General Instructions to Form 5500 -11-
4. Schedule D, to list CCTs, PSAs, and 103-12 IEs in which
the MTIA invested at any time during the MTIA year and to list
all plans that participated in the MTIA during its year.
5. Schedule G, to report loans or fixed income obligations in
default or determined to be uncollectible as of the end of the
MTIA year, all leases in default or classified as uncollectible,
and nonexempt transactions.
6. Schedule H, except lines 1b(1), 1b(2), 1c(8), 1g, 1h, 1i,
2a, 2b(1)(E), 2e, 2f, 2g, 4a, 4e, 4f, 4g, 4h, 4k, 4l, 4m, 4n, and
5, to report financial information. An independent qualified
public accountant’s (IQPA’s) opinion is not required for an
MTIA.
7. Additional information required by the instructions to the
above schedules, including, for example, the schedules of
assets held for investment and the schedule of reportable
transactions. For purposes of the schedule of reportable
transactions, the 5% figure shall be determined by comparing
the current value of the transaction at the transaction date with
the current value of the investment account assets at the
beginning of the applicable fiscal year of the MTIA. All
attachments must be properly labeled.
Common/Collective Trust (CCT) and Pooled
Separate Account (PSA)
A Form 5500 is not required to be filed for a CCT or PSA.
However, the administrator of a large plan or DFE that
participates in a CCT or PSA that files as specified below is
entitled to reporting relief that is not available to plans or DFEs
participating in a CCT or PSA for which a Form 5500 is not
filed.
For reporting purposes, ‘‘common/collective trust’’ and
‘‘pooled separate account’’ are, respectively: (1) a trust
maintained by a bank, trust company, or similar institution or
(2) an account maintained by an insurance carrier, which is
regulated, supervised, and subject to periodic examination by a
state or federal agency in the case of a CCT, or by a state
agency in the case of a PSA, for the collective investment and
reinvestment of assets contributed thereto from employee
benefit plans maintained by more than one employer or
controlled group of corporations as that term is used in Code
section 1563. See 29 CFR 2520.103-3, 103-4, 103-5, and
103-9.
Note. For reporting purposes, a separate account that is not
considered to be holding plan assets pursuant to 29 CFR
2510.3-101(h)(1)(iii) does not constitute a pooled separate
account.
The Form 5500 submitted for a CCT or PSA must comply
with the Form 5500 instructions for a Large Pension Plan,
unless otherwise specified in the forms and instructions.
The CCT or PSA must file:
1. Form 5500, except lines C, D, 1c, 2d, and 5 through 9.
Enter ‘‘C’’ or ‘‘P,’’ as appropriate, in Part I, line A, as the DFE
code.
2.
Schedule D, to list all CCTs, PSAs, MTIAs, and
103-12 IEs in which the CCT or PSA invested at any time
during the CCT or PSA year and to list in Part II all plans that
participated in the CCT or PSA during its year.
3. Schedule H, except lines 1b(1), 1b(2), 1c(8), 1d, 1e, 1g,
1h, 1i, 2a, 2b(1)(E), 2e, 2f, and 2g, to report financial
information. Part IV and an accountant’s (IQPA’s) opinion are
not required for a CCT or PSA.
Different requirements apply to the Schedules D and H
attached to the Form 5500 filed by plans and DFEs
participating in CCTs and PSAs, depending upon whether a
DFE Form 5500 has been filed for the CCT or PSA. See the
instructions for these schedules.
103-12 Investment Entity (103-12 IE)
DOL Regulation 2520.103-12 provides an alternative method
of reporting for plans that invest in an entity (other than an
MTIA, CCT, or PSA), whose underlying assets include ‘‘plan
assets’’ within the meaning of 29 CFR 2510.3-101 of two or
more plans that are not members of a ‘‘related group’’ of
employee benefit plans. Such an entity for which a Form 5500
is filed constitutes a ‘‘103-12 IE.’’ A Form 5500 is not required
to be filed for such entities; however, filing a Form 5500 as a
103-12 IE provides certain reporting relief, including the
limitation of the examination and report of the independent
qualified public accountant (IQPA) provided by 29 CFR
2520.103-12(d), to participating plans and DFEs. For this
reporting purpose, a ‘‘related group’’ of employee benefit plans
consists of each group of two or more employee benefit plans
(1) each of which receives 10% or more of its aggregate
contributions from the same employer or from a member of the
same controlled group of corporations (as determined under
Code section 1563(a), without regard to Code section
1563(a)(4) thereof); or (2) each of which is either maintained
by, or maintained pursuant to a collective-bargaining
agreement negotiated by, the same employee organization or
affiliated employee organizations. For purposes of this
paragraph, an ‘‘affiliate’’ of an employee organization means
any person controlling, controlled by, or under common control
with such organization. See 29 CFR 2520.103-12.
The Form 5500 submitted for a 103-12 IE must comply with
the Form 5500 instructions for a Large Pension Plan, unless
otherwise specified in the forms and instructions. The
103-12 IE must file:
1. Form 5500, except lines C, D, 1c, 2d, and 5 through 9.
Enter ‘‘E’’ in part I, line A, as the DFE code.
2. Schedule A (as many as needed), to report insurance,
annuity and investment contracts held by the 103-12 IE.
3. Schedule C, if applicable, to report service provider
information and any terminated accountants.
4. Schedule D, to list all CCTs, PSAs, and 103-12 IEs in
which the 103-12 IE invested at any time during the
103-12 IE’s year, and to list all plans that participated in the
103-12 IE during its year.
5. Schedule G, to report loans or fixed income obligations in
default or determined to be uncollectible as of the end of the
103-12 IE year, leases in default or classified as uncollectible,
and nonexempt transactions.
6. Schedule H, except lines 1b(1), 1b(2), 1c(8), 1d, 1e, 1g,
1h, 1i, 2a, 2b(1)(E), 2e, 2f, 2g, 4a, 4e, 4f, 4g, 4h, 4j, 4k, 4l, 4m,
4n, and 5, to report financial information.
7. Additional information required by the instructions to the
above schedules, including, for example, the report of the
independent qualified public accountant (IQPA) identified on
Schedule H, line 3c, and the schedule(s) of assets held for
investment. All attachments must be properly labeled.
Group Insurance Arrangement (GIA)
Each welfare benefit plan that is part of a group insurance
arrangement is exempt from the requirement to file a Form
5500 if a consolidated Form 5500 report for all the plans in the
arrangement was filed in accordance with 29 CFR 2520.104-
43. For reporting purposes, a ‘‘group insurance arrangement’’
provides benefits to the employees of two or more unaffiliated
employers (not in connection with a multiemployer plan or a
collectively-bargained multiple-employer plan), fully insures
one or more welfare plans of each participating employer, uses
a trust or other entity as the holder of the insurance contracts,
and uses a trust as the conduit for payment of premiums to the
insurance company. The GIA must file:
1 . Form 5500, except lines C and 2d. (Enter ‘‘G’’ in Part I,
line A, as the DFE code).