the plan This includes without limitation discretionary authority to determine eligibility for benefits or to construe the terms of the plan in conducting the review of any appeal
The Plan Documents provide that the Board of Trustees of PIPF may amend revise or terminate the Pension Plan from time to time as they deem necessary
Any changes authorized will take effect on the date specified by the Board and will apply to all affected persons regardless of status illness or injury sustained prior to the effective date Eligibility and benefits are not guaranteed In the event of Plan termination the Board of Trustees will within the limits of the Plans resources adopt a plan to discharge all outstanding obligations and provide that all remaining assets be used in a manner that best carries out the basic purpose for which the Plan was
established or otherwise be disposed of in a manner consistent with applicable law
5
Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
7
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Consultants to the Pipeline Industry Pension Fund
Accounting Firm
HoganTaylor LLP 6120 S Yale Suite 1200 Tulsa OK 74136-4242
Actuarial Consultant
Ron Merritt The Segal Company 1920 N Street NW Washington D C 20036
Disability amp Utilization Review Providers
Excel Care 218 West 6th St Tulsa OK 74119 (918) 594-5222 1-800-544-8922 wwwcookcom
Medical Review Institute of America PO Box 25547 Salt Lake City UT 84125-0547 1-800-654-2422 wwwmrioacom
Investment Consultants
Rich Ranallo Segal Advisors Inc 1300 E 9th St Suite 1900 (9th Floor) ClevelandOH 44114-1593
Brett Hazen Segal Advisors Inc 10740 North Gessner Suite 320 Houston TX 77064-1187
Legal Consultants
Louis L Robein Jr Robein Urann Spencer Picard amp Cangemi 2540 Severn Avenue Suite 400 Metairie LA 70002
J Patrick (Pat) Tielborg Akin Gump Strauss Hauer amp Feld LLP 4100 First City Center 1700 Pacific Avenue Suite 1400 Dallas TX 75201
7
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
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Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
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Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
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Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
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Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
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Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
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1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
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Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
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General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
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General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
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General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
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General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
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General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
AN INTRODUCTION TO THE PIPF
QUESTIONS REGARDING PENSION BENEFITS
PAYMENT TO INCAPACITATED PERSONS
BREAK IN SERVICE
ELIGIBILITY REQUIREMENTS
COMPUTATION OF BENEFITS
QUALIFIED DOMESTIC RELATIONS ORDER
APPLYING FOR BENEFITS
ADDITIONAL QUESTIONS
__ __
9
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
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Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
AN INTRODUCTION TO THE PIPELINE INDUSTRY PENSION FUND
This Pension Plan forms part of the program of benefits being provided for participants under the National Pipe Line Agreement between the Pipe Line Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada
Effective May 1 1964 the Trustees of the Pipeline Industry Pension Fund (a defined benefit Plan) adopted a trust agreement dated September 1 1964 for the purpose of providing retirement benefits for eligible employees
The Trustees adopted the amended and restated plan on January 1 1976 to comply with the federal law (ERISA)
The Trustees adopted the amended and restated plan on January 1 1994 to comply with the federal law (TEFRA)
The Trustees adopted the amended and restated plan effective January 1 2002 to comply with a series of federal laws designated as GUST
The Trustees adopted the amended and restated plan effective January 1 2010 to comply with several laws passed since the last restatement including the Pension Protection Act designated as PPA
The purpose of the pension plan is to provide participants who have devoted a major portion of their productive lifetime to the pipeline industry a retirement or disability pension The plan also provides certain benefits to spouses and designated beneficiaries of eligible participants The various forms in which normal and early retirement benefits are paid are as follows
1 The normal form life annuity 2 Joint and 50 survivor option 3 Joint and 75 survivor option 4 Joint and 100 survivor option 5 Guaranteed period option 6 Lump sum option which allows for either 12
months or 24 months of benefits paid in a lump sum up to $54000 in exchange for a reduction in the monthly benefit amount The Plan also provides certain benefits to participants who are disabled to spouses of
participants who die before they retire and to former spouses or other alternate payees pursuant to Qualified Domestic Relations Orders (QDROs)
Before October 1 2009 the participant at the time of retirement if electing one of the survivor options could include a pop-up provision On October 1 2010 this benefit became automatic This feature allows the Plan if a joint and survivor option is elected to return to the unreduced monthly penSion amount if the spouse predeceases the participant
The benefits provided by this plan are in addition to federal social security and are paid for entirely by contributions from employers No contributions are required or allowed from participants
The plan and the pension trust which the Fund operates under are governed by the Board of Trustees representing management and labor equally
The Board of Trustees administers the plan from a modern and fully equipped office where the efficient group administration does not diminish earned retirement benefits
A certified public accounting firm examines the finanCial transactions of the fund annually The full text of the auditors annual report as well as other plan documents is available for examination at the Fund Office during normal business hours
The information contained in this section is intended only as a brief summary of the prinCipal features of the Pipeline Industry Pension Plan Complete terms of the pension plan are covered by the approved text of the plan titled the Pipeline Industry Pension Trust Fund Plan Document which is on file and available for inspection and copying at the Fund Office
The Pension Plan text and the Declaration of Trust are authoritative If there should be any inconsistency between this Summary Plan Description and the actual instruments the provisions of the text of the Pension Plan and the Declaration of Trust will govern
10
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension BenefIts
QUESTIONS REGARDING PENSION BENEFITS
Who Is Covered By The Pension Plan When How
All employees who are performing work under the United Association National Pipe Line Agreement or who are having hours transferred to the Pipeline Industry Pension Fund via a reciprocity or a participation agreement are eligible to participate in the pension plan
If you earned at least 400 hours for which contributions were payable up to January 1 1965 you became a current participant on that date
If you were not a current participant on January 1 1965 you will qualify on January 1 of the calendar year during which you earn at least 400 hours
PartiCipation is automatic
How Do I Become Eligible For Benefits
To be eligible for benefits you must meet the age and service requirements under the plan as explained below Eligibility for benefits is based on your YEARS OF SERVICE under the Plan whereas CREDITED SERVICE or SERVICE CREDITS determine the amount of your accrued benefit These terms will be explained in a following section
What Happens If I Stop Earning Pension Credits
When you enter the pension plan you become a current participant As long as you earn at least 400 hours in each calendar year you remain a current participant until you retire
If you do not earn 400 hours during a calendar year you will cease to be a current participant You then become a vested partiCipant lapsed participant or a terminated partiCipant depending on the years of service you have earned up to that time
If a participant has a two-year period with no hours reported after January 1 1989 (called a break in service) the previous credit is frozen at the rate in effect at the time of the break Each two-year break causes credits to be frozen at the
rate in effect at the time of each break For example if you did not have hours reported in 1998 and 1999 your previous credit would be frozen at the rate in effect in 1999 - $7000 for journeymen and $4500 for helpers If you do not have a two-year break in service your benefit will be computed at the rate in effect at the time you retire or if earlier the time when you have a two-year break However effective January 1 2002 if you return to work after a break in service and your period of service after the break is greater than your period of break in service then your credits before the break will be updated to the rate in effect at your next two consecutive breaks in service or your date of retirement
Vested Participants
If you have earned at least one hour of service on or after January 1 1999 you become a vested participant when you have accrued five years of service If you have not earned at least one hour of service on or after January 1 1999 you become a vested participant if you have accrued ten vesting years You will also become a vested participant when you reach your normal retirement date Once you become a vested participant your service credits are nonshyforfeitable You will be eligible for a pension when you reach age 60 and retire
Lapsed Participants
If you have not attained vested participant status and you go one year without earning at least 400 hours called a break in service you will be considered a lapsed participant You will continue to be a lapsed participant until either you suffer forfeited service you are reinstated as a current partiCipant or you die
If you become a current participant again your additional service credits will be added to any credited service you already have that has not been forfeited
Terminated Participants and Forfeited Service
You will become a terminated participant if you suffer forfeited service If you are not vested service credited to you will be forfeited when you have enough consecutive one (1) year breaks in service to equal or exceed your pre-break service and effective January 1 1987 when you have at
11
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
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25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
least five consecutive breaks in service If you forfeit service you will not be entitled to prior service credited on your behalf However you will not forfeit service for any period of contiguous non-covered service with an employer maintaining this Plan If you become a terminated participant you will lose your prior service credit
What Happens In Case of Military Service Overseas Employment Or Extended Disability
If you have reason to believe that your status as a participant may be jeopardized by military service employment outside the United States or extended disability you should notify the Trustees within twelve months from the start of the event with an explanation of the circumstances so that they may give consideration to preserving your credited service
Notwithstanding any provisions of this plan to the contrary contributions benefits and service credit with respect to qualified military service will be provided in accordance with (USERRA)
What Is Credited Service
Credited service or service credit is the basis by which benefits are calculated Credited service can be a combination of past credited service and future credited service for those participants born before January 1 1929 or only future credited service for those participants born after January 1 1929
(a) Past credited service is based on years you worked in the pipeline industry before 1965 starting with the year of your 36th birthday and ending with the year 1964 Past service credits are available only to participants born before 1929
(b) Future credited service is based on hours of contributions within calendar years The first calendar year for future credited service was January 1 1965 through December 31 1965 If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to one full year of credit which is 1200 hours
However for the period of January 1 2007 through December 31 2012 service credit for
more than 1799 hours will be awarded at 1 12 times 1200 hours
If you have more than 1200 hours in a calendar year you can earn up to four reserve credits (one for each complete 100 hours between 1200 and 1600) which will be carried forward to the following calendar year If your MAXIMUM reserve credits of four are not used in the following year the unused reserve credits will be carried forward until used in calendar years you work at least 400 hours You cannot use any reserve credits to achieve more than one full year of credit in a calendar year
The purpose of the reserve credits is to help those partiCipants who work regularly in the pipeline industry but suddenly encounter a temporary shortage of pipeline work Reserve credits allow them to continue to earn a full year of credit Reserve credits will be terminated if the participant does not work in the industry earning at least four hundred hours in a year in any five consecutive years
How Will I Know My Status As A Participant
The Trustees will make every effort to notify you on an annual basis of any change in your status and whether you are a current participant vested partiCipant lapsed participant or a terminated participant
However the Pipeline Industry Pension Fund covers many thousands of participants all over the United States In many instances the only knowledge the Trustees may have that a participant is no longer working in the industry is that no contributions have been reported on the participants behalf It is the responsibility of every participant to keep the Fund Office notified of permanent address changes Without a current address the Trustees cannot keep you informed of pension changes
PAYMENT TO INCAPACITATED PERSONS
If the Board of Trustees receives satisfactory evidence that a Participant or Beneficiary entitled to receive any benefit under this Plan is at the time when such benefit becomes payable physically unable or mentally incompetent to receive such benefit or to give a valid release and that another person or an institution is then
12
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
maintaining or has custody of the participant or beneficiary and that no guardian committee or other representative of the estate of the participant or beneficiary duly appointed the Board of Trustees may authorize payment of the benefit otherwise payable to another person or institution and the payment of the benefit otherwise payable to the other person or institution and the release given by the other person or institution with a valid and complete discharge for the payment the benefit
BREAK IN SERVICE
For plan years beginning on or after January 1 1987 a break in service will not occur under the following circumstances
a) By reason of the pregnancy of the Participant or
b) By reason of the birth of a child to the Participant or
c) By reason of the placement of a child with the Participant in connection with the adoption of the child by the Participant (including placement with the Participant for a trial period prior to adoption) or
d) For purposes of caring for the child for a period beginning immediately following the birth or placement for adoption
FORMS OF PAYMENT HOW IS MY PENSION COMPUTED UNDER THE VARIOUS FORMS
NORMAL RETIREMENT
You may retire on the first day of any month after your 65th birthday provided you have at least ten years of service (five years for those who worked in 1999 or later) including one year of future service credit
WHAT ARE THE ELIGIBILITY REQUIREMENTS FOR VARIOUS BENEFITS
Minimum Service Years
19981999 Normal retirement 65 105 Early retirement 55 105 Disability retirement none 105
1 NORMAL FORM - SINGLE LIFE ANNUITY
Your normal retirement benefit is equal to the amount shown on the current pension rate tables for the number of years and months of credited service you have earned The normal form of payment is a life annuity
Under this form of retirement your pension is payable to you for life There are no survivors benefits so no further benefits will be paid upon your death If you are married your spouse must approve this selection in writing on the pension application before your penSion can begin
2 JOINT AND 50 75 AND 100 SURVIVOR OPTIONS
A participant who is married at the time of retirement must elect one of these retirement forms unless his spouse consents to a different option These forms of retirement benefit are computed the same as the normal form except that they are actuarially reduced based on the age of the participant and the age of the spouse so as to provide a lifetime annuity to the spouse if the participant dies first Fifty percent seventyshyfive percent or one hundred percent of the participants amount will be payable to the spouse based upon the selection after the partiCipants death for the spouses lifetime
13
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
Once a participant selects any of these joint and survivor options and the pension commences the benefit continues to be paid at the same rate even if the spouse should die before the participant However on January 1 2000 the Trustees adopted joint and survivor retirement forms with automatic pop-up provisions These pop-up options allow the partiCipants benefit to convert to the unreduced retirement amount in the event the spouse dies before the partiCipant These pop-up options like other retirement options must be selected at the time of retirement and cannot be changed after retirement Effective October 1 2010 the popshyup provision became an automatic feature of these payment options
NOTE To be able to receive a survivor annuity the spouse must have been married to the participant for at least the one year period ending on the earlier of the participants annuity starting date or death Alternatively if they were married within the one-year period ending on the annuity starting date and have been married for at least the one-year period ending on his death they will be treated as if they had been married for the one-year period ending on the annuity starting date
3 GUARANTEED PERIOD OPTION This form of benefit provides an income guaranteed to continue for ten years in any event and for life to the partiCipant thereafter In the event the pensioner dies within the first ten years payments will be continued to the designated beneficiary for the remainder of the ten-year period This optional form of pension is computed the same as the normal form life annuity except that it is reduced depending on the age of the participant The reduction would usually be less than 10 which is illustrated in the following chart
Age at Which Percentage of Pension Is To Pension Payable
Under Option 65 9113 64 9196 63 9272 62 9342 61 9406 60 9465 59 9517 58 9565 57 9607 56 9646 55 9680
If you are married your spouse must approve this election in writing on the pension application before your pension may begin Your spouse must also approve changes in the designated beneficiary
4 LUMP SUM
This form of benefit provides a lump sum to the retiree equal to 12 or 24 months of his accrued benefit The remainder of his accrued benefit can be paid as a life annuity as a joint and survivor annuity or as a Guaranteed Certain Period option This benefit form like the other optional forms is actuarially equal to the life annuity
You can elect to have any portion of the lump sum called an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover An Eligible Rollover Distribution cannot be a series of periodic payment like an annuity but is a lump sum distribution If you are going to receive an Eligible Rollover Distribution the Director will give you information about your right to directly roll it over to an Eligible Retirement Plan
EARLY RETIREMENT
You may retire on the first day of any month after your 55th birthday provided you have at least ten years of service including one year of future service or five years of service if you earned at least one hour of service on or after January 1 1999
Early retirement pensions are computed the same as normal retirement penSions but will be reduced by 12 of 1 for each month your retirement date precedes the first day of the month following your 60th birthday
You can receive your early retirement pension in the same form as the normal retirement pension
bull the normal form life annuity bull the joint and 50 75 or 100
survivor option bull the guaranteed period option or bull the lump sum option
The optional forms of benefits are all actuarially equivalent to the normal form single life annUity
14
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
THERE IS NO REDUCTION FOR EARLY RETIREMENT AFTER AGE 60
DISABILITY
A current participant under age 60 who becomes PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO WORK IN ANY TYPE OF GAINFUL EMPLOYMENT is eligible to receive a disability pension equal to the normal pension benefit accrued In order to qualify the current participant must be disabled and must have ten years of service or five years of service if you earned at least one hour of service on or after January 1 1999 Generally application for a disability pension must be made within two years of the date of the disabling accident or illness or the application will not be considered unless approved by the Trustees based on extenuating circumstances
Disability pension benefits begin the first day of the month following the Fund Offices receipt of the completed application form proof of birth and medical documentation showing that the applicant has been PERMANENTLY AND TOTALLY DISABLED AND UNABLE TO ENGAGE IN ANY TYPE OF GAINFUL EMPLOYMENT OR DOCUMENTATION THAT HE IS RECEIVING SOCIAL SECURITY DISABILITY BENEFITS Disability payments will not be retroactive to the date of the disabling accident or illness
No participant will be considered a disabled participant if the incapacity is the result of chronic alcoholism or addiction to controlled substances if the disability is a result of engaging in a felonious enterprise was the result of a selfshyinflicted injury or an injury or wound incurred while a member of the Armed Forces
Benefits will be payable as of the first day of the month after a completed application and supporting documentation are received at the Fund Office and payments will continue until the partiCipants death recovery from disability or attainment of the participants 60th birthday
The disabled participant will be considered reccvered from the disability if the participant returns to ANY TYPE OF EMPLOYMENT except for rehabilitation as determined by the Trustees in accordance with the rehabilitation provisions of the Social Security Act if the participant refuses to undergo medical examinations requested by
the Trustees or if the Trustees determine the disability has ended based on medical findings
At age 60 the disability benefit will cease and the participant will be able to select his early retirement benefit option If married the benefit will be paid as a joint and 50 survivor annuity unless the participant elects otherwise with his spouses consent If unmarried the participant will receive a payment in the form of a single life annuity unless he elects otherwise
RE-EMPLOYMENT OF A DISABLED RETIREE
Benefits of a disabled ~retiree who recovers will be terminated If the retiree should return to work covered employment and receive a minimum of 1200 hours of employer contributions the retiree will then be eligible to retire in accordance with the rules of normal or early retirement at the current benefit rate then in effect If the participant does not work at least 1200 hours the new retirement will be at the same rate as that in effect on the last date of his original disability retirement
In order to begin receiving benefits the Participant must make application as described in The Plan Document
SURVIVING SPOUSES BENEFIT
(a) Participants 55 years or older In the event of the death of a vested partiCipant or disabled retiree who was eligible to retire before his death but did not his spouse will be eligible to receive the same annuity as if the participant had retired the day before his death with a joint and 75 survivor option annuity
(b) Participants under 55 years old In the event of the death of a vested participant or a disabled participant who has not yet attained age 55 the spouse will be entitled to receive a pension benefit anytime after the participant would have reached his early retirement date The pension will be the survivors portion of the jOint and 75 survivor option form of retirement
QUALIFIED DOMESTIC RELATIONS ORDER
Under the law your benefits under this Plan generally may not be assigned or transferred There is however an exception for certain Qualified Domestic Relations Orders (QDROs) A
15
1------------------------------ -------------------shy
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
QDRO is a judgment decree or order (including approval of a property settlement agreement) which relates to the provision of child support alimony payments or marital property rights a spouse former spouse child or other dependent of a Plan participant and is made pursuant to a state domestic relations law If a domestic relations order is issued to the Plan the Fund Office will determine if it can be APPROVED as a QDRO and if it assigns to an alternate payee the right to all or a portion of the benefits payable with respect to a participant under the Plan If so the participants benefits will be reduced based on the terms of the QDRO In combination all benefits cannot exceed what the Fund would otherwise have to pay on behalf of that participant
What Information Is Required For A Qualified Domestic Relations Order
THE ORDER MUST (a) State that the Plan is a Defined Benefit
Plan (b) State the proper name of the Plan Pipeline
Industry Pension Fund (c) Clearly specify the name social security
number date of birth and last known address of participant and alternate payee covered by the order
(d) Clearly specify the amount or percentage of a Participants benefit to be paid to each alternate payee or the manner in which the amount or percentage is to be determined
(e) Clearly specify the number of payments or the period of payments
(f) Not require the payment of benefits to an alternate payee which are required to be paid to another alternate payee under another order previously determined to be a Qualified Domestic Relations Order
(g) Not require the Plan to provide any form of benefit or any option not otherwise provided under the Plan nor to provide increased benefits (determined on the basis of actuarial value)
(h) A domestic relations order that otherwise satisfies the requirements for a QDRO will not fail to be a QDRO just because it is issued after or revises another domestic relations order or solely because of the time at which it is issued
Sample QDROs and the Funds QDRO procedure are available from the Fund Office for the
convenience of participants benefiCiaries and alternate payees
APPLYING FOR BENEFITS
Where Do I Apply For Benefits
The participant can apply by telephone mail or in person at the Fund Office where proper forms and instructions can be obtained The mailing address is Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950
Pension payments will begin the first day of the month following the Fund Offices receipt of the completed application and all necessary proofs of birth marriage etc that are reasonably required to complete the application process
What Is Required For Making Application For Benefits
(a) A participant must notify the Fund Office of the desire to apply for pension plan benefits The Fund Office will send the participant all necessary forms within 30 days of receipt of the request to apply for benefits but not more than 180 days before the participants annuity starting date The participant may elect with spousal consent to waive this 3O-day explanation period All questions concerning the participants retirement should be included with the request for forms A written explanation will be sent to the partiCipant along with the application forms explaining the terms and conditions and effect of electing a normal or early retirement benefit rather than the normal or early with joint and 50 75 or 100 survivor benefit
(b) Waiver of jOint and survivor benefit form a statement must be signed by the participants spouse indicating that the spouse does not want the retirement benefits paid in the form of a joint and survivor annuity If a statement is not signed indicating the manner that retirement benefits are to be paid the participant will receive the normal or early retirement in the joint and 50 survivor benefit form of payment
(c) Proof of birth - One of the following is required If you do not have the first one on the list then submit the second third etc in the order listed 1 Birth certificate 2 Passport
16
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
Pension Benefits
3 Baptismal certificates or statement of date of birth as shown by church records certified by the custodian of the records
4 Notification of registration of birth in public registry of vital statistiCS
5 Hospital records of date of birth certified by the custodian of the records
6 Foreign church or government records 7 Family Bible or other records certified by a
Notary Public 8 Naturalization record 9 Record of military service 10 Union records
(d) Marriage certificate - If you are electing a joint and survivor option form of pension you must submit a copy of your marriage certificate You must be legally married before retirement and be married for at least 12 months before your death in order for your spouse to receive benefits The 12 month period can be a combination of months before and after retirement
(e) Notice The Fund Office will provide each participant who is married at the time of retirement at least 30 days and no more than 180 days before the annuity starting date with a written explanation of the following
1 the terms and conditions of the Qualified jOint and 50 survivor annuity
2 the PartiCipants right to make and the effect of an election to waive the qualified joint and 50 survivor annuity
3 the rights of a Participants Spouse 4 the right to make and the effect of a
revocation of a previous election to waive the Qualified Joint and 50 Survivor Annuity
5 the relative values of the various optional forms of benefit under the Plan and
6 the right to defer any distribution and the consequences of failing to defer distribution of benefits including a description of how much larger benefits wi II be jf the commencement of distributions is deferred
ADDITIONAL QUESTIONS
Where Can I Find Answers To Questions Not Usted In This Booklet
All questions regarding the pension plan should be directed to
Pipeline Industry Pension Fund P O Box 470950 Tulsa Oklahoma 74147-0950 918280-4800
How Long Is My Pension Payable
The Fund pays benefits on the first of each month for the month If you are alive on the first day of the month you are entitled to payment for the entire month If you do not work in the pipeline industry after your pension starts your benefit will be payable each month as long as you live
If you elected and are receiving a joint and survivor pension and predecease your spouse your spouse will receive the designated monthly survivor amount for life
If you elected a normal retirement benefit with a guaranteed period option and you die before the end of the designated period your beneficiary will receive monthly payments for the remainder of the guaranteed period
May I Change My Form Of Retirement
You may change your form of benefit before your annuity starting date but once your pension benefit has begun you may not change to another form of benefit
What Happens If I Return To Work
A RETIREMENT WITH AN IN-SERVICE DISTRIBUTION
In order to be deemed a Retired PartiCipant the PartiCipant must formally complete the retirement process including
a) cessation of work b) application for benefits c) approval of penSion and d) commencement of retirement benefits from
this Fund
The PartiCipant must remain retired for a period of at least one calendar month during which he cannot work in Employment described in the definitions
Should a Participant fail to meet the retirement requirements set forth above he shall remain subject to the Suspension of Benefit rules and
17
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General Eligibility
APPEALS PROCEDURE
BENEFITS COVERAGE AND EXCLUSIONS FOR RETIRED PARTICIPANTS amp THEIR DEPENDENTS
CURRENT PENSION RATES
TABLE OF FACTORS FOR JOINT amp SURVIVOR OPTION
STATEMENT OF ERISA RIGHTS
PRIVACY NOTICE
PENSION BENEFIT GUARANTY CORPORATION
THE PENSION PROTECTION ACT (PPA)
19
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General EIIgibitlty
Appeals Procedure
Whenever an applicant is notified that the application for pension benefits has been denied in whole or in part the notice will include in plain and concise language
(a) The specific reasons for the denial including identification of all pertinent provisions of the pension plan or trust that underlie the denial and
(b) A description of any material or information deemed necessary for the applicant to perfect the claim for a benefit together with an explanation for the necessity
Pension Appeal Procedure
A Claims for Benefits Claims for benefits under the Plan must be filed in writing on forms provided by the Plan Claimants for benefits will furnish at the request of the Plan any information or proof reasonably required to determine his rights to benefits
B Notice of Disposition The Plan will furnish written notice of the disposition of a claim other than a claim for Disability Benefits within a reasonable time period but no more than 90 days after the application is filed with the Plan or 45 days after receipt of a claim for a Disability Benefit for which disability is not established by submission of a Social Security Administration disability benefits award without regard to whether all the information necessary to make a benefit determination accompanies the filing
C Extension of Time for Review For claims other than Disability Benefits Claims the Plan may take an additional 90 days to review the claim if it determines that special circumstances require an extension of time for processing the claim If an extension is required written notice of the extension will be furnished to the claimant before the end of the initial 9Qday period and will indicate the speCial circumstances requiring the extension of time and the date by which the Plan expects to render a benefit determination
For Disability Benefits Claims the Plan may take an additional 30 days to review the claim if it determines that it is unable for reasons beyond its control to make a decision within the initial time period and it notifies the claimant before expiration of the initial time period of the
circumstances requiring the extension the date by which a final decision is expected to be rendered the standards on which entitlement to the benefit is based the unresolved issues that prevent a decision on the claim and the additional information necessary to resolve those issues The Plan may take a second 30-day extension to render a Disability Benefits Claim if it determines before expiration of the first 30shyday extenSion that a further extension is necessary because a decision cannot be rendered within the first extension period due to reasons beyond the Plans control If a second extension is necessary notice of the second extension will be sent to the claimant before the end of the first 30-day extension period in a form that satisfies the notice requirements applicable to the first extension notice
For any extension involving a Disability Benefits Claim where unresolved issues prevent a decision on the claim and additional information is needed to resolve the issue the claimant will be given at least 45 days from receipt of the extension notice in which to provide the specified information If the extension is due to the claimants failure to submit information necessary to decide the claim the time period for making the benefit determination on the Disability Benefits Claim will be suspended from the date of notification to the claimant until the earlier of the date on which a response from the claimant is received by the Plan or the date established by the Plan for furnishing the requested information (at least 45 days)
D Denial of Claims In the event the claim is denied in whole or in part the reasons for the denial will be set forth specifically in writing citing pertinent Plan references on which the determination is based explaining in a manner calculated to be understood by the claimant why the claim was denied and describing any additional material or information needed to perfect the claim and why the additional information is needed The Plan will provide the claimant with a copy of the Plans review procedure and a statement of the claimants right to bring a civil action under ERISA Section 502(a) if benefits are denied after review With regard to a Disability Benefits claim if an internal rule guideline protocol or Similar criterion is relied upon in making the determination the explanation to the claimant will include either the specific rule guideline protocol or criterion or a statement that it was relied upon and that a copy will be provided free
20
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General EligIbility
of charge upon request and if the determination is based on medical necessity or experimental treatment or a similar exclusion or limit the Plan will provide either an explanation of the scientific or clinical judgment applying the Plan to the claimants medical circumstances or a statement that it will be provided free of charge upon request
E Aooeal of Denial If the claim is denied in whole or part the claimant may appeal the determination in accordance with the following review procedure and have his claim reviewed If the claimant wishes to appeal the denial of his claim he must provide a written statement stating the basis for his appeal no later than 60 days or 180 days for a Disability Benefits Claim after the claimant receives notice of the denial of his claim If a timely written request for review is not made the initial decision on the claim will be final If a timely written request for review is made the claimant may submit written comments documents records and other information relating to the claim The claimant may also obtain upon request and free of charge reasonable access to and copies of all documents records and other information relevant to his claim and for a Disability Benefits Claim identification of any medical or vocational experts whose advice was obtained by the Plan A document record or other information relevant to the claim if (1) it was either relied upon in making the determination or was submitted considered or generated in the course of making the determination or (2) it relates to administrative processes and safeguards used to ensure and verify that claim determinations are consistent with the Plan and consistently applied with respect to similarly situated claimants or (3) in the case of a Disability Benefits Claim it is the statement of Plan policy or guidance concerning the denied benefit without regard to whether it was relied upon With regard to a Disability Benefits Claim no deference will be given to the initial determination If the initial determination is based in whole or part on medical judgment the Trustees will consult with a health care professional with appropriate medical training and experience who was not consulted in connection with the initial determination and who is not a subordinate of any individual who was consulted
F Decision on Appeal The Trustees will schedule a full and fair review of the issue and render a decision no later than the next scheduled meeting of the Board of Trustees
following receipt of the request for appeal unless the request is served within 30 days preceding the date of the next meeting In that case the decision will be rendered no later than the date of the second meeting following receipt of the request for appeal If special circumstances require a further extension of time for processing a decision will be rendered not later than the third meeting of the Board of Trustees following receipt of the request for review If an extension of time is required written notice of the extension will be furnished to the claimant prior to the extension describing the special circumstances and the date the determination will be made The decision following the review will be communicated in writing to the claimant no later than 5 days after the determination is made The decision on review will be written in a manner calculated to be understood by the claimant and will set forth the following information
1 The specific reasons for the decision on review
2 A reference to the specific Plan provisions on which the determination is based
3 A statement that the claimant is entitled to receive upon request and free of charge reasonable access to and copies of all documents records and other information relevant to the claim (as described above) and a statement of the claimants right to bring an action under ERISA Section 502(a) and
4 For a Disability Benefits Claim any internal rule guideline protocol or other similar criterion that was relied upon in making the determination or a statement that it was relied upon and that a copy will be provided free of charge upon request
A decision on review of any claim made under the Plan will be final and binding
G Limitation on Court Actions In no event may legal action be brought by or on behalf of any Participant or Beneficiary to recover benefits under the Plan unless the PartiCipant Beneficiary or his legal representative has first fully complied with and timely exhausted all of the requirements claims filing and claims review procedures under the Plan Any suit brought to contest or set aside a decision of the Plan must be brought in a court of competent jurisdiction within one year from the date of receiving notice of the Trustees decision on appeal
21
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General Eligibility
Amendment of Plan
The Pipeline Industry Pension Fund Board of Trustees intends to continue this pension plan indefinitely however it reserves the right to review this Plan at any future date and amend the Plan by written instrument and majority action or to terminate the Plan However no amendment can divert any part of the Plans trust fund for a purpose other than for the exclusive benefit of participants and beneficiaries Nor will the Trustees terminate or amend the Plan so as to affect a participants right to any benefit to which he or she had already become entitled at the time of the amendment other than upon the advice of a qualified actuary and after giving of any required notices under ERISA and as described in Section 4129(c)(8) of the Internal Revenue Code
-22
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General Eligibility
CURRENT PENSION RATES 7-1-1990 to Current
JOURNEYMEN The journeymen pension rate is calculated at the rate in effect as listed below
Retirement Journeymen Maximum Date Rate Pension
70190 $4400 $110000 70191 $4700 $117500 10194 $5100 $127500 10195 $5400 $135000 10195 $5700 $142500 10196 $6000 $150000 10197 $6400 $160000 10198 $6600 $165000 10199 $7000 $210000 10100 $7200 $216000 10101 $7500 $225000 10103 $7500 Unlimited 10109 $10000 Unlimited 10110 $11300 Unlimited 10111 $11300 Unlimited
Proportionate allowance is made for months Effective 10199 the maximum pension benefit is based on 30 years Prior to 10199 the maximum pension benefit was based on 25 years Effective 10103 the maximum pension benefit is unlimited
HELPERS The helpers pension rate is calculated at the rate in effect as listed below
Retirement Helper Maximum Date Rate Pension
70190 $1900 $47500 70191 $2200 $55000 10194 $2600 $65000 10195 $2900 $72500 10195 $3200 $80000 10196 $3500 $87500 10197 $3900 $97500 10198 $4100 $102500 10199 $4500 $135000 10900 $4700 $141000 10101 $5000 $150000 10103 $5000 Unlimited 10109 $6700 Unlimited 10110 $7600 Unlimited 10111 $7600 Unlimited
-
23
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
General Eligibility
Retired participants were granted a 5 raise (maximum of $5000) in pension benefits each time the rate of credited service was increased from July 1 1985 through January 1 1997
Retired participants were granted a 3 raise (maximum of $3000) effective January 1 1998
Retired partiCipants were granted a 6 raise (maximum of $6000) effective January 1 1999
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 1 2000
Retired partiCipants were granted a 4 raise (maximum of $4000) effective January 12001
Retired partiCipants in pay status on 12012001 were granted a 13th pension check on December 14 2001
Retired participants in pay status on 12312008 were granted a 13th pension check on December 15 2009
Retired partiCipants in pay status on 12312008 were granted a 10 raise (maximum $20000) effective January 1 2010
Retired participants in pay status on 12312009 were granted a 13th pension check equal to 10 of their monthly benefit not less than $30000 on December 15 2010
Retired participants on 12312009 were granted a 7 raise (maximum $20000) effective January 1 2011
Active Participants
Effective January 12003 the maximum pension benefit will not be limited to 30 years Active partiCipants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning each January 1 after the date of retirement All years earned up to 30 years before January 1 2003 and all years earned exceeding thirty years after December 31 2002 will be combined and included in the retirement calculation at the date of retirement
Retired Participants
Effective January 1 2003 the maximum pension benefit will not be limited to 30 years Retired participants who have earned more than 30 years of service prior to January 1 2003 will have those years exceeding 30 years added to their pension one year at a time beginning on January 1 2004 and then each January 1 thereafter Years earned after December 31 2002 will be calculated the following year under the option chosen at the date of retirement added to the retirees pension in the year after the credit was earned
24
General Eligibility
PENSION RATES
Yearly Table to 40 years (Unlimited Years)
Number Helper Journeymen
of Years 2003-2008 2009 Current 2003-2008 2009 Current
1 $ 5000 $ 6700 $ 7600 $ 7500 $ 10000 $ 11300 2 $ 10000 $ 13400 $ 15200 $ 15000 $ 20000 $ 22600 3 $ 15000 $ 20100 $ 22800 $ 22500 $ 30000 $ 33900 4 $ 20000 $ 26800 $ 30400 $ 30000 $ 40000 $ 45200 5 $ 25000 $ 33500 $ 38000 $ 37500 $ 50000 $ 56500 6 $ 30000 $ 40200 $ 45600 $ 45000 $ 60000 $ 67800 7 $ 35000 $ 46900 $ 53200 $ 52500 $ 70000 $ 79100 8 $ 40000 $ 53600 $ 60800 $ 60000 $ 80000 $ 90400 9 $ 45000 $ 60300 $ 68400 $ 67500 $ 90000 $ 101700 10 $ 50000 $ 67000 $ 76000 $ 75000 $ 100000 $ 113000 11 $ 55000 $ 73700 $ 83600 $ 82500 $ 110000 $ 124300 12 $ 60000 $ 80400 $ 91200 $ 90000 $ 120000 $ 135600 13 $ 65000 $ 87100 $ 98800 $ 97500 $ 130000 $ 146900 14 $ 70000 $ 93800 $ 106400 $ 105000 $ 140000 $ 158200 15 $ 75000 $ 100500 $ 114000 $ 112500 $ 150000 $ 169500 16 $ 80000 $ 107200 $ 121600 $ 120000 $ 160000 $ 180800 17 $ 85000 $ 113900 $ 129200 $ 127500 $ 170000 $ 192100 18 $ 90000 $ 120600 $ 136800 $ 135000 $ 180000 $ 203400 19 $ 95000 $ 127300 $ 144400 $ 142500 $ 190000 $ 214700 20 $ 100000 $ 134000 $ 152000 $ 150000 $ 200000 $ 226000 21 $ 105000 $ 140700 $ 159600 $ 157500 $ 210000 $ 237300 22 $ 110000 $ 147400 $ 167200 $ 165000 $ 220000 $ 248600 23 $ 115000 $ 154100 $ 174800 $ 172500 $ 230000 $ 259900 24 $ 120000 $ 160800 $ 182400 $ 180000 $ 240000 $ 271200 25 $ 125000 $ 167500 $ 190000 $ 187500 $ 250000 $ 282500 26 $ 130000 $ 174200 $ 197600 $ 195000 $ 260000 $ 293800 27 $ 135000 $ 180900 $ 205200 $ 202500 $ 270000 $ 305100 28 $ 140000 $ 187600 $ 212800 $ 210000 $ 280000 $ 316400 29 $ 145000 $ 194300 $ 220400 $ 217500 $ 290000 $ 327700 30 $ 150000 $ 201000 $ 228000 $ 225000 $ 300000 $ 339000 31 $ 155000 $ 207700 $ 235600 $ 232500 $ 310000 $ 350300 32 $ 160000 $ 214400 $ 243200 $ 240000 $ 320000 $ 361600 33 $ 165000 $ 221100 $ 250800 $ 247500 $ 330000 $ 372900 34 $ 170000 $ 227800 $ 258400 $ 255000 $ 340000 $ 384200 35 $ 175000 $ 234500 $ 266000 $ 262500 $ 350000 $ 395500 36 $ 180000 $ 241200 $ 273600 $ 270000 $ 360000 $ 406800 37 $ 185000 $ 247900 $ 281200 $ 277500 $ 370000 $ 418100 38 $ 190000 $ 254600 $ 288800 $ 285000 $ 380000 $ 429400 39 $ 195000 $ 261300 $ 296400 $ 292500 $ 390000 $ 440700 40 $ 200000 $ 268000 $ 304000 $ 300000 $ 400000 $ 452000
__---shy
25
General EligIbility
PARTIAL TABLE OF FACTORS FOR JOINT and 50 SURVIVOR OPTION NORMAL FORM - LIFE ANNUITY
RETIREMENT AGE OF PARTICIPANT
AGE OF SPOUSE 55 56 57 58 59 60 61 62 63 64 65 66 67 68
40 88 87 86 85 84 83 82 81 80 79 77 76 75 74 41 88 87 86 85 84 83 82 81 80 79 77 76 75 74 42 88 87 86 85 84 84 82 81 80 79 78 77 76 74 43 88 87 87 86 85 84 83 82 81 79 78 77 76 75 44 88 88 87 86 85 84 83 82 81 80 79 77 76 75
45 89 88 87 86 85 84 83 82 81 80 79 78 76 75 46 89 88 87 87 86 85 84 83 82 80 79 78 77 75 47 89 88 88 87 86 85 84 83 82 81 80 78 77 76 48 90 89 88 87 86 85 84 83 82 81 80 79 77 76 49 90 89 88 87 87 86 85 84 83 81 80 79 78 77
50 90 89 89 88 87 86 85 84 83 82 81 79 78 77 51 90 90 89 88 87 86 85 84 83 82 81 80 79 77 52 91 90 89 88 88 87 86 85 84 83 81 80 79 78 53 91 90 90 89 88 87 86 85 84 83 82 81 80 78 54 91 91 90 89 88 87 86 86 84 82 81 80 79 77
55 92 91 90 89 89 88 87 86 85 84 83 82 80 79 56 92 91 91 90 89 88 87 86 85 84 83 82 81 80 57 92 92 91 90 89 89 88 87 86 85 84 83 81 80 58 92 92 91 90 90 89 88 87 86 85 84 83 82 81 59 93 92 92 91 90 89 88 88 87 86 85 84 82 81
60 93 93 92 91 90 90 89 88 87 86 85 84 83 82 61 93 93 92 92 91 90 89 88 88 87 86 85 84 82 62 94 93 92 92 91 90 89 88 88 87 86 85 84 83 63 94 93 93 92 92 91 90 89 89 88 87 86 85 84 64 94 94 93 93 92 91 91 90 89 88 87 86 85 84
65 95 94 94 93 92 92 91 90 89 89 88 87 86 85 66 95 94 94 93 93 92 91 91 90 89 88 87 86 85 67 95 95 94 94 93 93 92 91 90 90 89 88 87 86 68 95 95 95 94 94 93 92 92 91 90 89 88 87 86 69 96 95 95 94 94 93 93 92 91 91 90 89 88 87
Note This table is an illustration of the joint and 50 survivor option Tables for the joint and 75 survivor option and joint and 100 survivor options are available for inspection - as well as other tables
26
General Eligibility
STATEMENT OF ERISA RIGHTS
As a participant in the Pipeline Industry Pension Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) ERISA provides that all plan participants shall be entitled to
1 Examine without charge at the plan Directors office and at other locations (work sites and union halls) all plan documents including insurance contracts collective bargaining and participation agreements periodic actuarial reports applications filed with the Secretary of Treasury requesting an extension under 304 of the Act or Section 431(d) of the Code copies of all documents filed with the U S Department of Labor such as annual reports (5500) and plan descriptions and a list of contributing employers
2 Obtain copies of all plan documents and other plan information upon written request to the plan Director The Director may make a reasonable charge for the copies
3 Receive a summary of the plans quarterly semi-annually or annual financial report The plan Director is required by law to furnish each participant with a copy of the report called the Annual Funding Notice
4 Obtain a statement telling you whether you have a right to receive a pension at normal retirement age and if so what your benefits would be at normal retirement age if you stop working under the Plan now If you do not have a right to a penSion the statement will tell you how many more years you must work in order to qualify for a pension This statement must be requested in writing and is not required to be given more than once every twelve months The Plan must provide the statement free of charge
5 File suit in federal court if any materials requested are not received within 30 days of your request unless the materials are not sent because of matters beyond the control of the Director The court may require the Plan Director to pay a fine for each days delay until the materials are received
In addition to creating rights for the plan participants ERISA imposes obligations upon the persons who are responsible for the operation of
the employee benefit program These persons are referred to as fiduciaries in the law
Fiduciaries are under a duty to act solely in the interest of the plan participants and they must exercise prudence in the performance of their plan duties Fiduciaries who violate the provisions of ERISA may be removed and required to make good any losses they have caused the plan
No one inCluding your employer your union or any other person may discriminate against you or may take action which will prevent you from obtaining a benefit to which you are entitled or exercising your rights under ERISA
If you have a claim for benefits which is denied in full or in part or is ignored you have a right to know why this was done to obtain copies of documents related to the decision without charge and to appeal any denial all within a certain time schedule
Under ERISA there are steps you can take to enforce the above rights For instance if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days you may file suit in federal court In such a case the court may require the Plan administrator to provide the materials and pay you up to $110 a day until you receive the materials unless the materials were not sent because of reasons beyond the control of the administrator If you have a claim for benefits which is denied or ignored in whole or in part you may file suit in a federal or state court but only after you have appealed to the Board of Trustees under the procedures specified in the claims appeal procedure If the plan fiduciaries are misusing the plans money you have a right to file a suit in a federal court or to request assistance from the U S Department of Labor If you are discriminated against for asserting your rights you may seek assistance from the U S Department of Labor or you may file suit in a federal court If you are successfUl in your lawsuit the court may if it so decides require the other party to pay your legal costs including attorneys fees If you are unsuccessful in your lawsuit the court may order you to pay the costs and fees of the Fund as well as your own if for example the court decides that your claim is frivolous or has no merit
General Eligibility
You have the right to inquire of the Fund Office information as to whether a particular employer or employee organization is covered by the collective bargaining agreement or is a particishypant in this pension plan
If you have any questions concerning your rights and responsibilities under ERISA you should contact the Plan administrator or the nearest area office of the Employee Benefits Security Administration (EBSA) U S Department of Labor listed in your telephone directory or the Division of Technical Assistance and Inquiries EBSA U S Department of Labor 200 Constitution Avenue NW Washington DC 20210 You may also obtain certain publications about your rights and responsibilities under EERISA by calling EBSAs hotline
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Your pension benefits under this multi-employer plan are insured by the Pension Benefit Guaranty Corporation (PBGC) a federal insurance agency A multi-employer plan is a collectively bargained pension arrangement involving two or more unrelated employers usually in a common industry Under the multi-employer plan program the PBGC provides financial assistance through loans to plans that are insolvent A multi-employer plan is considered insolvent if the plan is unable to pay benefits (at least equal to the PBGCs guaranteed benefit limit) when due
The maximum benefit that the PBGC guarantees is set by law Under the multi-employer program the PBGC guarantee equals a partiCipants years of service multiplied by (1) 100 of the first $11 of the monthly benefit accrual rate and (2) 75 of the next $33 The PBGCs maximum guarantee limit is $3575 per month times a participants years of service For example the maximum annual guarantee for a retiree with 30 years of service would be $12870 If the Plan terminates without enough money to pay all benefits or if the Plan becomes insolvent the PBG will step in to pay pension benefits subject to limitations established by law for example there is a ceiling on the amount of monthly benefits that the PBGC guarantees
The PBGC guarantee generally covers normal and early retirement benefits that are vested disability benefits if you become disabled before
the Plan terminates and certain survivor benefits
The PBGC guarantee generally does not cover benefits greater than the maximum guaranteed amount set by law benefit increases and new benefits that have been in place for fewer than five years from the earlier of the date the Plan terminates or becomes insolvent benefits that are not vested because you have not worked long enough benefits for which you have not met all of the requirements at the time the Plan terminates or becomes insolvent and certain non-pension benefits
For more information about the PBGC and the benefits it guarantees ask your Plan Administrator or contact the PBGCs Technical Assistance Division 1200 K Street NW Suite 930 Washington DC 20005-4026 or call 202shy326-4000 (not a toll-free number) TTYTDD users may call the federal relay service toll-free at 1-80Q877-8339 and ask to be connected to 202-3264000 Additional information about the PBGCs pension insurance program is available through the PBGCs web site on the Internet at httpwwwpbgcgov
THE PENSION PROTECTION ACT (PPA)
The PenSion Protection Act of 2006 (PPA) added requirements for measuring the financial health of multiemployer plans such as ours Starting with the 2008 plan year the PPA requires that a Pension Funds actuary annually determine the Funds status under these new rules and certify that status to the IRS and to the Trustees If the actuary determines that the Fund is in endangered status (known as the yellow zonen
) or critical status (known as the red zonen
) the Trustees must notify all Plan participants and the bargaining parties and take corrective action to restore the financial health of the Plan
28
General Definitions
29
General Eligibility
GENERAL DEFINITIONS
Accrued Benefit Accrued Benefit means a monthly benefit beginning at Normal Retirement Age that has been earned by a Participant based on the Service Credits he accrued by working for an Employer according to the benefit formula described in Article IV Section 401 of the Pipeline Industry Pension Trust Fund Plan Document
Act-ERlSA Act or ERISA means the Employee Retirement Income Security Act of 1974 any amendments as may from time to time be made and any regulations promulgated pursuant to the provisions of said Act
Actuarial Equivalent Actuarial Equivalent means a benefit having the same value as the benefit for which it is substituted based upon the actuarial assumption and methods which are upon recommendation of a qualified actuary adopted by the Trustees
The factors for use in converting from a normal form of benefits to a Joint and 50 Survivor Option a Joint and 75 Survivor Option a Joint and 100 Survivor Option or a Ten Year Guaranteed Period Option shall be 65 compound annual rate of interest and the UPshy1984 mortality table In the event that it is required to pay the commuted value of the remaining payments of a period certain annuity in a lump sum to an estate the remaining payments shall be discounted using 65 compound annual rate of interest
The determination of the amount of a single sum cash out (other than a commuted value of remaining payments as described above) paid prior to January 1 2000 shall be based upon the Unisex Pension 1984 (UP-84) mortality table and the immediate and deferred interest rates in effect at the beginning of the Plan Year containing the date of distribution as published by the Pension Benefit Guaranty Corporation (PBGC) for use in determining the present value of a lump sum distribution The determination of the amount of a single sum cash out (other than a commuted value of
remaining payments as described above) paid on or after January 1 2000 shall be based upon the Commissioners Standard Table and an interest rate equal to the annual rate of interest on 30shyyear Treasury securities for the month before the first day of the Plan Year containing the date of distribution
Alternate Payee Alternate Payee means any spouse former spouse child or other dependent of a Participant who is recognized by a Qualified Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to the Participant
Annuity StartlllJl Date Annuity Starting Date except in the case of a Disability Benefit means the first day of the first calendar month after the later of a Thirty days after the Employee has fulfilled all of the conditions for entitlement to benefits and submitted a completed application for benefits or
b Thirty days after the Director advises the Employee of the availability of his benefit payment options (or eight days if the Employee with Spousal consent waives the thirty day period) and after the Employee has fulfilled the conditions for entitlement to benefits
Notwithstanding any other provision of the Plan to the contrary the Annuity Starting Date shall not be later than the Employees Required Beginning Date The definition of Annuity Starting Date for a Spouse Beneficiary or Alternate Payee shall be the same as it is for the Employee
BargaIned Employee Bargained Employee means a PartiCipant whose participation is covered by a Collective Bargaining Agreement
Beneficiary BenefiCiary means a person designated by a Participant or a Retiree to receive a benefit under the terms of this Plan To be valid the designation must be in writing and filed with the Trustees If no valid deSignation of a living person is in effect on the PartiCipants date of death the Beneficiary shall be the Surviving
30
General EligIbility
Spouse or if there is no Surviving Spouse the estate of the ParticipantRetiree
Board of Trustees Board of Trustees means the Trustees designated by the Trust Agreement and their duly appointed successors
CodeorlRC Code or IRC means the Internal Revenue Code of 1986 as amended from time to time any valid regulation promulgated thereunder and any comparable provision of future legislation that amends supplements or supercedes such provision
Collective Bargaining Agreement Collective Bargaining Agreement means a current written collective bargaining agreement between an Employer or an association of which the Employer is a member or by whose actions the Employer agrees to be bound and the Union which written agreement requires contributions to the Pension Trust or any written agreement covering certain employment entered into in lieu thereof between the Employer and either the Trustees or the Union
Contiguous Non-Covered Service Contiguous Non-Covered Service means service with an Employer which is not covered by the applicable Collective Bargaining Agreement or other approved written agreement Periods of Contiguous Non-Covered Service will be considered in the same manner as Covered Service for vesting purposes provided that the periods of Contiguous Non-Covered Service immediately precede or immediately follow Covered Service for the same employer and provided further that there is no intervening quit discharge or retirement between the NonshyCovered and Covered Service Contiguous NonshyCovered Service will not constitute Credited Service for pension credit and shall be used only in determining the length of service for vesting under the Plan for all employment subsequent to January 11976
Contribution Period Contribution Period means the twelve (12) month period beginning each January 1 and ending the following December 31
Covered Service a Covered Service or Covered Employment means service for which an Employer is required to make contributions to the Pension Fund on behalf of an Employee pursuant to the terms of a National Agreement or other participating agreement
b Military Service in the Armed Forces of the United States provided the service does not exceed four (4) years prior to December 13 1994 or five (5) years after December 13 1994 and the partiCipant returns to work in covered employment or can show proof in a form acceptable to the Trustees that the participant made reasonable efforts to obtain work in covered employment (including covered employment under a reciprocal agreement) within ninety (gO) days of discharge from Military Service
Credited Service Credited service is the basis by which benefits are calculated If you have at least 400 hours of contributions in a calendar year you will be credited with one month of service for each complete 100 hours up to a full year of credit which is 1200 hours
Director The person appointed by the Trustees whose duties consist of ministerial duties as outlined in the PIPF plan document
Earliest Retirement Age Earliest Retirement Age means the earliest age on which a Participant could elect to receive Early or Normal Pension under the Plan
Effective Date Effective Date subject to the provisions of the Preamble means January 12002 the date that the provisions of the amended and restated Pension Plan became effective and cover all instances in which a Participant retires on or after that date
Employee Employee means any member of a Signatory Union employed by an Employer and all other journeymen pipefitters welders andor welder helpers engaged in the construction of mainline pipelines as defined in the National Pipeline
31
General EUgibJllty
Agreement who is employed by an Employer who is obligated to make or who does make contributions to the Pension Fund under and by virtue of the Collective Bargaining Agreement with the Union or with the Trustees or otherwise voluntarily contributes to such Pension Fund
Employee also means all employees of the Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the United Associations International Representative presently assigned as Director of Pipeline and Gas Distribution the employees of the National Pipeline Welding School andor Local 798 Training Center all employees of the 401middotK program managed by the Trustees and all United Association local unions having jurisdiction in mainline pipeline construction who meet the Service requirements
Employer The term Employer means
a Each of the members of the Pipeline Contractors Association which is Signatory to the National Pipeline Agreements and
b A contractor who is not a member of the Association but who has or will have entered into a Collective Bargaining Agreement with the Union or with any of its affiliated local unions concerning wages fringe benefits hours of work andor conditions of employment in the jurisdiction of work contained in the current National Pipeline Agreement between the Union and the Association and
c A contractor who does not have a written Collective Bargaining Agreement with the Union but adheres to and abides by the contract terms of the National Pipeline Agreement existing between the Association and the Union governing wages fringe benefits hours or work andor conditions of employment and who make contributions for his employees to this Pension Fund and
d The Pipeline Industry Benefit Fund the Pipeline Industry Pension Fund the National Pipeline Welding School andor Local 798 Training Center the 401-K program managed by the Trustees and all United Association local unions having jurisdiction over mainline pipeline construction as described in the National
Pipeline Agreement which do not have already in existence a pension plan for the sole purpose of making required contributions to the Pipeline Industry Pension Trust Fund will be considered as Employers within the definition of this Section
Fiduciary Fiduciary means a person who
a Is a Trustee and as such is named fiduciary or
b Exercises any discretionary authority or discretionary control respecting management of this Plan or exercises any authority or control respecting management or disposition of its assets or
c Renders investment advice for a fee or other compensation direct or indirect with respect to any moneys or other property of this Plan or has any authority or responsibility to do so or
d Has any discretionary authority or discretionary responsibility in the administration of this Plan
Gender and Number Wherever applicable the masculine pronoun as used in this Summary Plan Description includes the feminine pronoun and the singular includes the plural
Helper Helper means a person who is defined as a Helper andor Apprentice in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Hour ofService Hour of Service or Hours of Service means
a Each hour for which an Employee is paid or entitled to payment for the performance of Covered Service or Contiguous Non-Covered Service for an Employer
b Each hour for which the Employee is paid or entitled to payment by an Employer on account of a period of time which is continuous with a period of Covered Service or Contiguous NonshyCovered Service and during which no duties are
32
General Eligibility
performed (irrespective of whether the employment relationship has terminated) due to vacation holiday illness incapacity (including disability) layoff jury duty or leave of absence However no more than 400 Hours of Service will be credited under this paragraph to the Employee on account of any single continuous period during which the Employee performs no duties whether or not such period occurs in a single year Hours of Service will not be credited under this paragraph with respect to payments under a plan maintained solely for the purpose of complying with applicable workmens compenshysation unemployment compensation or disability insurance laws or with respect to a payment which solely reimburses the individual for medical or medically related expenses incurred by the Employee
c Each hour for which back pay irrespective of mitigation of damages is either awarded or agreed to by an Employer with respect to a period during which an Employee would otherwise have been employed in Covered Service or Contiguous Non-Covered Service
d Each hour for which an Employee is awarded Covered Service for qualified Military Service in accordance with Plan provisions or as prescribed by the Uniformed Services Employment and Re-employment Rights Act of 1994
Hours of Service under this Section will be calculated and credited in accordance with regulations issued by the Secretary of Labor
HoulS of ContributIons Hours of Contributions means the number of hours for which contributions are made to the Pension Fund on behalf of an Employee by an Employer under the rules established by the Board of Trustees and uniformly applied to all Employees in similar circumstances
Journeyman Journeyman means a person who is defined as a Journeyman in the Constitution and By-Laws of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
National Agreement National Agreement means the National Pipeline Agreement between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Non-Vested Employee Non-Vested Employee with respect to a bargaining unit Employee (one who is represented in collective bargaining by either a participating local Union or Association) means a PartiCipant who has earned less than ten (10) Years of Service and with respect to a nonshybargaining unit Employee (one who is NOT represented in collective bargaining by either a participating local Union or Association) means a Participant who has earned less than five (5) Years of Service However effective January 1 1999 the term Non-Vested Employee means an Employee who has earned less than five (5) Years of Service
NonnalReU~mentAge
Normal Retirement Age means the later of 1) the Participants sixty-fifth (65th) birthday or 2) the fifth (5th) anniversary of the date on which a Participant first commences participating under the Plan
Nonnal Retl~ment Date Normal Retirement Date means the date a Participant attains his Normal Retirement Age
PartIcipant Participant means an Employee partiCipating in the Plan in accordance with the provisions of Article I of the Pension Plan
PensIon Fund Pension Fund means the trust estate of the Pipeline Industry Pension Trust Fund as defined in Article IX Section 19 of the Trust Agreement
Pension Plan Pension Plan means the Pipeline Industry Pension Plan as described in this instrument and the same as from time to time amended
33
General Eligibility
PlPF An abbreviation which refers to the Pipeline Industry Pension Fund
Plan Year Plan Year means the twelve (12) consecutive month period beginning January 1 of each year and ending December 31 of the same year
Pop-up ProvisIon Allows Joint and Survivor pension benefit amounts to adjust to the normal amount in the retirement option chosen should the spouse preshydecease the participant
Qualified Domestic Relations Order (QDRO) Qualified Domestic Relations Order or QDRO means an order issued by a court of competent jurisdiction over domestic relations matters and satisfying the requirements of Section 414(p) of the Code that creates or recognizes the existence of an Alternate Payees right to or assigns to an Alternate Payee the right to receive all or a portion of the benefits payable to or with respect to a Participant under the Plan
As used in this Section an Alternate Payee means any spouse former spouse child or other dependent of a Participant or former Participant who is recognized by a Domestic Relations Order as having a right to receive all or a portion of the benefits payable under the Plan with respect to a Participant or former Participant
Service Year A service year is a year of service for eligibility purposes that means a calendar year during
which the employee at least earns 1200 hours of service
Spouse Spouse means the legal spouse of the Participant during the entire twelve (12) month period ending on the earlier of the PartiCipants date of death or the date of the Participant commences receiving a Pension Benefit except that if
a) a Participant marries within one (1) year before the Annuity Starting Date and
b) the Participant and the PartiCipants spouse in a marriage have been married for at least a 1shy
year period ending on or before the date of the partiCipants death the Participant and spouse will be treated as having been married throughout the 1-year period ending on the PartiCipants annuity starting date
Trust Agreement Trust Agreement means the Agreement and Declaration of Trust for the Pipeline Industry Pension Trust Fund initially executed September 1 1964 amended and restated on April 28 1965 and again amended and restated effective September 23 1975 between the Pipeline Contractors Association and the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Union Union means the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada and Local Union 798 of the United Association of Journeymen and Apprentices of the Plumbing and Pipefitting Industry of the United States and Canada
Vested Participant For an Employee who has earned at least one Hour of Service on or after January 1 1999 the term Vested Participant means a Participant who has earned at least five Years of Service Otherwise the term Vested Participant with respect to a Bargained Employee means a Participant who has earned at least ten (10) Years of Service and with respect to a non-Bargained Employee means a Participant who has earned at least five (5) Years of Service provided at least one (1) Hour of Service was earned on or after January 11999
Vesting Year A vesting year is the minimum number of hours of service which is 400 hours in any calendar year
-34
Pension Package
Example Forms
MESSAGE FROM THE DIRECTOR
EXAMPLE OF APPLICATION
RELATIVE VALUES OF OPTIONAL FORMS OF RETIREMENT PAYMENTS
EXPLANATION OF JOINT SURVIVOR
30-DAY ELECTION WAIVER
ALTERNATE PAYEE OR LIEN DISCLOSURE
ELECTION OR REJECTION OF LUMP SUM ROLLOVER amp CERTIFICATION
SPECIAL TAX NOTICE
AUTHORIZATION FOR AUTOMATIC DEPOSIT
RETIREE HampW PREMIUM NOTICE
ASSIGNMENT AND AUTHORIZATION REQUEST
COORDINATION OF BENEFITS FORM
35
I HEREBY APPLY FOR THE FOLLOWING 12 MONTH LUMP SUM PENSION BENEFIT OPTION 2 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $1564200
RETIREMENT AMT $130350 LUMP SUM ADJ -$10595 NET MONTHLY AMT $119755
TYPE OF ACTUARIAL MEMBERS SURVIVOR
RETIREMENT SELECTED FACTOR PENSION BENEFITS
1 a Early Retirement 10000 $119755 NONE 2 a Early Retirement with Joint amp50 Survivor Option 8659 $103694 $51847 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $97178 $72883 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $91432 $91432 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $110127 $110127 I have retained a copy of this application for my personal records
DATED -------- Sianature of Member (sianature reQuired)
I HEREBY APPLY FOR THE FOLLOWING 24 MONTH LUMP SUM PENSION BENEFIT OPTION 3 (If you choose this option please check selection before returning) LUMP SUM BENEFIT $3128400
RETIREMENT AMT $130350 LUMP SUM ADJ -$21190 NET MONTHLY AMT $109160
TYPE OF ACTUARIAL MEMBERS
RETIREMENT SELECTED FACTOR PENSION
1 a Early Retirement 10000 $109160 2 a Early Retirement with Joint amp50 Survivor Option 8659 $94520 3 a Early Retirement with Joint amp75 Survivor Option 8114700 $88580 4 a Early Retirement with Joint amp100 Survivor Option 7634900 $83343 5 a Early Retirement with Ten Year Guaranteed Period
Survivor Benefit Guaranteed through 11-31-2020 9196 $100384 I have retained a copy ofthis application for my personal records
DATED -------shy Signature of Member (signature required)
SURVIVOR
BENEFITS
NONE $47260 $66435 $83343
$100384
SPOUSES WAIVER OF BENEFIT RIGHTS (Must be signed by spouse and Notarized)
By signing this form I understand and acknowledge the pension choice my spouse has chosen Item 1 No beneficiary benefits to spouse after death of member - Item 2 thru 4 Widows benefit guaranteed to widow for hisher lifetime after death of member - Item 5 Spouse can be beneficiary but I understand the member can change the beneficiary at any time before hisher death I have read the enclosed notice and explanation of joint and survivor benefits
DATED STATE OF--------
COUNTY OF SS
Signature of Spouse (signature required)
Before me the undersigned a Notary Public in and for said County and State on this day of 20_ personally appeared Mr and Mrs to me known to be the identical persons who executed the within and foregoing instrument and acknowledged to me that they executed the same as free and voluntary act and deed for the uses and purposes therein set forth
Given under my hand and seal of office the day and year above written
My commission expires ________ PAGE 20F 2 Notary Public
Members Copy Pension Application Form
Copy of TEST - Pension Calculation Master 201 0
ATTENTION SPOUSE OF RETIREE APPLICANT Notice and Explanation of Joint and Survivor Benefits
Spousal Waiver Provisions On Application
1 What is a Qualified Joint and Survivor Annuity (QJSA)
Federal law requires the Pipeline Industry Pension Fund to pay retirement benefits in a special payment form unless your spouse chooses a different payment form and you agree to that choice This special payment form is often called a qualified joint and 50 survivor annuity or QJSA payment form The QJSA payment form gives your spouse a monthly retirement payment for the rest of his or her life This is often called an annuity Under the QJSA payment form after your spouse dies each month the plan will pay you 50 percent of the retirement benefit that was paid to your spouse The benefit paid to you after your spouse dies is often called a survivor annuity or a survivor benefit You will receive this survivor benefit for the rest of your life Alternatively your spouse can elect an optional survivor annuity that would pay you 75 or 100 of the retirement benefit that was paid to your spouse In each case the amount that would otherwise be paid to your spouse for his lifetime is reduced to provide a benefit to you for your lifetime after his death
Example
Pat Doe and Pats spouse Robin receive payments from the plan under the QJSA payment forms of retirement While he worked Pat earned 20 years of credited service before his retirement at age 60 in 2001 Therefore beginning after Pat retires Pat receives $124500 each month from the plan Pat then dies The plan will pay Robin $62250 a month for the rest of Robins life
2 How Can Your Spouse Change the Way Benefits Are Paid
If you and your spouse are married ata the time he retire your spouse and you will receive benefits from the plan in the special QJSA payment form required by federal law unless your spouse chooses a different payment form and you agree to the choice If you agree to change the way the plans retirement benefits are paid you give up your right to the special QJSA payments
3 Do You Have to Give Up Your Right to the QJSA Benefit
No your choice must be voluntary It is your personal decision whether you want to give up your right to the special QJSA or other optional survivor annuity payment form
4 What Other Benefit Forms Can My Spouse Choose
If you agree your spouse can choose to have the retirement benefits paid in a different form Other payment forms may give your spouse larger retirement benefits while he or she is alive but might not pay you any benefits after your spouse dies Or the other payment forms might pay a lump sum to your spouse and give you a smaller monthly benefit after your spouse dies Or the other payment forms might pay a different person who your spouse names as beneficiary to receive the remaining benefit The
plans optional forms are the Single Life Annuity the Joint and 50 75 or 100 Survivor Annuity the Ten Year Guaranteed Period option and the 12 or 24 month Lump Sum options
Example of Single Life Annuity Payment Form
If Pat and Robin Doe receive retirement benefits in the special QJSA payment form Pat would receive retirement benefits of $124500 each month from the plan until Pat dies and Robin would receive $ 62250 a month for the rest of Robins life However Pat and Robin Doe agree not to receive retirement benefits in the special QJSA payment form and decide instead to receive payments only during Pats life - a life annuity After Pat retires Pat will receive $150000 each month from the plan until Pats death Robin will not receive any payments from the plan after Pats death
Example of Partial Lump Sum Payment Form
Pat and Robin Doe agree not to receive the special QJSA payments and decide instead that Pat will receive a single payment equal to the value of 24 months of Pats accrued retirement benefits and will then receive an actuarially reduced joint and 50 survivor option Pat will receive a lump sum payment of $36000 and will receive a monthly benefit of $113500 When Pat dies Robin will receive monthly benefits in the amount of $56750 until her death
Example of Naming a Beneficiary Who Is Not the Spouse
If you agree your spouse can select the Ten Year Guaranteed Period option and can name someone other than yourself to receive the rest of the Guaranteed Period benefit from the plan after your spouse dies under the Ten Year Guaranteed Period option The person your spouse selects to receive the remaining benefit is called a beneficiary If you agree to let your spouse name someone else as the beneficiary for this benefit you will not receive any payments from the plan after your spouse dies If your spouse dies before the end of the 10-year period following his retirement his beneficiary will receive the rest of the payments for the remainder of the 10-year period and you will not receive a benefit
Pat and Robin Doe select the Ten Year Guaranteed Period option payment form Pat and Robin agree that if Pat dies before the end ofthe Ten Year Guaranteed Period the survivor benefit will be paid to Pat and Robins child Chris Pat receives $140130 each month for 8 years and then dies After Pat dies the plan will pay $140130 a month to Chris for 2 years and Robin will not receive a benefit
5 Can Your Spouse Make Future Changes If You Sign Your Waiver
No not unless you agree If you waive your rights to a QJSA benefit you agree that benefits under the plan will be paid in the form stated in your spouses pension application You also agree that the beneficiary named if other than yourself in the application will receive the rest of the Ten Year Guaranteed Period benefits from the plan after your spouse has died if he dies before the end of that period Your spouse cannot change the benefiCiary unless you agree to the change by signing a request of change
2
6 Can You Change Your Mind After You Sign Your Waiver
Once pension payments begin your decision is final You cannot change your waiver after you sign it unless you change before the members date of retirement and you notify the plan administrator before that date
7 What Happens to this Agreement If You Become Separated or Divorced
The plan is only required to pay benefits in the form of a OJSA or an optional survivor annuity if your spouse is married to you at the time of his retirement or if you have a special court order (which is called a qualified domestic relations order or a ODRO) that would give you rights to receive retirement benefits If you are thinking about separating or getting a divorce you should get legal advice on your rights to benefits from the plan
8 What Should You Know Before Signing A Waiver
This is a very important decision You should think very carefully about whether you want to waive your rights to a OJSA or optional survivor annuity Before signing a waiver be sure that you understand what retirement benefits you may get and what benefits you will no longer be able to receive
Your spouse should have received information on the types of retirement benefits available from the plan If you have not seen this information you should get it and read it before you sign this agreement For additional information you can contact the Fund Office at the following address or telephone number P O Box 470950 Tulsa Oklahoma 74147-0950 (918) 280-4800
9 Your Waiver
By Signing the Spouses Waiver Of Benefit Rights on the pension application you understand that you have the right to have the Pipeline Industry Pension Fund pay your spouses retirement benefits in the special OJSA payment form and you agree to give up that right You understand that by signing this waiver you may receive less than you would have received under the special OJSA payment form or you may receive nothing after your spouse dies depending on the payment form [or beneficiary] that your spouse chooses
You agree that your spouse can receive retirement benefits in the form he chooses You also agree to your spouses choice of benefiCiary who will receive the rest of the Ten Year Guaranteed Period after your spouse dies You understand that your spouse cannot choose a different form of retirement benefit except the OJSA or optional survivor annuity or a different benefiCiary unless you agree to the change
You understand that you do not have to sign this agreement You are signing this agreement voluntarily
You understand that if you do not sign this agreement then your spouse and you will receive payments from the plan in the special OJSA payment form
3
Dear Participant
Subject Relative Values of Optional Forms of Retirement Payments and the Consequences of Failing to Defer the Commencement of Benefits
This letter and the attached chart explain what Relative Value is how it affects the benefit payment options available under the Plan and how it can help you make a more informed decision about the form in which you receive payment of your retirement benefits
What is Relative Value
IRS regulations require pension plans such as ours to give retiring participants and their spouses a comparison of the relative values of the benefit payment options genemlly available under the plan The aim is to help you make an informed choice about the form in which you receive your retirement benefits
Relative value means the actuarial present value of each optional form of payment compared to the value of the Qualified Joint and Survivor Annuity (QJSA) or for unmarried people the Plans normal form of annuity payment the Single Life Annuity If the relative value of the optional form falls within IRS-prescribed parameters it may be described as approximately equal to the QJSA or normal form In the boxes next to the names of optional benefit forms on the chart that follows AE stands for approximately equal
How Am I Impacted
The attached chart shows the relative values of the benefit payment options that our Plan makes generally available to retiring participants As you can see most of them are approximately equal in value (indicated by AE) as a QJSA or normal form of annuity for a participant who is the same age as his or her spouse or beneficiary and who is retiring at age 55 60 65 or 70 However the relative value of the Partial Lump Sum Payment for a Married Participant retiring at age 70 is higher than the benchmark QJSA form of payment This conclusion is based on the valuation and reporting methodologies described in the IRS regulation which can be found at Treas Reg section 1417(a)(3)-1 Upon your written request we will give you a similar comparison based on your own age and estimated benefits and on any other payment forms for which you are eligible
1132010
How Are Relative Values Detennined
These relative values compare the actuarial values of the benefit payment options to the actuarial value ofthe QJSA fonn ofpayment (or the nonnal fonn of payment of a Single Life Annuity) Actuarial values of pension benefits are detennined using mortality and interest rate assumptions Mortality assumptions are based on standardized tables developed by actuarial organizations and life insurance companies These organizations analyze information about large groups ofpeople to project the rates at which groups of individuals at different ages are expected to die These statistical mortality projections are used to develop average life expectancies The interest rate assumption is an estimate of the likely investment earnings over time on the money put aside to pay the Plans benefits This is relevant in the detennination of actuarial value because investment earnings will provide some ofthe funds used to pay the retirement benefits
These values were calculated for comparison purposes assuming the Plans investments will earn 7 interest per year and that on average participants will live as long as predicted under the 1971 Group Annuity Mortality Table However for comparing the partial lump sum option to the other fonns the interest assumption was the Yield Curve for December 2008 and the mortality table was the 2009 Lump Sum Unisex Mortality Table as required by the IRS regulation
Please Note
It is important that you realize that the infonnation provided in the attached chart does not guarantee or even predict the amount of benefits you will actually receive after you retire The actual value of a stream of annuity payments for any individual and its comparison to the values of different payment fonns will vary depending on how long the individual and spouse in fact live and on their ages when payments start
This is only one source of infonnation you should take into account when choosing the payment fonn for your retirement benefits under the Plan Other factors to help you decide what a payment option is worth to you personally include your health your other sources of retirement income the resources available to your spouse or family after your death availability of life insurance etc You may want to consult a financial advisor in making this important decision
If you wish to obtain a comparison of relative values for your specific benefit estimate please send a written request to
Pipeline Industry Pension Fund 4845 South 83rd East Avenue
Tulsa Oklahoma 74145
1132010
Relative Value Charts for
Pipeline Industry Pension Fund
Non-Disability Single Participant
Commenceme ntAge
Normal Form Life Only
Life with 10 Year Certain
Partial Lump Sum Payment
55 100 AE AE 60- 100 AE AE
65 100 AE AE 70 100 AE AE
Non-Disability Married Participant
I Commenceme nt Age
55
Life Only
AE
QJSA 50 JampS
100
I
i
75 JampS
AE
100 JampS
AE
I 50 JampS with
Pop-up
AE
I 75 JampS with
Pop-up
AE
100 JampS with
Pop-up
AE
Life with
10Year Certain
AE
Partial Lump Sum
Paymen t
AE
I
60 AE 100 AE AE AE AE AE AE AE 65 AE 100 AE AE AE AE AE AE AE 70 AE 100 AE AE AE AE AE AE 1052
FOR LUMP SUM PAYMENT OPTION AE Approximately equal in value Assumptions Interest Yield Curve Segmented for December 2008 441 (5) 457 (15) 427 Participant Mortality 2009 Lump Sums Unisex Beneficiary Mortality 2009 Lump Sums Unisex Spouse Age Spouse and participant are same age
FOR ALL OTHER OPTIONS AE Approximately equal in value Assumptions Interest 700 Participant Mortality 1971 Group Annuity Mortality Table for Males Beneficiary Mortality 1971 Group Annuity Mortality Table for Males with ages set back 7 years Spouse Age Spouse and participant are same age
1132010
PIPELINE INDUSTRY PENSION FUND 30 DAY ELECTION WAIVER
FOR John Doe Sally Doe Participant Spouse
IF YOU DO NOT RETURN THIS FORM SIGNED AND NOTARIZED WE WILL NOT BE ABLE TO ISSUE YOUR CHECK UNTIL AT LEAST 30 DAYS AFTER THE EFFECTIVE DATE OF YOUR RETIREMENT
You have at least 30 days after the Plan provides you with notice of your payment options to decide which form of payment you wish to elect
You may waive the 30-day waiting period and begin receiving payment as early as the first day of the month of your written effective date on your application for retirement benefits provided your completed application for benefits and all required documents and information have been submitted to the Fund office 7 days before the first day of the month of scheduled retirement If you waive the 3~-day waiting period you may revoke your payment election at any time during the 7 -day waiting period or prior to the date your payments are scheduled to begin
Once the 3~-day or if waived the 7-day waiting period has passed and we have received your election form indicating how you would like your pension to be paid your pension payment will begin as soon as administratively practical In no event will the notice of your payment options and your election period begin more than 90 days before the date your payments are scheduled to begin
I hereby acknowledge receipt of this explanation and waive the 3~-day waiting period
Participant Signature ________________ Date ______
Spouse Signature ________________ Date______
NOTARY PUBLIC
State of ___________________ ) ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
and to me known and known to me to be the person(s) described in and who executed the above statement(s) and heshethey duly acknowledge to me that heshethey executed the same
(Notary PubliC) My Commission Expires
--- ----- -------------------------------shy
ALTERNATE PAYEE OR LIEN DISCLOSURE
If you have any knowledge of any court ordered deduction from your available
pension benefit that is not reflected on your application for benefits it is your
responsibility to make the PIPF staff aware of it
I John Doe do swear that to the best of my knowledge I have
provided all information and documentation required to verify any liens against
any pension benefit available on my behalf with the Pipeline Industry Pension
Fund such as a Qualified Domestic Relations Order (QDRO) Community
Property Petition or any other court ordered lien against my eligible pension
benefits
Participants Signature _______________ Date ______
NOTARY PUBLIC
State of ___________________ ) SS
County of ___________________ )
On the __ day of _____ 20_ before me came __________
to me known and known to me to be the person described in and who executed the above statement(s) and heshe duly acknowledge to me that heshe executed the same
(Notary Public) My Commission Expires
PIPELINE INDUSTRY PENSION FUND CERTIFICATION
If you elected a direct rollover (Items 2 or 3) you must provide all of the following information
Name of Trustee
Contact
(IRA or Plan Name) Participant
Mailing Address Account Number
City State Zip Code
CERTIFICATION
I certify that the recipient of a direct rollover that I have named above is an Individual Retirement Account an Individual Retirement Annuity or a eligible retirement plan that accepts rollovers I understand that payment of my benefits to the Trustees of the IRA or eligible retirement plan will release the Trustees of this Defined Benefit Pension Plan from any further obligations or responsibilities with respect to the benefits so paid
Signature Date
Rollover Page 2
SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS
A payment from the Plan that is eligible for rollover can be taken in 2 ways You can have all or any portion of your payment either
1 PAID IN A DIRECT ROLLOVER or
2 PAID TO YOU
A rollover is a payment of your Plan benefits to your individual retirement arrangement (IRA) or to another employer plan This choice will affect the tax you owe
If you choose a Direct Rollover
1 Your payment will not be taxed in the current year and no income tax will be withheld
2 Your payment will be made directly to your IRA or if you choose to another employer plan that accepts your rollover
3 Your payment will be taxed later when you take it out of the IRA or the employer plan
If you choose to have your Plan benefits PAID TO YOU
1 You will receive only 80 of the payment because the Plan administrator is required to withhold 20 of the payment and send it to the Internal Revenue Service (IRS) as income tax withholding to be credited against your taxes
2 Your payment will be taxed in the current year unless you roll it over You may be able to use special tax rules that could reduce the tax you owe
3 You can roll over the payment to your IRA or to another employer plan that accepts your rollover within 60 days of receiving the payment The amount rolled over will not be taxed until you take it out of the IRA or employer plan
4 If you want to roll over 100 of the payment to an IRA or an employer plan you must find other money to replace the 20 that was withheld If you roll over only the 80 that you received you will be taxed on the 20 that was withheld and that is not rolled over
Tax Notice
FROM
PIPELINE INDUSTRY PENSION FUND P O BOX 470950 TULSA OK 74147-0950
The TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982 requires that federal income tax be withheld
from payment on the taxable portion of pensions some annuities and other deferred compensation plans
effective January 1983You may however elect not to have this tax withheld If you elect not to have Federal
income tax withheld you are liable for Federal income tax on the portion of those payments You may also
be subject to the tax pena~ies under estimated tax payment rules if your payments of estimated tax and
withholding if any are not adequate You may change your election at any time The election you make on this
form will remain in effect until you revoke it Recipient Social Security Number
Listed below are plans you have with this institution that will be affected by this tax law 999-99-9999IPIPELINE INDUSTRY PENSION FUND
PLEASE COMPLETE THE INFORMATION BELOW AND RETURN IN THE ENCLOSED ENVELOPE BY THIS DAT-EoII- 11-15-2010 Withholding Choice (Check V ) box 1 or 2 below) Complete ~ and Q below if you chose to have Federal income tax withheld onyowperiodic
10 Do not withhold Federal income tax from payments on the above plan(s pensionannuity payments
2 0 Withhold Federal income tax from payment onthe above plan(s) a Marital Statusl-t)
D DSingle Married
IMPORTANT middotIf you do not return this form by the above date federal b Withholding Allowances (Check ( ) boxes that apply)
income tax will automatically be withheld from the following o Yourself 065 or Over 0 Bli~ Total boxes Checked
PERIODIC PAYMENTS (Pensions and some annuities as if you were married
claiming three withholding allowances As a result no Federal income tax will be
withheld if the taxable portions of your pension or annuities is less than $1480Io Spouse D 65 or Ovel D BIi~ and enter number here
Enter number of dependents here
TOTAL WITHHOLDING ALLOWANCES (Add Boxes 1 and 2)
10
20
3D a month
NONPERIODIC PAYMENTS (Distributions or withdrawals from Annuities IRAS
Pensions Profit Sharing Stock Bonus and other deferred comoensation plans)
according to established IRS tables and rates Marital status and withholding
allowances do not pertain to nonperiodic payments
ADDITIONAL DEDUCTIONS (OPTIONAL)
If you wish to have any additional income tax withheld from each payment enter
amount here
$
John Doe Name
111 Pipeline Lane Home Address- Number and Street
Tulsa OK 74147 City St Zip Code
Signature (Form must be signed and dated) Date
Tax Withholding Form
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS
I hereby authorize the PIPELINE INDUSTRY PENSION FUND hereinafter call COMPANY to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries in error
my account indicated below at the depository named below hereinafter call DEPOSITORY to credit andor debit the same to such account
STATE ZIP
o Checking o
authorization is to remain in full force and effect until COMPANY has received written notification me of its termination in such time and in such manner as to afford COMPANY and DEPOSITOR
a reasonable opportunity to act on it
NAME John Doe S SEC NUM 999-99-9999
SIG DATE
RETURN THIS FORM TO
PIPELINE INDUSTRY PENSION FUND PO BOX 470950
TULSA OK 74147-0950
Direct Deposit Form
e PIBF ASSIGNMENT AND AUTHORIZATION REQUEST
AT INITIAL RETIREMENT To Board of Trustees
Pipeline Industry Pension Fund
I the undersigned wish to maintain my eligibility for retiree health care benefits under the Pipeline Industry Benefit Fund by means of self-payments As a convenience to me and to assure my continued health care coverage I hereby request and authorize you to deduct from my monthly Pipeline Industry Pension Fund benefit whatever amounts may be required from time to time to maintain my coverage under the retiree health care plan as shall be reported to you by the Pipeline Industry Benefit Fund and to remit such deducted amounts directly to the Pipeline Industry Benefit Fund
I understand that I may revoke this authorization at any time by written notice to you but also understand that at least thirty days advance notice to do so is required The amount assigned cannot be more than my monthly benefit from the Pipeline Industry Pension Fund Excess amount not deducted from my monthly retirement benefit must be paid to the Fund office by the first day of each month
Please print all information except your signature IF APPLICABLE YOU MUST SUBMIT A COpy OF YOU ANDOR YOUR SPOUSES MEDICARE CARD WITH TmS FORM
Retired Members Name (Printed) Social Security Number Other Coverage (Medicare etc)
Are you Married DYes D No
Spouse Social Security Other Coverage
Dependent Relationship Social Security Number Other Coverage
Street Address City State Zip I wish to cover myself and my dependents as allowed by the plan and to have my premiums deductedo from my pension benefit I understand that retiree coverage wont start and my premium wont be deducted until my active coverage runs out (if applicable)
____________Si(~~~~___________________~~~_____________ _________________
WAIVER OF AUTHORIZATION TO AUTOMATICALLY WITHHOLD PREMIUM I wish to cover myself and my dependents (if applicable) as allowed by the plan but do not want theo premium withheld from my pension check I understand that retiree coverage wont start and my premium wont be due until my active coverage runs out (if applicable)
Signature Date
o I am under sixty-five but I am covered under Medicare I have attached a copy of my Medicare card or ~~~~~~~~~e~~~~~~~~~ry_~t~~V~~~g~~ ________________________________________
WAIVER OF HEALTH CARE COVERAGE I DO NOT wish to cover myself andor my spousedependents (if applicable) as allowed by the plan I o understand that I can opt-out and have the option to re-enter into the plan when I become eligible for Medicare or upon providing proof of continuous coverage If it applies my spouse may re-enter at that time or when heshe becomes eligible for Medicare OR - I am on Medicare and my spouse wishes to opt out until heshe becomes eligible for Medicare Check the boxes you do not want covered 0 Myself 0 Spouse D Dependents
Retired Members Signature Social Security Number
Pipeline Industry Benefit Fund
e PIBF
COORDINATION OF BENEFITS FORM Member Name ____________Member ID
Do you or your dependents have other health insurance _YES _NO Do you or your dependents have Medicare _YES _NO
you answered NO to both questions listed above please sign this form amp return to PIBF
ADDITIONAL INSURANCE
Policy Holders Name __________________________
Policy 10 Number_______ Group_______
Effective Date ____ Term Date _____
Coverage type _active employment _retirement _private policy _Medicare _ Medicaid
Coverage plan is __ Single__ Family
List all dependents that are covered by this policy ________________
If retirement coverage please list date of retirement ______
Does plan provide Prescription _ Medical __ Dental__ Vision___
Employer Name and Address ________________________ I__________________city ________state _---zip___
Other Carriers Name and Address ______________________ _________ _________city _________state___zip___
Telephone ~_-____
The undersigned certifies that to the best of their knowledge the facts set forth are troe and correct I HEREBY AUTHORIZE my insurance company or other provider to release any medical or other information necessary Any fraudulent information could result in legal action
Signature of Member____________Date _---____
Failure to make a complete disclosure of other insurance coverage will result in a delay of payment of your claims Any resulting overpayment by our office must be reimbursed
4845 S 83rd E Ave I Box 470950 I Tulsa Oklahoma 74147-0950 I (918) 280-4800 I Fax (918) 280-4899 I wwwpibforg
