Pension Benefits Standards Regulations, 1985

23 (1) The written statement to be provided in accordance with paragraph 28(1)(b) of the Act shall include

• (a) the name of the plan member;

• (b) the period to which the statement applies;

• (c) the date of birth of the plan member;

• (d) the period that has been credited to the plan member for the purpose of calculating the pension benefit of the plan member;

• (e) the date on which the plan member attains pensionable age;

• (f) the date on which the plan member is first entitled to an immediate pension benefit pursuant to subsection 16(2) of the Act;

• (g) the name of the spouse or common-law partner of the plan member listed on the records of the administrator;

• (h) the name of any person on the records of the administrator designated as the beneficiary of the pension benefit of the member;

• (i) the additional voluntary contributions of the plan member made for the plan year and the accumulated additional voluntary contributions of the plan member as of the end of the plan year;

• (j) the required contributions of the plan member made for the plan year and the accumulated required contributions of the plan member as of the end of the plan year;

• (k) in the case of a plan with a defined contribution provision, the contributions of the employer in respect of the plan member made for the plan year and the accumulated contributions of the employer in respect of the plan member as of the end of the plan year;

• (l) the amount of any funds transferred to the plan in respect of the plan member and the benefit under the plan attributable to that amount or the length of service credited to the plan member in respect of that amount;

• (m) in the case of a plan other than a defined contribution plan, the annual amount of the pension benefit accrued in respect of the plan member as of the end of the plan year and payable at pensionable age;

• (n) if applicable, the interest rates credited to the contributions of the plan member for the plan year;

• (o) the benefit payable on the death of the plan member and the extent to which that benefit would be reduced by a payment under a group life insurance plan;

• (p) a statement setting out the right to access the documents described in paragraph 28(1)(c) of the Act;

• (q) in respect of the defined benefit provisions of an uninsured defined benefit plan,

  • (i) if the ratio as calculated in accordance with paragraph (b) of the definition solvency ratio in subsection 2(1) is less than one,

    • (A) the value and description of the ratio,

    • (B) a description of the measures the administrator has implemented or will implement to bring that ratio to one, and

    • (C) the extent to which the member’s benefit would be reduced if the plan were terminated and wound up with that solvency ratio; and

  • (ii) in any other case, a statement that the plan is fully funded based on the most recent solvency ratio of the plan.

(2) A written statement referred to in paragraph 28(1)(d) of the Act, in the case of a member who has retired from a plan, shall be in the form set out in Form 1 of Schedule IV.

(3) A written statement referred to in paragraph 28(1)(d) of the Act, in the case of a plan member who has ceased to be a member of the plan or where the whole or part of the plan has terminated and that member is entitled to a deferred pension benefit, shall be in the form set out in Form 2 of Schedule IV.

(4) A written statement referred to in paragraph 28(1)(d) of the Act, in the case of a plan member who has ceased to be a member of the plan and who is not entitled to a deferred pension benefit, shall be in the form set out in Form 3 of Schedule IV.

(5) A written statement referred to in paragraph 28(1)(d) of the Act, in the case of a plan member who has died, shall be in the form set out in Form 4 of Schedule IV.