This notice explains how your Plan benefits will be calculated and
distributed if you die before payment of your benefits has begun,
unless you and your spouse elect otherwise.
Qualified Preretirement Survivor Annuity. If you die before pay-
ment of your benefits has begun, your benefits will be paid to your
surviving spouse in the form of a Qualified Preretirement Survivor
Annuity (“QPSA”). A QPSA election is not applicable if benefit pay-
ments have commenced. In other words, a QPSA will not be
payable to your surviving spouse if the Plan had commenced
benefit payments to you prior to your death.
Under the QPSA, your surviving spouse will receive a lifetime
level monthly payment. The Trustee will distribute the QPSA using
100% of your vested Account balance to purchase an annuity
contract from an insurance company. The Trustee then will distrib-
ute the contract to your surviving spouse as evidence of his/her
right to receive the annuity payments from the insurance
company. Generally, the annuity will begin within one year after
a Participantʼs date of death, but the surviving spouse may elect
to have the annuity deferred to the date the Participant would
have attained age 70
1
⁄2. If, at the time of the Participantʼs death,
the Account balance is not greater than $5,000, the Plan will make
a lump sum distribution of the Account balance to the surviving
spouse, in lieu of providing the QPSA.
The actual level monthly payments made under the QPSA will
depend on the annuity purchase rate used by the insurance com-
pany, your surviving spouseʼs age and life expectancy at the time
the distribution begins, and the amount of the Account balance at
the time the Trustee purchases the annuity contract. If anyone
(a former spouse, for instance) is entitled to a portion of your
benefits pursuant to a Qualified Domestic Relations Order, the
amount available for the annuity will be reduced by the amount
specified in the Order. The amount available for the annuity will
also be reduced by any outstanding amount due on a loan
secured with your vested Account balance. The Plan may charge
your Account for the commission incurred incident to the purchase
of the annuity contract.
The following table provides the approximate monthly annuity pay-
ments under an immediate annuity per $1,000 of Account balance
for a surviving spouse ranging from age 50 to age 80. The table
assumes an annuity factor based on the UP-1984 mortality tables,
assuming a 6% interest rate. The insurance company from which
the Trustee purchases the QPSA may use different factors. Dif-
ferent factors will produce a different monthly payment. The Plan
Administrator, upon request, will provide a more precise calculation.
Annuity Factor Table
(per $1,000 of Account balance)
For example, if a Participantʼs Account balance at death is $10,000,
a surviving spouse who is age 60 will receive a monthly annuity
payment approximately equal to $78.60 ($7.86 x 10). The approx-
imate monthly payments are only estimates.
Waiver Election. The Plan requires payment of the QPSA unless
a valid waiver election is in effect on the date of death. The waiver
election is not valid unless you and your spouse make the elec-
tion within the election period. Generally, the election period
begins on the first day of the Plan year during which you
reached age 35. The election period ends on the date of your
death. A waiver will be effective only if your spouse consents to
the waiver of the QPSA. A designation of a nonspouse Primary
Beneficiary (if you are married) requires both a waiver of the QPSA
and spousal consent to the nonspouse Beneficiary. The spousal
consent must be in writing and must be witnessed either by the
Plan Administrator or a notary public. You may waive or revoke
a waiver anytime during the election period. You may revoke a
waiver without your spouseʼs consent, but your spouse would
have to consent to a new waiver election.
Financial Effect of the Election. Under a QPSA, the surviving
spouse will receive lifetime income. The QPSA will not pay any
benefits to other beneficiaries after the spouseʼs death. The Plan may
offer the surviving spouse the option of receiving the Account bal-
ance in a lump sum or in installment payments, in lieu of the QPSA.
If you waive the QPSA, the Plan Administrator will authorize pay-
ment of the Account balance to your designated Beneficiary in a
form permitted under the Plan. The optional forms of distribution
available to your Beneficiaries are extremely varied, and include,
but are not limited to, the alternatives discussed below. One alter-
native is a lump sum distribution under which the Trustee will dis-
tribute the entire Account balance. Certain distributions are eli-
gible for rollover or other special tax benefits. If the Beneficiary
receives a lump sum distribution or an eligible rollover distribution,
the Plan Administrator will provide the Beneficiary a notice of the
special tax benefits or rollover options, if any, available for the dis-
tribution. A second alternative is a periodic installment distribution
from the trust over a fixed period of years. Under an installment
distribution, payments continue until the Account balance is
exhausted. Furthermore, the Account balance will continue to earn
investment income.
The relative values of optional forms of benefit are equal. The value
of any distribution your Beneficiary may receive is based solely on
the investments purchased with the employer, employee and/or
rollover contributions or transfers made to your separate Account
under the Plan. If funds are left in the Account at the time of the
Primary Beneficiaryʼs death (after your death), the Plan will pay the
remaining Account balance to the Primary Beneficiaryʼs estate.
What To Do. If you do nothing, your surviving spouse will auto-
matically be provided with a QPSA (unless s/he elects another
form of distribution). If you are currently eligible to make an elec-
tion to waive the QPSA or wish to revoke a prior waiver, please
complete the Qualified Preretirement Survivor Annuity section on
the appropriate form. If you have any questions regarding the
information provided in this notice, or you need further informa-
tion, please contact the Plan Administrator listed below.
Plan Name
Plan Administrator Name
Address
City/State/Zip
Telephone ( )
