TN 1 (04-20)

RM 03253.002 SSA-L99-C1, Notice of Potential Private Retirement Benefit Information

A. Notifying Separated Participants With Deferred Vested Pension Benefits

The Social Security Administration (SSA) is required to furnish individuals (and dependents or survivors) deferred vested benefit information upon request and automatically upon application of a claim for social security benefits.

SSA provides individuals the exact information that the Internal Revenue Service (IRS) forwards to us from the plan administrator. We furnish this pension information on Form SSA-L99-C1, Notice of Potential Private Retirement Benefit Information:

B. SSA-L99-C1: Notice Contents

  • Plan name.

  • Plan number (twelve digit number).

NOTE: 

For identification and retrieval purposes SSA combines the three digit plan number and nine digit EIN, respectively, furnished on the Form 8955-SSA to establish this twelve digit plan number.

  • Plan Admininstrator's name and address.

  • Plan Administrator's identification number (Nine digit EIN).

  • Deferred vested benefit information:

  • Year Reported (Plan year, calendar or fiscal, for which the information was submitted).

  • Estimated Amount (This is periodic payment paid monthly, annually, etc.).

  • Type of Annuity code (See back of SSA-L99-C1)

  • Payment Frequency code (See back of SSA-L99-C1).

  • Unit or Shares (Total number of units or share held at the time of separation).

  • Value of Account

NOTE: 

This notice explains that the recipient MAY be entitled to some retirement benefits from a private employer and that these are NOT Social Security benefits. It refers individuals with questions to the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). We are not the source of information for this notice and therefore, in the majority of cases, we will not be able to address specific questions regarding the data provided.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0103253002
RM 03253.002 - SSA-L99-C1, Notice of Potential Private Retirement Benefit Information - 04/13/2020
Batch run: 04/13/2020
Rev:04/13/2020