Statement Concerning Your Employment in a Job
Not Covered by Social Security
Employee Name
Employee ID # (SSN)
myWSU ID #
Employer Name
Wichita State University
Employer ID#
48-6029925
Your earnings from this job are not covered under Social Security. When you retire, or if you become
disabled, you may receive a pension based on earnings from this job. If you do, and you are also
entitled to a benefit from Social Security based on either your own work or the work of your husband
or wife, or former husband or wife, your pension may affect the amount of the Social Security benefit
you receive. Your Medicare benefits, however, will not be affected. Under the Social Security law,
there are two ways your Social Security benefit amount may be affected.
Windfall Elimination Provision
Under the Windfall Elimination Provision, your Social Security retirement or disability benefit is figured
using a modified formula when you are also entitled to a pension from a job where you did not pay
Social Security tax. As a result, you will receive a lower Social Security benefit than if you were not
entitled to a pension from this job. For example, if you are age 62 in 2005, the maximum monthly
reduction in your Social Security benefit as a result of this provision is $313.50. This amount is
updated annually. This provision reduces, but does not totally eliminate, your Social Security benefit.
For additional information, please refer to Social Security Publication, “Windfall Elimination Provision.”
Government Pension Offset Provision
Under the Government Pension Offset Provision, any Social Security spouse or widow(er) benefit to
which you become entitled will be offset if you also receive a Federal, State or local government
pension based on work where you did not pay Social Security tax. The offset reduces the amount of
your Social Security spouse or widow(er) benefit by two-thirds of the amount of your pension.
For example, if you get a monthly pension of $600 based on earnings that are not covered under
Social Security, two-thirds of that amount, $400, is used to offset your Social Security spouse or
widow(er) benefit. If you are eligible for a $500 widow(er) benefit, you will receive $100 per month
from Social Security ($500 - $400=$100). Even if your pension is high enough to totally offset your
spouse or widow(er) Social Security benefit, you are still eligible for Medicare at age 65. For
additional information, please refer to Social Security Publication, “Government Pension Offset.”
For More Information
Social Security publications and additional information, including information about exceptions to
each provision, are available at
www.socialsecurity.gov. You may also call toll free 1-800-772-1213,
or for the deaf or hard of hearing call the TTY number 1-800-325-0778, or contact your local Social
Security office.
I certify that I have received Form SSA-1945 that contains information about the possible
effects of the Windfall Elimination Provision and the Government Pension Offset Provision on
my potential future Social Security benefits.
Signature of Employee Date
Form SSA-1945 Revised: 12/06
