Fee Disclosure Evaluation Request for Information
(Date of Request)
(Service provider contact)(Service provider name)
(Service provider address)
(Service provider phone number)
(Service provider e-mail)
Requested By
Employer submitting this RequestName of Employer
(Plan Sponsor)
Name of Individual Submitting Request
Title
Address
City, State, Zip
Phone (s)
Name of Responsible Plan Fiduciary
Title
Address
City, State, Zip
Phone (s)
Professional assisting with evaluation
Name of Professional
Professional’s Firm Name
Title
Address
City, State, Zip
Phone (s)
Basis for Request
Per Department of Labor release “Reasonable Contract or Arrangement Under Section 408(b)(2)--Fee Disclosure [7/16/2010]”:
“Ultimately, though, the responsible plan fiduciary must, under sections 404 and 408(b)(2) of ERISA, decide whether it has enough information about the services to be provided pursuant to the contract or arrangement to determine whether the cost of such services to the plan is reasonable.
Accordingly, if a particular description of services provided by a covered service provider lacks sufficient detail to enable the responsible plan fiduciary to determine whether the compensation to be received for such services is reasonable, the responsible plan fiduciary must request additional information concerning those services.”
Instructions
This Request is designed to obtain information to comply with ERISA 408(b)(2) regulations that require us to obtain certain information and to use that information in a prudent process that determines if the services you provide are necessary, reasonable and that the cost of these services are reasonable.
We understand that as the responsible plan fiduciary we must report our failure to comply with the regulations to the Department of Labor after 90 days in order to obtain an exemption from a prohibited transaction violation. In order to avoid filing for such an exemption, please complete and return this Request as soon as possible.
After completing this Request please return it to the individual listed above as “Individual Submitting the Request”.
Please use the Glossary at the end of this Request for a description of terms that are unclear. The Glossary uses the numbers in the leftmost column for reference.
Plan Overview
Item / Response1.00 / Plan Characteristics:
1.01 / Plan Name
1.02 / Effective Date of Information
1.03 / Value of Plan Assets in Designated Investments
1.04 / Number of Participants
1.05 / Average Deferral Rate per Participant
1.06 / Average Age of Participants
1.07 / Average Annual Income of Participants
1.08 / Number of Non-Participating Eligible Employees
1.09 / Number of ex-employees still participating (include retirees)
2.00 / Allocation in Designated Investment Alternatives
Equity / Fixed Income / Stable Value / Cash Equiv. / Blended
2.01 / Allocation of assets classes in the plan / % / % / % / % / %
2.02 / Mutual Funds
Share classes used: / No If “Yes”, approximate %
2.03 / ETFs / No If “Yes”, approximate %
2.04 / Separate Accounts / No If “Yes”, approximate %
2.05 / Collective Investment Funds / No If “Yes”, approximate %
2.06 / Fixed Annuities / No If “Yes”, approximate %
2.07 / Variable Annuities / No If “Yes”, approximate %
2.08 / Guaranteed Investment Contract (GICs) / No If “Yes”, approximate %
2.09 / Company Stock / No If “Yes”, approximate %
2.10 / Investment Models / No If “Yes”, approximate %
2.11 / Managed Account Service / No If “Yes”, approximate %
2.99 / Other Investment:
/ No If “Yes”, approximate %
3.00 / Annual Plan Expenses:
3.01 / Investment Expense
3.02 / Recordkeeping Expense
3.03 / Other Non-Investment Expenses
3.04 / Total Annual Plan Expense
Service Provider Summary
Item / Response6.00 / Services / Provider Name / *
4
0
8
b
2 / Est. Annual Cost / Fidu-ciary Status / Relationship to Your Firm
(Enter as $$ or bp) / (Yes or No) / (Specify if affiliate or subcontractor)
6.01 / Administration
6.02 / Recordkeeping
6.03 / Investment Platform
6.04 / Trustee
6.05 / Custodian
6.06 / Participant Services
6.07 / Investment Advice
6.08 / Investment Management
6.99 / Other Service:
6.99 / Other Service:
6.99 / Other Service:
Note / * Enter a “Y” in this column if the 408(b)(2) disclosure document has been delivered. Enter an “N” if not delivered. Enter a “?” if you don’t know.
Plan Features
Item / Response7.00 / Plan Features / In the Plan?(Y or N) / Provider Name / Additional Cost
(If any)
7.01 / Automatic Enrollment
7.02 / Automatic Escalation of Contributions
7.03 / Electronic Document Delivery
7.04 / SafeHarbor (eliminates ADP & ACP testing)
7.05 / Loans
7.06 / Hardship Withdrawals
7.07 / Self Directed Brokerage
7.08 / Roth (taxable contributions)
7.09 / Participant Advice by Computer Model
7.10 / Face to Face Participant Advice
7.11 / Catch-up Contributions
7.12 / In-service Distributions
7.13 / Pre-retirement Counseling
7.14 / Matching Contributions
Match %:
Up to %:
7.15 / Enrollment/Education
Number of meetings per year:
7.16 / Automatic Rollovers
7.99 / Other Feature:
7.99 / Other Feature:
Cash Flow
Please use the table below to specify the source, the estimated amount of all compensation and services to this plan for each service provider listed in Sections 6 and 7 above.
8.00 / Provider Name / Source of Payment(Name of payor) / Estimated Amount / Service(s)
(Use codes from Sections 6 & 7)
Potential Conflicts of Interest
Please list parties involved and explain any potential conflicts of interest associated with providing services or investments to this plan.
9.0 / Party with Potential Conflict / ExplanationGlossary
Term / Definition1.00 / Plan Characteristics: / These describe the structure and condition of the plan.
1.01 / Plan Name / The name of the plan as it appears on the Summary Plan Description (“SPD”) or other official document.
1.02 / Effective Date of Information / The balances provided should all reflect conditions on this date.
1.03 / Value of Plan Assets in Designated Investments / Designated investments include only those that have been specifically chosen for the plan. This excludes investments that participants make through brokerage accounts but should include un-invested cash that may be in the plan.
1.04 / Number of Participants / The participant count includes beneficiaries, retirees, terminated employees and any others as long as they have a balance in the plan.
1.05 / Average Deferral Rate per Participant / The deferral rate specified should include both employer and employee contributions.
1.06 / Average Age of Participants / The average includes only living persons.
1.07 / Average Annual Income of Participants / This average includes only current employees.
1.08 / Number of Non-Participating Eligible Employees / Employees that are eligible but elect not to participate. Eligible employees include those waiting to be automatically enrolled but not yet enrolled.
1.09 / Number of ex-employees still participating (include retirees) / Terminated employees, employees on disability or employees who may no longer be eligible to participate and retirees are included.
2.00 / Allocation in Designated Investment Alternatives / These questions seek to determine the types and allocation in various categories.
2.01 / Allocation of assets classes in the plan / Equity (Stocks), Fixed Income (Bonds), Stable Value, Cash Equivalents (Money Market and similar), Blended (A mix of other categories)
2.02 / Mutual Funds / These are the generally known mutual funds and include money market funds.
2.03 / ETFs / Exchange traded funds specifically include “ETF” in their name. These are not included as mutual funds but may be QDIAs if designated as such by the plan.
2.04 / Separate Accounts / Separate accounts are similar to mutual funds in some respects but are managed by insurance companies under insurance regulations.
2.05 / Collective Investment Funds (“CIF”) / CIFs are similar to mutual funds in some respects but are managed by bank trust departments under banking regulations.
2.06 / Fixed Annuities / Fixed annuities are insurance contracts that pay participants a specified rate of interest over a stated period of time.
2.07 / Variable Annuities / Variable annuities are insurance contracts in which the participant may have some degree of control of where investments are made. There is no specified rate of interest but some guarantees may be included. Returns are generally determined by the market conditions.
2.08 / Guaranteed Investment Contract (GICs) / As the name implies, these investments pay a predetermined rate of interest that is guaranteed by the company issuing the GIC.
2.09 / Company Stock / A corporation may include its own stock as a designated investment option in the corporation’s own retirement plan. There are a number of limitations about the ways in which Company stock may be used in an ERISA plan.
2.10 / Investment Models / Investment models are typically separately managed accounts using the designated investments in the plan to build model portfolios. Models themselves are designated investments in the plan that participants may elect to use.
2.11 / Managed Account Service / Managed account service uses personal characteristics of the participant to select investments or investment models for each specific participant.
2.12 / Other Investment / Since ERISA relies on the plan fiduciary to determine what investments are permitted in the plan, there are no restrictions on the types of investments allowed. Any investments that do not fit into the preceding categories are included here.
3.00 / Annual Plan Expenses: / These expenses represent those that are the focus of the fee disclosure regulations.
3.01 / Investment Expense / This is the fee charged to manage the plan’s investments and excludes any other uses of expenses charged to plan investments.
3.02 / Recordkeeping Expense / The portion of expenses that is used to compensate Recordkeepers is reported here. This could be a portion of the fees collected from the investments or could be charged directly to participants. Please note how this fee is paid.
3.03 / Other Non-Investment Expenses / This represents the total paid to other service providers, including advisors, custodians, trustees, TPAs, etc.
3.04 / Total Annual Plan Expense / This represents the total of all fees charged to the plan.
6.00 / Services / The basic plan services and the associated service providers are listed here. Use the following guidelines to rate each service:
408(b)(2) was the disclosure delivered by each service provider listed:
YYes, disclosure was delivered
NNo, disclosure was not delivered
?Not known if disclosure was delivered
Est. Annual Cost:
If known, enter the estimated cost of the service as basis points or dollar amounts. If not known, leave blank.
Fiduciary Status:
YesThe service provider is acting in a fiduciary capacity.
NoThe service provider is NOT acting in a fiduciary capacity.
Relationship with other entities:
AffiliateThe service provider is an affiliated company.
SubcontractorThe service provider has a contractual relationship to provide services to this plan.
NoneThere is no business relationship with this service provider.
6.01 / Administration / Includes plan design, compliance procedures and regulatory filing. This service can be provided by the same firm performing recordkeeping services.
6.02 / Recordkeeping / Includes the maintenance of participant accounts, transactions and reporting.
6.03 / Investment Platform / Provides access to plan investments. The platform provider is often the same firm as the recordkeeper.
6.04 / Trustee / The trustee handles contributions, plan investments, and distributions in aggregate for the plan.
6.05 / Custodian / The custodian is the holder of the plan’s assets and acts at the direction of the trustee.
6.06 / Participant Services / Consists of communication to and from participants and includes written, telephone, in-person, Web sites and other electronic forms. Participant services also include education and enrollment services.
6.07 / Investment Advice / Consists of recommendations to plan sponsors and/or participants about investments and investment activity. This is provided by an ERISA 3(21) adviser.
6.08 / Investments / Active management of some or all of the plan’s investments. This includes actively managed mutual funds and use of an ERISA 3(38) manager.
6.99 / Other Service / Services provided to the plan that are not included in any of the foregoing services.
7.00 / Plan Features
7.01 / Automatic Enrollment / Eligible employees are given the opportunity to decline enrollment in the retirement plan and if not declined the employee is enrolled with no further action on his/her part.
7.02 / Automatic Escalation of Contributions / Participant’s contributions are increased each year up to a level that can be expected to fund a secure retirement.
7.03 / Electronic Document Delivery / Permits participants to elect to receive plan communications electronically instead of paper through the postal service.
7.04 / SafeHarbor (eliminates ADP & ACP testing) / The plan is exempted from annual testing by meeting minimum requirements such as automatic enrollment and matching employer contributions.
The ADP & ACP test is to determine whether all participants are benefiting equitably from the plan. ADP stands for “actual deferral percentage” and ACP stands for “actual contribution percentage”.
7.05 / Loans / The plan permits participants to borrow funds in their plan by paying interest until the funds are repaid.
7.06 / Hardship Withdrawals / The plan permits participants who qualify as being in a hardship situation to withdraw funds from their plan without a penalty.
7.07 / Self Directed Brokerage / The plan includes a brokerage account which enables participants to make investments that are not designated by their plan.
7.08 / Roth (taxable contributions) / The Roth feature allows participants to pay taxes on the money contributed to the plan. By doing this the participant owes no federal income taxes when the funds are withdrawn.
7.09 / Participant Advice by Computer Model / The plan makes a computer model available to participants to enter personal information and receive investment recommendations.
7.10 / Face to Face Participant Advice / The plan has engaged advisors to assist participants with managing their investments. This service is often paid for by the participants who use it.
7.11 / Catch-up Contributions / Participants approaching retirement are permitted to make larger contributions than younger counterparts.
7.12 / In-service Distributions / Participants who qualify may withdraw funds from their plan without a penalty.
7.13 / Pre-retirement Counseling / The plan has engaged advisors to assist participants who are approaching retirement with preparation for retirement.
7.14 / Matching Contributions / Employer adds a certain percentage to plan contributions made by employees up to a maximum percentage of the employees’ income.
“ / Match % / The percentage of the employees’ contribution that the employer adds. This is typically 25%, 50% or 100% of the employees’ contribution.
“ / Up to % / The maximum percentage of the employees’ income that is matched by the employer. This is typically between 3% and 6% of the employees’ income.
7.15 / Enrollment/Education Meetings / Employee meetings set up to assist employees to enroll in the retirement plan and to teach the principles of investing.
7.16 / Automatic Rollovers / Terminated employees are automatically rolled over into an IRA account.
7.99 / Other Feature / Any other plan feature(s) that has not been included.
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