PART II — Internal Revenue Bulletin 2014-1

Does the Plan limit transfers to “Excess Assets” as defined in § 420(e)(2) of the Code? Yes No ___
Does the Plan provide that only one transfer may be made in a taxable year (except with regard to transfers relating to prior years pursuant to § 420(b)(4) of the Code)? Yes No ___
Does the Plan provide that the amount transferred shall not exceed the amount reasonably estimated to be paid for qualified current retiree health liabilities? Yes No ___
Does the Plan provide that no transfer will be made after December 31, 2021? Yes No ___
Does the Plan provide that transferred assets and income attributable to such assets shall be used only to pay qualified current retiree health liabilities for the taxable year of transfer? Yes No ___
Does the Plan provide that any amounts transferred (plus income) that are not used to pay qualified current retiree health liabilities shall be transferred back to the defined benefit portion of the Plan? Yes No ___
Does the Plan provide that amounts paid out of a health benefits account will be treated as paid first out of transferred assets and income attributable to those assets? Yes No ___
Does the Plan provide that participants’ accrued benefits become nonforfeitable on a termination basis (i) immediately prior to transfer, or (ii) in the case of a participant who separated within 1 year before the transfer, immediately before such separation? Yes No ___
In the case of transfers described in § 420(b)(4) of the Code relating to 1990, does the Plan provide that benefits will be recomputed and become nonforfeitable for participants who separated from service in such prior year as described in § 420(c)(2)? Yes No ___
Does the Plan provide that transfers will be permitted only if each group health plan or arrangement contains provisions satisfying § 420(c)(3) of the Code, as amended? Yes No ___
Does the Plan define “applicable employer cost”, “cost maintenance period” and“ benefit maintenance period”, as needed, consistently with § 420(c)(3) of the Code, as amended? Yes No ___

January 2, 2014 236 Bulletin No. 2014–1

Do the Plan’s provisions reflect the transition rule in section 535(c)(2) of TREA’99, if applicable? Yes No ___
Does the Plan provide that transferred assets cannot be used for key employees? Yes No ___

Bulletin No. 2014–1 237 January 2, 2014

26 CFR 601.201: Rulings and determination letters.

Rev. Proc. 2014–7