5 - Member Benefits / Health Insurance Continuation - IMRF

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55 - Member Benefits / HealthInsurance ContinuationBENEFITS............................................................................................................................................................ 1435.00 INTRODUCTION .............................................................................................................................................. 1435.10 SEPARATION REFUND OF MEMBER'S IMRF CONTRIBUTIONS .................................................................................. 1435.10 A. Eligibility for Separation Refund ........................................................................................................ 1435.10 B. Amount of Separation Refund ........................................................................................................... 1445.10 C. Application for Separation Refund ..................................................................................................... 1445.10 D. Payment of Separation Refund .......................................................................................................... 1445.10 E. Members are Not Required to Withdraw IMRF Contributions........................................................... 1455.10 F. Income Taxes on Refund of IMRF Member Contributions ................................................................. 1455.20 RETIREMENT PENSIONS .................................................................................................................................... 1475.20 A. Eligibility for an IMRF Retirement Pension ......................................................................................... 1475.20 B. Amount of IMRF Retirement Benefits ................................................................................................ 1495.20 C. IMRF Early Retirement Incentive (ERI) ............................................................................................... 1645.20 D. Application for Retirement Pension ................................................................................................... 1745.20 E. Pension Payment Procedures ............................................................................................................. 1765.20 F. How the IMRF Pension is Affected by Returning to Work .................................................................. 1775.20 G. Income Taxes on Retirement Pensions ............................................................................................... 1795.30 DEATH BENEFITS ............................................................................................................................................ 1815.30 A. Types and Amounts of IMRF Death Benefits ...................................................................................... 1815.30 B. Eligible Beneficiaries for Death Benefits ............................................................................................... 1855.30 C. Application for IMRF Death Benefits .................................................................................................. 1855.30 D. Death Benefit Payment Procedures ................................................................................................... 1865.30 E. Federal Income Taxes on Death Benefits ........................................................................................... 1875.30 F. Illinois Income Tax on Death Benefits ................................................................................................ 1885.40 DISABILITY BENEFITS........................................................................................................................................ 1895.40 A. Eligibility for IMRF Disability Benefits ................................................................................................ 1895.40 B. Amount of IMRF Disability Benefits ................................................................................................... 1945.40 C. Application for Disability Benefits ...................................................................................................... 2005.40 D. Disability Benefit Payment Procedures .............................................................................................. 2045.40 E. Cost of IMRF Disability Benefits ......................................................................................................... 2085.40 F. Income Taxes on Disability Benefits ................................................................................................... 2095.50 RECIPROCITY .................................................................................................................................................. 2105.50 A. Purpose of Reciprocal Act .................................................................................................................. 2125.50 B. Form of the Reciprocal Act ................................................................................................................. 2125.50 C. Proportional Annuities ....................................................................................................................... 2135.50 D. Concurrent reciprocal service ............................................................................................................. 2145.50 E. Reciprocal Applications ...................................................................................................................... 2155.50 F. Repayment of Refunds ....................................................................................................................... 216January 2014 Page 141

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund5.50 G. Return to Work .................................................................................................................................. 2165.60 VERIFICATION OF IMRF BENEFIT PAYMENTS ........................................................................................................ 2165.70 APPEAL RIGHTS .............................................................................................................................................. 2165.80 HEALTH INSURANCE CONTINUATION................................................................................................................... 2175.80 A. Continued Health Insurance Under COBRA ........................................................................................ 2185.80 B. Continued Health Insurance Under Section 367j of the Illinois Insurance Code ................................ 2185.80 C. Pension Protection Act: Deduction of insurance premiums from IMRF benefit payment on a pre-taxbasis .................................................................................................................................................. 2215.80 D. Medicare ............................................................................................................................................ 2225.80 E. When Health Insurance Coverage Ends ............................................................................................. 2225.80 F. Public Safety Employee Benefits Act (820 ILCS 320/1 et seq.) .......................................................... 222Sample FormsExhibits5A 5.10 Application for Separation Refund (e-form also available)5B 5.20 Application for IMRF Pension5C 5.21 Notice of Intent to Retire Under Employer’s IMRF Early Retirement Incentive5D 5.30 Application For Death Benefit5E 5.40 Application for Disability Benefits5F 5.41 Employer’s Statement--Disability Claim5G 5.42 Physician’s Statement--Disability Claim5H 5.45 Employer’s Notice of Termination of Disability or Trial Work / Light DutyPeriod5I 5.48 Disability Payment Agreement5J 7.10 Health Insurance Continuation through Employer Premium DeductionAuthorization5K 1199 Application for Direct Deposit5L BW-60 Distribution/Rollover Certification5M-a S-40 Certificate of Benefits for IMRF Pension5M-b S-40 Certificate of Benefits for Surviving Spouse Annuity5N 7.12D Election For Deductions for Health or Long Term Care InsurancePremiums Paid Directly to Insurer5O 7.12E Election for Deductions for Health or Long Term Care Premiums Paidthrough Employer or Endorsed Plan Administrator5P 3.01 Change Account for Electronic Payments from IMRF5QTier 1/Tier 2 Comparison Chart for IMRF Regular Plan andTier 1/Tier 2 Comparison Chart for IMRF SLEP Plan5RReturn to Work and Effect on Tier 1 and Tier 2 Members Chart5SPublic Act 98-0389 Return-to-Work Rules ChartPage 142 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5Benefits5.00 IntroductionThis section explains the IMRF benefits available to members and their beneficiaries, the procedures for filingclaims for benefits and the methods of payment. We also discuss income tax treatment, which is intended forinformation as to our opinion and not as tax counseling for any individual member or employer.Checklists for Authorized AgentsIMRF also developed procedure checklists to assist Authorized Agents by providing a record of a member’sapplication process for IMRF benefits as well as for a member’s enrollment and termination process. Refer to theforms chart in the front of this manual.Tier 1, Tier 2 ComparisonA side-by-side comparison chart of Tier 1 and Tier 2 provides you with another view of the two tiers for both theIMRF Regular Plan and the IMRF SLEP Plan. See Exhibit 5Q for the comparison charts.Find the Right FormSample claim forms are included as exhibits at the end of this section.Benefits Information for MembersA member can view estimates of his or her IMRF benefits via Member Access area of IMRF’s website,www.imrf.org/myimrf. See 1.80 B. IMRF Website.IMRF also developed checklists for members: a Retirement Checklist and a Disability Benefits Checklist, which areavailable on the IMRF website, www.imrf.org.5.10 Separation Refund of Member's IMRF ContributionsFor information on Voluntary Additional contributions, refer to Paragraph 6.20C5.10 A. Eligibility for Separation RefundMembers eligible to receive a separation refund when they stop working for their IMRF employer include:1. Regular plan members Tier 1a. Members under age 55, irrespective of length of service.b. Members with less than 8 years of service, irrespective of age.c. Members, age 55 or over, who are eligible for a pension of less than $30 a month.2. Regular plan members Tier 2a. Members under age 62, irrespective of length of serviceb. Members with less than 10 years of Regular Tier 2 service, irrespective of agec. Members, age 62 or over, who are eligible for a pension of less than $30 a month.3. SLEP plan members Tier 1a. Members under age 50, irrespective of length of service. However, such members will forfeit theright to a future SLEP pension if they have at least 20 years of SLEP service, or a Regular planpension if they have at least eight years of SLEP and/or Regular plan service.b. Members age 50 but under age 55 with less than 20 years of SLEP service.c. Members age 55 or older who have less than eight years of SLEP and/or Regular plan service orwho are eligible for a pension of less than $30 per month.January 2014 Page 143

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund4. SLEP plan members Tier 2a. Members under age 50, irrespective of length of service. However, such members will forfeit theright to a future SLEP pension if they have at least 10 years of service.b. Members of any age with less than 10 years of service.5. To be eligible for a refund, the member must terminate employment as well as IMRF participation.6. The member is not eligible for a refund if he or she will continue working for the same unit ofgovernment in a position that is not eligible for IMRF or in a position that will participate in a reciprocalor local police or fire fund.For example, if a member works for a school district as a teacher’s aide and accepts a certificated teachingposition with the same school district, the member is not eligible for a separation refund.7. A member who is immediately eligible for a pension of $30 or more (even if it is reduced because of age)cannot receive a refund of IMRF member contributions in lieu of a pension unless the member rolls therefund over into another defined benefit retirement plan to purchase qualifying service credit.8. A member who transfers from one IMRF employer to another and continues as an IMRF participant is noteligible for a separation refund.However, if a gap exists between the termination date for the first employer and the enrollment date for thesecond employer, and the member’s refund application is received by IMRF during that gap, the membermay be eligible for a refund.A member working for two IMRF employers concurrently must terminate from both to be eligible for aseparation refund.5.10 B. Amount of Separation RefundThe separation refund consists of IMRF member contributions less any benefit prepayment. No interest is paidwith a separation refund, nor are the IMRF employer contributions refunded to the member. However, if themember purchased service, e.g., paid back a refund, purchased military service, etc., and the member’spayment(s) included interest, the separation refund will include the “member-paid” interest.A member can view an estimate of his or her IMRF Separation Refund via the secure Member Access area ofIMRF’s website, www.imrf.org. See 1.80 B. IMRF Website.5.10 C. Application for Separation RefundThe member should fill out IMRF Form 5.10, “Application for Separation Refund,” (Exhibit 5A) and send it toIMRF after the member has terminated employment. Members can also apply for a refund via Member Access.The Authorized Agent should file the member’s termination via Employer Access “Terminate IMRFParticipation” function. (Employers with Internet access are required to submit member terminations viaEmployer Access. Employers without Internet access may continue to use paper Form 6.41, ”Notice ofTermination of IMRF Participation”).See 6.30 To Close an Account for more detail. The termination notice should be sent to IMRF promptly.5.10 D. Payment of Separation RefundIMRF will pay the separation refund after receiving IMRF Form 5.10, “Application for Separation Refund,”(Member Access refund application or Form 5.10) and the Notice of Termination of IMRF Participation(Employer Access termination or Form 6.41, “Notice of Termination of IMRF Participation). (Employers withInternet access are required to submit member terminations via Online Termination in Employer Access.Employers without Internet access may continue to use paper Form 6.41.) Payment of all of the member’scontributions on deposit at that time is normally made within two to three weeks after this information isreceived.Page 144 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5If the member is vested for a pension, an estimate of the monthly pension he or she will forfeit by accepting therefund will be printed on the refund check. The member can reinstate the service credit by returning the uncashedcheck to IMRF along with a letter requesting the reinstatement. After IMRF receives the employer’s “MonthlyReport of IMRF Member Earnings and Contributions” (Web wage report or Form 3.11) listing the member’s lastearnings and contributions, the member will be paid a subsequent refund.5.10 E. Members are Not Required to Withdraw IMRF ContributionsA member is not required to withdraw his or her IMRF contributions upon separation from employment(termination of IMRF participation).A Tier 1 member with eight or more years of any service (Regular and/or SLEP) may receive a pension at age 55or thereafter. A Regular Plan Tier 2 member with 10 or more years of service may receive a pension at age 62 orthereafter.A SLEP Tier 1 member with 20 or more years of SLEP service may receive a SLEP pension at age 50 orthereafter. A SLEP Tier 2 member with 10 or more years of SLEP service may receive a SLEP pension at age 50or thereafter.A Tier 1 member with less than eight years or a Tier 2 member with less than 10 years of service may earn apension by earning future service under IMRF or with another Illinois public pension system under theReciprocal Act (see 5.50 Reciprocity).5.10 F. Income Taxes on Refund of IMRF Member Contributions1. Illinois Income Tax (Illinois Residents only)The Illinois Income Tax Act exempts IMRF separation refunds from Illinois income tax. Because thefederally taxable portion of the separation refund is included in federal adjusted gross income, the federallytaxable portion will also be entered on Line 1 of the Illinois IL-1040.In order to claim the exemption on Illinois Income Tax Return, IL-1040, it is necessary to follow thespecific instructions provided with the IL-1040 concerning subtractions to arrive at Illinois taxable income.2. Federal Income Taxa. Previously Taxed Member ContributionsAll IMRF member contributions prior to 1982 were paid by the member who was taxed on the amount.After January 1982, IMRF member contributions continued to be member paid “after tax”contributions, unless the employer had adopted a 414(h) tax deferral plan (Paragraph 4.16). EffectiveJuly 1, 1984, all IMRF member contributions have been made under a 414(h) tax deferral plan.Refunds of IMRF member contributions which were made before a 414(h) plan was in effect are notsubject to federal income tax because they have already been taxed.b. 414(h) Tax Deferred Member ContributionsUnder the 414(h) plan (Paragraph 4.16), member contributions are not subject to federal income taxwhen withheld and reported to IMRF. The refund is taxable in the year paid as explained in paragraph(e) below.c. Tax Withholding and ReportingIMRF is required by federal law to withhold 20% of the taxable portion of a separation refund. Themember can avoid the 20% withholding by having the taxable portion directly rolled over to atraditional IRA, Roth IRA, or other qualified retirement plan, or a 457 or 403(b) plan. A rollover to aRoth IRA will be taxable but not subject to any additional taxes.IMRF issues Internal Revenue Service Form 1099-R reporting the amount of the taxable refund andthe amount withheld or the amount directly rolled over. The member is mailed a copy in January of theyear following the year of payment and a copy is filed with the Internal Revenue Service.January 2014 Page 145

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fundd. Direct RolloversAt the member’s request, IMRF will roll over all or any portion of the taxable separation refunddirectly to a traditional IRA, Roth IRA, or other qualified retirement plan, or 457 or 403(b) plan. Arollover to a Roth IRA will be taxable but not subject to any additional taxes.The refund will be mailed to the member, but the check will be made payable to the custodian of theaccount or plan. No withholding is taken from the portion of the refund directly rolled over.The non-taxable portion of the refund may be rolled over to a traditional IRA or another qualifiedretirement plan that accepts such rollovers, provided the receiving financial institution agrees toseparate accounting.Also, a member who does not ask for a direct rollover of a separation refund may decide to roll it overinto a traditional IRA, Roth IRA , a qualified pension plan, a 457 or 403(b) plan, as provided bySection 402(c) of the Internal Revenue Code. A rollover to a Roth IRA will be taxable but not subjectto any additional taxes.e. Taxes on Lump Sum DistributionsNote: Regular Tier 1 members who are age 55 or older with eight or more years of service or RegularTier 2 members who are age 62 or older with 10 or more years of service are not eligible for a refund ifthey have earned a monthly pension of $30 a month or more unless the member rolls the refund overinto another defined benefit retirement plan to purchase qualifying service credit.The age of a member as well as the length of the member’s IMRF service can affect the income taxstatus of the taxable portion of the refund. The categories are:A. Under age 55 when employment with IMRF employer terminatedThe part of the refund representing 414(h) tax deferral plan contributions is taxable at the member’stax rate plus an additional 10% tax on the taxable amount. (Unless the member is age 59-1/2 or morein the year the refund is paid.) The additional 10% tax applies, even though the member may nothave sufficient income to be liable for income tax. The member may defer the tax and avoid theadditional 10% tax by a rollover into a traditional IRA or qualified pension plan, or 457 or 403(b)plan.B. Age 55 or more (50 or older if a public safety officer) when employment with IMRFemployer terminated or age 59-1/2 at time of refundThe part of the refund representing 414(h) tax deferral plan contributions is taxable at the member’stax rate. The additional 10% tax is not applicable. The member may defer the tax by a rollover of thetaxable amount into a traditional IRA or qualified pension plan, or 457 or 403(b) plan.C. Special Tax Treatment available to members born before January 1, 1936 and participatingin IMRF for five or more years prior to the year the refund is paidThe part of the refund representing 414(h) tax deferral plan contributions is taxable income. It istaxed at the member’s regular rate. The member may defer the tax by rolling over the taxableamount into a traditional IRA or qualified pension plan, or 457 or 403(b) plan. Alternatively, themember may report the taxable portion under 10-year averaging at 1986 tax rates.Page 146 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55.20 Retirement PensionsIMRF has developed a Retirement Application Checklist to assist Authorized Agents with a member’s applicationfor an IMRF pension. Refer to the IMRF Forms Chart in the front of this manual.IMRF has also developed a Member Retirement Checklist to assist members in the retirement application process.5.20 A. Eligibility for an IMRF Retirement Pension(For information on IMRF’s Early Retirement Incentive (ERI) refer to paragraph 5.20 C. IMRF Early RetirementIncentive [ERI].)1. Under the Regular Plan Tier 1a. Age - Member must be at least 55 years old. (Under current federal tax law and the IllinoisPension Code, IMRF is required to begin a member’s pension once the member reaches age 70-1/2 if the member is no longer working for an IMRF employer or participating in a reciprocalretirement system.)b. Service - Member must have at least 8 years of service. (A member with less than 8 years may beeligible if he or she has reciprocal service. Refer to 5.50 Reciprocity.)c. Employment status - Member must not be working in any position qualifying for IMRF coverage.d. Employment status of elected officials - Member may be working as an elected official if he or shehas not earned service credit for that elected office and has chosen not to participate in IMRF withrespect to that elected office.2. Under the Regular Plan Tier 2a. Age - Member must be at least 62 years old. (Under current federal tax law and the IllinoisPension Code, IMRF is required to begin a member’s pension once the member reaches age 70-1/2 if the member is no longer working for an IMRF employer or participating in a reciprocalretirement system.)b. Service - Member must have at least 10 years of service. (A member with less than 10 years maybe eligible if he or she has reciprocal service. Refer to 5.50 Reciprocity.)c. Employment status - Member must not be working in any position qualifying for coverage inIMRF or hold any full-time employment covered by any other pension system established by theIllinois Pension Code.d. Employment status of elected officials - Member may be working as an elected official if he or shehas not earned service credit for that elected office and has chosen not to participate in IMRF withrespect to that elected office.3. Under the SLEP Plan Tier 1a. Age - Member must be at least 50 years old.b. Service - Member must have at least 20 years of SLEP service. SLEP service is total service as acounty sheriff, full-time deputy sheriff or forest preserve ranger, or certain service as a police chiefor other qualified SLEP position. (See Section 3.10 for a complete listing of qualified SLEPpositions.) SLEP service with more than one SLEP employer is combined.If a SLEP member retires with: Less than 20 years’ SLEP service credit, but eight or more years of SLEP and/or Regularservice credit, the service will be combined to determine a Regular plan pension at age 55.The member’s SLEP contributions will be refunded with interest. (Certain SLEP memberscan convert up to 10 years of Regular plan service to SLEP. Refer to paragraph 6.40.12., PastService Credits/Member Account Corrections, Conversion of Regular Service to SLEPService)January 2014 Page 147

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund20 or more years’ SLEP service credit plus other periods of non-SLEP service credit underIMRF, he or she will receive a Regular plan pension in addition to a SLEP pension.c. Employment Status - Member must not be working in any position qualifying for IMRF or SLEPcoverage.d. Employment Status of Elected Officials - Member may be working as an elected official but hasnot earned service credit for that elected office and has not elected to participate in IMRF withrespect to that elected office.4. Under the SLEP Plan Tier 2a. Age - Member must be at least 50 years old. If the member retires between age 50 and 55, thepension will be reduced by 1/2% for each month he/she is under age 55.b. Service - Member must have at least 10 years of SLEP Tier 2 service. SLEP service is total serviceas a county sheriff, full-time deputy sheriff or forest preserve ranger, or certain service as a policechief or other qualified SLEP position. (See Section 3.10 for a complete listing of qualified SLEPpositions.) SLEP service with more than one SLEP employer is combined.If a SLEP member retires with:SLEP Tier 2 service plus other IMRF service10 or more years of SLEP Tier 2 service credit plus other Regular service, the member willreceive a SLEP Tier 2 pension plus a Regular plan pension.Less than 10 years of SLEP Tier 2 service credit but have other Regular service:i. Regular Tier 1 and SLEP Tier 2Eight or more years of total service, the service will be combined to determine aRegular Tier 1 pension. The member’s SLEP contributions will be refunded withinterest.ii. Regular Tier 2 and SLEP Tier 210 or more years of total service, the service will be combined to determine aRegular Tier 2 pension. The member’s SLEP contributions will be refunded withinterest.Certain SLEP members can convert up to 10 years of Regular plan service to SLEP. Refer toparagraph 6.40.12., Past Service Credits/Member Account Corrections, Conversion of RegularService to SLEP Service.Note: Members who joined the SLEP plan on or after August 8, 2011 are not eligible to upgradeRegular service credit to SLEP.c. Employment Status - Member must not be working in any position qualifying for IMRF or SLEPcoverage.d. Employment Status of Elected Officials - Member may be working as an elected official but hasnot earned service credit for that elected office and has not elected to participate in IMRF withrespect to that elected office.Felony convictionIf an IMRF member is convicted of a felony in connection with his or her IMRF employment, the member is noteligible for an IMRF pension.If a retired IMRF member receiving an IMRF pension is convicted of a felony in connection with his or her IMRFemployment, the pension is terminated. The member may apply for a refund of his/her member contributions.Page 148 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55.20 B. Amount of IMRF Retirement Benefits1. Regular Plan Pensiona. Calculation of a Regular plan pension (Tier 1 and Tier 2)A Regular plan pension is based on the member’s length of service and final monthly rate ofearnings (FRE). All service is considered in calculating a pension, including partial years.Under Tier 1, the final monthly rate of earnings is the sum of the highest total earnings during any48 consecutive months within the last 10 years of service divided by 48.Under Tier 2, the final monthly rate of earnings is the sum of the highest total earnings (under thewage cap) during any 96 consecutive months within the last 10 years of service divided by 96.Those 48 or 96 months (as appropriate) can include the month after the last day of work, if amember receives his or her final paycheck in that month. In that case, the member could stillreceive an IMRF monthly pension for that month.Alternative FRE Formula: “Lifetime FRE”The Illinois Pension Code provides for an alternative FRE formula when a member has higherearnings at the beginning of his or her career. This FRE is known as a “Lifetime FRE.” This FREaverages all of a member’s earnings reported by all of his or her employer(s) over the member’sentire career.When a member retires, IMRF calculates the FRE using both methods and uses the FRE thatprovides the member with the larger pension.b. Regular Plan Pension Calculation IllustrationThe formula for computing a Regular plan monthly pension (Tier 1 and Tier 2) is as follows:First 15 years of 1-2/3% x years of service x final monthly rate of earningsservice:plus Service over 15 years: 2% x years of service x final monthly rate of earningsFor example:8 years of service 13% of final rate of earnings10 years of service 17% of final rate of earnings15 years of service 25% of final rate of earnings20 years of service 35% of final rate of earnings25 years of service 45% of final rate of earningsNote: the total pension at retirement (including any portion attributable to converted sick leave) cannotexceed 75% of the member’s final rate of earnings (reached after earning 40 years of service).Example:A Tier 1 member retires at age 60 with 20 years of service and final monthly rate of earnings of $2,000. Thepension calculation is as follows:First 15 years of service: 1-2/3% x 15 x $2,000 = $500+ Service over 15 years: 2% x 5 x $2,000 = $200Total monthly pension $700The above example assumes the member retired under IMRF’s standard payout plan.Note: members retiring under Tier 2 must be at least age 62; normal retirement age is 67.January 2014 Page 149

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund2. SLEP Plan Pensiona. Calculation of a SLEP pension (Tier 1 and Tier 2)A Tier 1 SLEP plan pension is based on the member’s length of SLEP service and final rate ofearnings. The final rate of earnings is the highest total earnings during any 48 consecutive monthswithin the last 10 years of service divided by 48.A Tier 2 SLEP plan pension is based on the member’s length of SLEP service and final rate ofearnings. The final rate of earnings is the highest total earnings under the wage cap during any 96consecutive months within the last 10 years of service divided by 96.Those 48 or 96 months (as appropriate) can include the month after the member’s last day of work,if the member receives his or her final paycheck in that month. In that case, the member could stillreceive a SLEP pension for that month.b. SLEP pension calculation illustrationFor SLEP pensions for members who terminate service on or after July 1, 2006, the formula forcomputing a SLEP monthly pension is 2.50% of the final rate of earnings for each year of SLEPservice credit. The total pension at retirement cannot exceed 80 percent (75 % for SLEP Tier 2) ofthe final rate of earnings.For example:20 years of service 50% of final rate of earnings25 years of service 62.5% of final rate of earnings30 years of service 75% of final rate of earningsThe total pension at retirement cannot exceed 80% of the member’s final rate of earnings (reached afterearning 32 years of SLEP service) for SLEP Tier 1. SLEP Tier 2 maximum pension is 75% of themember’s final rate of earnings (after 30 years of service).Example: A SLEP Tier 1 member who retires at age 50 with 27 years of service and average monthlyearnings of $5,000 will receive a pension of $3,375 a month. The pension calculation is as follows:27 years of service: 2.5% x 27 = 67.5% x $5,000 = $3,375Total monthly pension $3,375Note: SLEP Tier 2 pensions are reduced ½% for each month a member is under age 55 at retirement.If a member with 20 or more years of SLEP service has other periods of non-SLEP service under IMRF,the member will receive a pension under the SLEP formula plus a pension under the Regular plan formulafor the non-SLEP service.For SLEP pensions for members who terminated service before July 1, 2006, the formula for computing aSLEP pension is 50% of the final rate of earnings for the first 20 years of service credit, plus 2% of thefinal rate of earnings for each year of service credit over 20 and under 30 years, plus 1% of the final rate ofearnings for each year of service credit over 30 years. The total pension at retirement cannot exceed 75percent of the final rate of earnings.3. Pension Payment PlansWhen a member retires, his or her initial pension payments are always based on IMRF’s standard (straightlife) plan. However, the member may be eligible for other payment options.Page 150 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5Standard (straight life) PayoutUnder the standard payout, a member receives the same pension amount every month after he or she retiresfor the rest of his or her life, regardless of how long he or she lives. (Retired members also receive an annualnon-compounded increase. See 5.20 B. 10. Pension Increases After Retirement).Optional PayoutIf a member is less than 62 years of age on the effective date of his or her pension, the member can elect toreceive the pension under an optional payout. (The optional payout is not available to members retiring underthe Regular Plan Tier 2. The earliest retirement age under Regular Plan Tier 2 is 62.)Under the optional payout, the member would receive a larger pension until age 62 and a reduced pensionthereafter.With the addition of a Social Security pension at age 62, or later, this enables the member to achieve a morelevel retirement income.Note: To determine the amount of a member’s optional pension, IMRF uses a table of estimated SocialSecurity benefits. This table includes general assumptions about the average person’s work record.IMRF will advise members under age 62 at retirement of the amounts payable under the Standard plan andunder the optional payout. The calculations of the optional payout vary and can be computed on an individualbasis only.Alternate pension formulas, that is, money purchase and reversionary annuities, are discussed in paragraph 13in this section.4. Total Pension PayoutIf we assume the Tier 1 member from the example above retired on December 31, 2009, he would be entitledto receive a Regular Tier 1 pension of $700 per month for life effective January 1, 2010.On average, a male IMRF member retiring at age 60 would be expected to live another 18 years. If his wifewere age 59, she would be expected to live 10 years longer than her husbandThe following table illustrates the total payout for the above example:OriginalYearMonthlyPensionMonthly PensionWith Increase*AnnualPayout1 2012 700.00 700.00 8,400.002 2013 700.00 721.00 8,652.003 2014 700.00 742.00 8,904.004 2015 700.00 763.00 9,156.005 2016 700.00 784.00 9,408.006 2017 700.00 805.00 9,660.007 2018 700.00 826.00 9,912.008 2019 700.00 847.00 10,164.009 2020 700.00 868.00 10,416.0010 2021 700.00 889.00 10,668.0011 2022 700.00 910.00 10,920.0012 2023 700.00 931.00 11,172.0013 2024 700.00 952.00 11,424.0014 2025 700.00 973.00 11,676.0015 2026 700.00 994.00 11,928.00January 2014 Page 151

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund16 2027 700.00 1,015.00 12,180.0017 2028 700.00 1,036.00 12,432.0018 2029 700.00 1,057.00 12,684.00Total Pension Payout $ 189,756.00Single Sum Payment $ 3,000.00**Surviving Spouse pension of $528.50 Per month for 10 years $ 71,984.40with an annual increase of $15.81Total Cash Payout $ 263,989.88Please note: The total cash payout shown above does not include the supplemental retirement benefit (13thpayment). The supplemental retirement benefit is paid in addition to the pension and surviving spouse pensionamounts.*Under Tier 1, the annual increase is 3% of the original amount and is paid each January 1. Under Tier 2, theannual increase is the lower of 3% of the original pension amount or one-half of the increase in the ConsumerPrice Index (urban) for the preceding year as of September. The increase not paid until the later of age 67 orafter one year of receiving a pension.**Under Tier 1, the Surviving Spouse monthly pension equals 50% of member’s monthly Standard pension attime of death. Under Tier 2, the Surviving Spouse monthly pension equals 66-2/3% of member’s monthlypension at time of death.5. Unused and Unpaid Sick Leave Service CreditRetiring IMRF members may qualify for a maximum of one year of additional pension service credit forunpaid, unused sick leave accumulated with their last employer. The effective date of the member’s pensionmust be within 60 days of the member’s termination date.Cost to the EmployerThere is no immediate cost to the member or the employer for converted sick leave. The cost of this additionalservice credit (up to one year) is funded through the employer reserve and may be reflected in future employercontribution rates.School district employees:Members retiring from a school district may convert unused, unpaid sick leave accumulated with anyprior school district employers. (All other members may convert unused sick leave accumulated withtheir last employer only.) The effective date of the member’s pension must be within 60 days of themember’s termination from a school district.(Employees of other educational entities, such as special education cooperatives, and employees of allother non-school district units of government are not eligible to convert unused, unpaid sick leave fromprior employers.)To report unused, unpaid sick leave, the previous school district employer may submit a correctedNotice of Termination of Participation via Employer Access.If the school district does not submit a corrected termination notice, the member may provide IMRFwith evidence of the unused sick leave. Acceptable evidence must have originated on or before the datethe previous employment ended, e.g., copies of original payroll information or original paycheck stubsshowing earned sick leave. IMRF cannot accept recreated documents or letters of certification.Page 152 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5One month of service is credited for every 20 days, or fraction thereof, of unpaid, unused sick leave not toexceed 240 days (one year). Since elected officials generally do not earn sick leave, they are not entitled toadditional pension service credit under this provision.The sick leave must have been accumulated under an established sick leave plan available to all employees ora class of employees, and the effective date of the pension must be within 60 days of termination. Thisadditional pension service credit provision applies solely to employees terminating for retirement purposes.The sick leave plan must provide for the periodic accumulation of sick leave. Sick leave allotted incontemplation of retirement is not acceptable.Examples of sick leave plans under which unused, unpaid sick leave may be converted to service credit:a. An employer maintains two separate sick leave plans, one for employees of a bargaining unit andone for non-unionized employees.b. An employer maintains a plan which allows accumulation of sick leave days up to a maximum of100 days, and any days over that number may be accumulated only for conversion to servicecredit.c. An employer cashes out accumulated sick leave at the rate of $25 per day for all days in excess of100 (under this plan, the first 100 days may be converted to service credit).d. An employer cashes out 10% of accumulated sick leave days at the member’s own salary rate ifthe member accumulates 50 days or more, 25% of accumulated days if the member has 100 daysor more, 50% of accumulated days if the member has 200 days or more (the remaininguncompensated days may be converted to service credit).e. An employer allows terminating employees to convert accrued vacation and/or personal leave tosick leave days.Employer “gifts” of sick leave not eligibleUnder the Illinois Pension Code, an employer may not simply grant sick leave solely to allow a retiringmember to convert the sick leave to service credit. Therefore, an employer may not “gift” sick leave to amember if the sick leave was not accumulated in the usual manner, i.e., under a written plan established bythe employer and available to all employees or to a class of employees.For example, an employer has an agreement with a union that it will provide to retiring members an additional100 days of sick leave to be used solely to enhance their retirement benefit. That sick leave was notaccumulated in the usual manner and the member may not convert those days to service credit.Converted sick leave cannot be used to meet vesting requirementsPlease note that converted sick leave service cannot be used to meet the requirements of a minimum of eightyears for an IMRF Regular Tier 1 pension, minimum of 10 years for an IMRF Regular Tier 2 pension, the 35years for a non-discounted Regular Tier 1 pension under age 60, the 35 years for a non-discounted RegularTier 2 pension under age 67, the 20 years for a SLEP Tier 1 pension, the 10 years for a SLEP Tier 2 pension,or the 20 years for an ERI.6. Concurrent Service CreditFor a discussion of concurrent service under two or more reciprocal retirement systems, refer to 5.50DConcurrent Reciprocal Service Credit.a. Concurrent service under the same planOne type of concurrent service occurs when a member is reported under the same plan by more thanone employer for the same month.January 2014 Page 153

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundUnder this type of concurrent service, the member’s wages for the month are combined, and, by law,the member is credited with one month of service.Although the member receives only one month of service credit, the salaries are combined for thatmonth. Therefore, if the concurrent service occurs during the member’s final rate of earnings (FRE)period, it can increase the amount of his or her pension.FRE is one factor used to calculate the amount of an IMRF pension. Under Regular Tier 1, the FREis the average monthly earnings over the highest consecutive 48 months of earnings within the last10 years of IMRF service.Example:A member is reported under the Regular plan by two school districts for May, June, July, andAugust. For these 4 months,School District A reports Regular plan earnings of $1,500+ School District B reports Regular plan earnings of $3,200Total Regular earnings reported $4,700The member earns 4 months of Regular IMRF service credit.b. Concurrent service under different plansWhen a member is reported under different plans by more than one employer for the same month,the concurrent service is treated as one month of service and the member’s wages are recordedseparately under each plan for the calculation of benefits.Example:A member is reported under the Regular plan by a park district for May, June, July, and August andunder SLEP by a county for May, June, July, and August. For these 4 months,The Park District reports Regular plan earnings of $1,500The County reports SLEP earnings of $3,200The member earns: 4 months of service The Regular formula is applied to his Regular earningsThe SLEP formula is applied to the SLEP earningsHowever, if a member is reported concurrently under the Regular plan and SLEP and vests for aSLEP pension, when the pensions are calculated, each concurrent month will be treated as onemonth of service in two plans. When the member’s pension is calculated, the calculation will applythe Regular formula to those months with Regular wages and the SLEP formula to those monthswith SLEP wages.7. Under Age 60 Reduction for a Regular Tier 1 pensionIf a Tier 1 member retires between the ages of 55 and 60 with less than 30 years of service credit, thepension will be reduced by 1/4% for each month the member is under age 60.If a member retires between the ages of 55 and 60 with at least 30 but less than 35 years of pensionservice credit, the pension will be reduced by the lesser of1/4% for each month the member is under age 60 or1/4% for each month of service less than 35 years.Page 154 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5If the member has 35 or more years of pension service credit, the full amount of the pension will be paid,regardless of the age of the member at retirement.If the member retires under ERI, the IMRF ERI does not alter the existing pension reduction if a memberretires before age 60. This reduction will apply if the member’s ERI enhanced age is less than 60. If whenthe member retires:a. His or her ERI enhanced age is between 55 and 60 and his or her ERI enhanced service is1. Less than 30 years, the pension will be reduced by 1/4% for each month the members’ERI enhanced age is under 60.2. At least 30 but less than 35 years, the pension will be reduced by the lesser of1/4% for each month the ERI enhanced age is less 60 or1/4% for each month the ERI enhanced service is less than 35 years.b. His or her ERI enhanced age is 60 or his or her ERI enhanced service is 35 years, the full amountof the pension is paid.If the member’s actual age is 55 or greater, he or she can avoid the reduction by purchasingsufficient service to reach an enhanced age of 60 or 35 years of service credit.If the member’s actual age is less than 55, the pension reduction will be calculated using theenhanced age and service credit.Example:Actual Age 51 yrs. 4 mo. Actual Service 22 yrs. 3 mo.Member purchases 5 yrs. 0 mo. 5 yrs. 0 mo.ERI age 56 yrs. 4 mo. ERI service 27 yrs. 3 mo.Number of Months ERI enhanced age less than 60:44 monthsPension would be reduced 1/4% for each month under age 60:The amount of the ERI enhanced pension would be permanently reduced by 11%.For details on IMRF's ERI, see 5.20 C. IMRF Early Retirement Incentive (ERI).44 monthsx .25%11%8. Under Age 67 Reduction for a Regular Tier 2 pensionIf a Tier 2 member retires between the ages of 62 and 67 with less than 30 years of service credit, thepension will be reduced by 1/2% for each month the member is under age 67.If a member retires between the ages of 62 and 67 with at least 30 but less than 35 years of pensionservice credit, the pension will be reduced by the lesser of1/2% for each month the member is under age 67 or1/2% for each month of service less than 35 years.If the member has 35 or more years of pension service credit, the full amount of the pension will be paid,regardless of the age of the member at retirement.January 2014 Page 155

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundIf the member retires under ERI, the IMRF ERI does not alter the existing pension reduction if a memberretires before age 67. This reduction will apply if the member’s ERI enhanced age is less than 67. If whenthe member retires:a. His or her ERI enhanced age is between 62 and 67 and his or her ERI enhanced service is2. Less than 30 years, the pension will be reduced by 1/2% for each month the members’ ERIenhanced age is under 67.At least 30 but less than 35 years, the pension will be reduced by the lesser of1/2% for each month the ERI enhanced age is less 67 or1/2% for each month the ERI enhanced service is less than 35 years.b. His or her ERI enhanced age is 67 or his or her ERI enhanced service is 35 years, the full amount of thepension is paid. NOTE: An ERI enhanced age of 67 does NOT make a Tier 2 member eligible for anannual pension increase. The member must reach the later of age 67 or 12 months of pension paymentsto be eligible for annual increases. See Paragraph 5.20 B 11. Pension Increases After Retirement.If the member’s actual age is 62 or greater, he or she can avoid the reduction by purchasingsufficient service to reach an enhanced age of 67 or 35 years of service credit.If the member’s actual age is less than 62, the pension reduction will be calculated using theenhanced age and service credit.Example:Actual Age 58 yrs. 4 mo. Actual Service 22 yrs. 3 mo.Member purchases 5 yrs. 0 mo. 5 yrs. 0 mo.ERI age 63 yrs. 4 mo. ERI service 27 yrs. 3 mo.Number of Months ERI enhanced age less than 67:44 monthsPension would be reduced 1/2% for each month under age 67:The amount of the ERI enhanced pension would be permanently reduced by 22%.For details on IMRF's ERI, see 5.20 C. IMRF Early Retirement Incentive (ERI).44 monthsx .5%22%9. Under Age 55 Reduction for a SLEP Tier 2 pensionIf a SLEP Tier 2 member retires between the ages of 50 and 55, the pension will be reduced by 1/2% foreach month the member is under age 55.If the member retires under ERI, the IMRF ERI does not alter the existing pension reduction if a memberretires before age 55. This reduction will apply if the member’s ERI enhanced age is less than 55. Fordetails on IMRF's ERI, see 5.20 C. IMRF Early Retirement Incentive (ERI).10. Over Age 70-1/2 Requirement to Receive PensionUnder current federal tax law and the Illinois Pension Code, IMRF is required to begin a member’s pensiononce the member reaches age 70-1/2 if the member is no longer working for an IMRF employer orparticipating in a reciprocal retirement system.IMRF contacts those members who are at least age 70-1/2 and who are not working for an IMRF employer orparticipating in a reciprocal retirement system and advises them of the requirement that they start receivingtheir pension.Page 156 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 511. Pension Estimate TableYou can also estimate a member’s future pension using the pension calculator available on the IMRF websiteat www.imrf.org.A member can calculate a pension estimate using his or her actual final rate of earnings and service credit viathe secure Member Access area of the IMRF website. See 1.80 B. IMRF Website.a. Regular Plan Pension Tiers 1 and 2:You can consult IMRF’s Table for Estimating an Approximate Monthly Regular plan pension.b. SLEP Plan Pension Tiers 1 and 2:You can consult IMRF’s Table for Estimating an Approximate Monthly SLEP plan pension.Table for Estimating an Approximate Monthly Regular Plan Tier 1 & Tier 2 PensionSocial Security benefits are in addition to the figures shown in the table.To use this table:a. Find the final monthly rate of earnings in the left hand vertical column.b. Find the years of service credit in the top line.c. The pension at age 60 and older for Tier 1 members or age 67 and older for Tier 2 members will be inthe amount shown at the point where the earnings line and the service column intersect.Example: 25 years of service and final monthly rate of earnings of $1,000 will provide an IMRFpension of $450 per month.January 2014 Page 157

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fundd. For Tier 1 members, the pension is reduced by 1/4% for each month below age 60 for those membersbetween the ages of 55 and 60 with less than 35 years of service. For Tier 2 members, the pension isreduced by 1/2% for each month below age 67 for those members between the ages of 62 and 67 withless than 35 years of service.Regular Tier 1 Example:Age Percentage of Pension Reduction Age Percentage of Pension Reduction55 15% 58 6%56 12% 59 3%57 9% 60 0%Regular Tier 2 Example:Age Percentage of Pension Reduction Age Percentage of Pension Reduction62 30% 65 12%63 24% 66 6%64 18% 67 0%Table for Estimating an Approximate Monthly SLEP Tier 1 Plan PensionSocial Security benefits are in addition to the figures shown in the table.To use this table:a. Find the final monthly rate of earnings in the left hand vertical column.b. Find the years of service credit in the top line.c. The pension at age 50 or older will be in the amount shown at the point where the earnings line and theservice column intersect.Page 158 January 2014

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund12. Pension Increases After Retirementa. Tier 1 All PlansTier 1 pensions are increased automatically on January 1 of each year. The amount of the increaseis 3% of the original amount. (The first year is prorated; the first increase will be less than 3%unless the effective date of the retirement is January 1.) Note: With the optional pension, the 3%increase is also reduced at age 62.Example:Retirement date: January 1OriginalYearMonthlyAmount 1st 2nd 3rd 5th 10th 15th$400 $400 $412 $424 $448 $508 $568$600 600 618 636 672 762 852$800 800 824 848 896 1,016 1,136$1,000 1,000 1,030 1,060 1,120 1,270 1,420$1,500 1,500 1,545 1,590 1,680 1,905 2,130b. Tier 2 Regular Plan, SLEP, and ECOTier 2 Regular and ECO pensions are increased on January 1 after the member reaches age 67 orreceives 12 months of pension payments, whichever occurs later.If a Regular Tier 2 member retires under age 67, he or she will receive the annual increase theJanuary 1 following the date he or she reaches age 67, or has received 12 months of pensionpayments whichever is later. Thereafter, the pension will be increased annually each January 1.If a SLEP Tier 2 member retires under age 60, he or she will receive the annual increases theJanuary 1 following the year the member reaches age 60 or receives 12 months of payments,whichever is later. Thereafter, the pension will be increased annually each January 1.The increase, which is not compounded, is the lower of 3% or one-half of the increase in theConsumer Price Index Urban (CPI-U) for the preceding 12 months as of September, of theoriginal amount. If the CPI-U decreases or is zero, no increase is paid.13. Retirement Refundsa. Surviving Spouse ContributionsSurviving spouse contributions are refunded with interest when a member applies for a pension if:1. The member is single, widowed, or divorced.2. The member is married or in civil union, less than one year prior to the date IMRF or IllinoisReciprocal Retirement System participating employment ended.b. SLEP Plan ContributionsSLEP plan contributions (currently 3%, 2% before June 1, 2006, and 1% before July 1, 1988) arerefunded with interest when a SLEP member does not qualify for a SLEP pension when he or sheretires, but does qualify for a Regular plan pension.Page 160 January 2014

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund16. Pension EstimatesIMRF will furnish an estimate of a pension upon request. The member’s Social Security number andanticipated retirement date should be included with each request.A member can also calculate a pension estimate using his or her actual final rate of earnings and servicecredit via the secure Member Access Area of the IMRF website. See 1.80 B. IMRF Website.If a member is vested for an IMRF pension (Regular Tier 1, eight or more years of service credit; RegularTier 2, 10 or more years of service credit) and applies for a separation refund, an estimate of the monthlypension he or she will forfeit by accepting the refund will be printed on the refund check.5.20 C. IMRF Early Retirement Incentive (ERI)1. Features of the IMRF Early Retirement Incentivea. The IMRF Early Retirement Incentive (ERI) is a permanent part of the IMRF benefit program. Itis a tool IMRF employers can use, if and when they need it, to save fringe benefits and payrollcosts by providing an incentive for long-term members to retire.In order to save money with an ERI, employers are encouraged to either replace no more than 80%of members electing to retire under the program, or to reduce replacement staff salaries to no morethan 80% of current salary levels.b. Eligible members can purchase between one month and five years of age and service credit for thepurpose of determining retirement benefits.c. The ERI provides flexibility for employers by allowing the employer to determine the timing ofmember terminations. However, if a member requests to retire before July 1st so he or she will beeligible to receive the following year’s Supplemental Benefit Payment (13th payment), theemployer must allow the member to do so.d. Members may terminate up to a year from the effective date of the employer’s ERI program.e. The employer cost of adopting the ERI can be paid for over a period of no more than 10 years.(See Subsequent Offerings in this section.) If an employer adopts the program, the ERI applies toall IMRF members, including elected officials participating in IMRF.2. Eligible employersAll IMRF employers can adopt the IMRF ERI, however, some restrictions apply. See Subsequent Offeringsin this section.3. Member benefits under ERIa. Tier 1Without the ERI, Regular Tier 1 members can retire at age 55. With ERI, they can retire at age 50 providedthey have 20 years of service credit before adding the incentive.Without the ERI, Regular Tier 1 members receive reduced benefits if they are less than age 60 with lessthan 35 years of service credit when they retire. Under ERI, members less than age 55 can purchasesufficient service to reach age 55. Members age 55 to 60 can avoid the reduction by purchasing sufficientservice/age to reach age 60 or 35 years of service.IMRF pensions are based upon a formula which provides a member with a percentage of his or her finalrate of earnings for each year of service credit. A member will be able to increase the percentage he or shereceives by purchasing one month to five years of additional service credit.Eligible members may purchase from one month up to five years of additional service credit. For eachperiod of service established, the member’s age at retirement will be increased accordingly.Page 164 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5Tier 1 Example:Member’s actual age 56 yrs. 5 mo. Actual service 22 yrs. 3 mo.Member purchases 3 yrs. 7 mo + 3 yrs. 7 mo.Member’s ERI age 60 yrs. 0 mo. ERI service 25 yrs. 10 mo.If the member’s enhanced ERI age will be less than age 60 when he or she retires, the under age 60reduction will still apply. See 5.20 B. 7. Under Age 60 Reduction.Members age 60 or older may also purchase up to five years of additional service credit. Although ageenhancement is no longer necessary, the additional service credit will result in a larger pension.SLEP Tier 1 members are eligible to retire without ERI at age 50 with 20 years of SLEP service. Althoughage enhancement is not necessary, ERI allows a SLEP member to purchase additional credit.Note: Although a member can use reciprocal service credit to meet the service requirement for the IMRFERI, the member will not be eligible to receive a pension from the reciprocal system unless he or she meetsits age requirement without the IMRF ERI age/service enhancements.If a member participates in the Elected County Official (ECO) Tier 1 plan.The maximum ECO pension (80% of final rate of earnings) is earned after 20 years of ECO service credit.Age 55 is the minimum age to retire under ECO. An ECO member who retires under ERI with 20 years ofECO service will have his or her age enhanced for retirement purposes, but the pension amount will not beincreased (because it is already at the maximum amount).ECO Example:An ECO member at age 50 with 20 years of ECO service can purchase five years of ECO service allowinghim or her to retire at age 50 (instead of the minimum age of 55). However, the amount of the pension willnot increase.b. Tier 2Regular Tier 2 members can retire at age 62 without ERI. With ERI, they can retire at age 57 provided theyhave 20 years of service credit before adding the incentive.Without the ERI, Regular Tier 2 members receive reduced benefits if they are less than age 67 and haveless than 35 years of service credit when they retire. Under ERI, Tier 2 members less than age 62 canpurchase sufficient service to reach age 62. Tier 2 members age 62 to 67 can avoid the reduction bypurchasing sufficient service/age to reach age 67 or 35 years of service.IMRF pensions are based upon a formula which provides a member with a percentage of his or her finalrate of earnings for each year of service credit. A member will be able to increase the percentage he or shereceives by purchasing one month to five years of additional service credit.Eligible members may purchase from one month up to five years of additional service credit. For eachperiod of service established, the member’s age at retirement will be increased accordingly.Tier 2 Example:Member’s actual age 63 yrs. 5 mo. Actual service 22 yrs. 3 mo.Member purchases 3 yrs. 7 mo + 3 yrs. 7 mo.Member’s ERI age 67 yrs. 0 mo. ERI service 25 yrs. 10 mo.If the member’s enhanced ERI age will be less than age 67 when he or she retires, the under age 67reduction will still apply. Also, an ERI-enhanced age of 67 does not make the member eligible for annualJanuary 2014 Page 165

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fundpension increases. Tier 2 pensions are increased after the member reaches the actual age 67 or receives 12months of pension payments, whichever occurs later. See Paragraph 5.20 B.10 Pension Increases AfterRetirement.Members age 67 or older may also purchase up to five years of additional service credit. Although ageenhancement is no longer necessary, the additional service credit will result in a larger pension.Note: Although a member can use reciprocal service credit to meet the service requirement for the IMRFERI, the member will not be eligible to receive a pension from the reciprocal system unless he or she meetsits age requirement without the IMRF ERI age/service enhancements.If a member participates in the SLEP Tier 2 planSLEP Tier 2 members have the same ERI eligibility requirements as other plan members, except they areeligible to retire at age 50 with 20 years of SLEP service. However, the normal retirement age for SLEPTier 2 is age 55. If a SLEP member retires under age 55, the under age 55 reduction will apply.4. Eligible membersTo be eligible to retire under the IMRF ERI:a. The member’s employer must adopt the program.b. The member must be participating in IMRF on the effective date of his or her employer’s ERIprogram. A member would still be considered participating in IMRF if he or she is:1. On layoff status with right of re-employment,2. On IMRF Benefit Protection Leave of Absence, or3. Receiving IMRF disability benefits for less than two years.c. Tier 1 members must be at least age 50; Tier 2 (except SLEP) members must be at least age 57.Members must have at least 20 years of service credit by his or her date of retirement.1. The 20 years of service credit can include reciprocal service2. The 20 years of service credit can include service with another IMRF employer3. Unused, unpaid sick leave cannot be used to meet the 20-year service requirementd. The member’s date of retirement must be no later than 12 months from his or her employer’s ERIprogram effective date.e. The member cannot have previously received a pension using IMRF service credit.5. Adopting the IMRF ERI/Cost Study RequirementBefore an employer can adopt an ERI and in order to utilize the ERI as a budgeting tool, the employer musthave IMRF prepare an actuarial cost estimate.The cost estimate must be based on the same time period as the ERI being considered by the governingbody. If the employer does not know when it will offer the ERI, the employer’s IMRF Field Representativecan prepare multiple cost estimates each using a different time period.After reviewing the cost estimate, the governing body would pass a resolution or ordinance adopting theERI. (See Exhibit 6KK, Form 6.77, “Suggested Form of Resolution to Adopt IMRF Early RetirementIncentive.”)If an employer submits the ERI resolution without a cost estimate, IMRF will not implement theprogram, and the employer will need to both conduct the cost estimate and adopt a second resolution.Page 166 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5Dissolving employersIf an employer is aware or has reason to be aware of its future dissolution under state law, the process ofadopting an ERI has an additional requirement. If an employer is dissolving, and its IMRF assets andliabilities will be transferred to:a. One successor unit of government:The dissolving employer must provide the ERI Cost Study to the successor, and the successormust also approve the ERI. A copy of the successor unit’s resolution approving the ERI must beavailable to IMRF upon request.b. More than one successor unit of government:The dissolving employer must provide the ERI Cost Study to each successor unit, and a majorityof the successors must approve the ERI. Copies of the successor unit’s resolutions approving theERI must be available to IMRF upon request.c. No successor unit of government and the law does not specify responsibility for the IMRF assetsand obligations:The IMRF Board of Trustees must approve the ERI.The ERI is available for one year from the program effective date.If an employer adopts the program, the ERI applies to all eligible IMRF members, regardless of theposition held or length of service with the unit of government. The ERI would also apply to electedofficials participating in IMRF.Note: Although an employer may believe that it knows which/how many of its IMRF members will retireunder the ERI, it is possible that other members may also be eligible. A member may have reciprocalservice credit, previous IMRF service credit with a former employer, a separation refund he or she plans torepay, past service credit he or she plans to purchase, etc.6. Employer costs for the ERIOnce an employer adopts the ERI and a member retires under it, a separate ERI reserve account will beestablished. For details on employer costs for ERI, refer to 7.23 Financing the cost of IMRF EarlyRetirement Incentive (ERI).7. Resolution to Adopt Amortization PeriodEmployers can customize the ERI to the financial circumstances of their own unit of local government.This flexibility is provided by allowing employers to determine the amount of time needed to pay off theincurred pension liability.An amortization period of 10 years is assumed. Amortization of the incurred pension liability can take nolonger than 10 years and no less than five years. If an employer would like an amortization period of otherthan 10 years, it would submit a resolution to adopt that period. (Refer to Exhibit 6LL, IMRF Form 6.78,“Suggested form of Resolution to Adopt Amortization Period for IMRF Early Retirement Incentive.”)Please note: due to the method IMRF uses to calculate employer contribution rates, only whole year (5, 6,7, 8, 9, 10) amortization periods are allowed.The amortization period resolution should be received in the IMRF office no later than six months from theeffective date of the employer’s ERI program. If no resolution is received, a 10-year amortization periodwill be assumed. If an employer would like an amortization period of less than 10 years, it would submitIMRF Form 6.78, Suggested form of Resolution to Adopt Amortization Period for IMRF Early RetirementIncentive.8. Subsequent ERI offeringsAn employer cannot adopt later ERI programs until the cost of the previous ERI is paid in full, or five yearsafter the close of a previous ERI window, whichever is later. (For ERI programs effective December 31,January 2014 Page 167

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund2013 and after.) If an employer needs to implement a second ERI program before the cost of the firstprogram has been amortized, the employer should contact IMRF for payoff information.The lump sum payment should be submitted to IMRF via First Data Government Solutions ElectronicFunds Transfer (EFT) pay-by-phone or pay online system. The First Data Government Solutions EFTsystems allow you to identify the payment as employer ERI cost.An ERI cost estimate must be prepared before any subsequent ERI programs can be adopted.9. Informing members of the ERIAfter an employer adopts the ERI by resolution, it should inform its members of the program. If anemployer has any IMRF members who have been on IMRF disability for less than two years, thosemembers may also be eligible for ERI and must also be notified of the program. Employers should notifytheir members for two reasons:a. IMRF will not inform members of an individual employer that their employer has adopted theprogram. Adoption of the program is an internal personnel matter for the employer. However, if amember contacts IMRF, we will confirm whether an employer adopted the program.To assist employers, we have developed a member ERI packet employers can duplicate and giveto their members. You can download and print the member ERI booklet from the IMRF website,www.imrf.org.b. The legislation requires members who intend to retire under the ERI to notify IMRF of theirintention by completing IMRF Form 5.21, “Notice of Intent to Retire Under IMRF ERI.” (SeeExhibit 5C.) For more information on the Notice of Intent, refer to paragraph 11 Notice of Intentto Retire Under Employer’s IMRF ERI in this section.Federal law requires an employer who is seriously considering offering early retirement benefits to informcertain employees who ask about such benefits. A unit of government which intends to keep itsinvestigation into IMRF’s ERI confidential may want to consult with its attorney about this issue.10. Determining member termination datesThe employer determines the timing of member terminations. A member may terminate up to one yearfrom the effective date of the employer’s ERI program.Example:Effective date of ERI program: September 30, 2010Termination date can be: September 30, 2010, through September 30, 2011If a member requests to retire before July 1st so he or she will be eligible to receive the following years’Supplemental Benefit Payment (13th payment), the employer must allow the member to do so.Employers are to give a member at least 30 days notice of his or her designated termination date. The 30-day notice may be waived by the member.11. Notice of Intent to Retire Under Employer’s IMRF ERI (Form 5.21, Exhibit 5C)If a member intends to retire under his or her employer’s ERI program, the member must notify IMRF ofhis or her intention.The member can either complete and mail IMRF Form 5.21, Notice of Intent to Retire Under IMRF ERI,(Exhibit 5C), or fax the Notice of Intent to IMRF at 630-368-5397.Page 168 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5The member can file the Letter of Intent with his or her application for retirement (IMRF Form 5.20,“Application for IMRF Pension”) and can also file the Letter of Intent as late as his or her retirement date.However, we encourage members to file a Letter of Intent (IMRF Form 5.21) as soon as his or heremployer adopts the ERI and the member decides to retire under it.Receipt of a notice does not guarantee eligibility for the ERI or for an IMRF pension.As a general rule, a Notice of Intent is not a letter of resignation. Although a member may file a Notice, heor she is not required to apply for an IMRF pension. However, some employers may treat a Notice of Intentas a letter of resignation. Members should talk with their employers regarding this issue.IMRF will acknowledge receipt of a member’s notice of intent with a letter and the publication, “Can IAfford to Retire?” The member’s employer will receive a courtesy copy of the acknowledgment letter.12. Member Costs for ERIFor each year of service credit a member purchases, he or she will pay 4.5% (7.5% for SLEP) of themember’s highest 12 consecutive months of salary within the final rate of earnings period. (ECO memberspay 7.5% of their final salary for each year of service credit purchased.)Example (Regular Plan):The highest 12 months of salary $27,000x member contribution x 4.5%Subtotal $ 1,215x 3 years 7 months x 3.583Member ERI Cost $ 4,353A member will make a maximum payment of 22.5% (37.5% for SLEP and 37.5% for ECO) to IMRF forfive years of service credit and age enhancement.a. If the member has any combination of service credit, e.g., SLEP and Regular, or Regular andECO, the type of service credit he or she may purchase under the ERI will be determined by theplan the member currently participates in. If the member’s current employer adopts ERI and themember participates in:1. Regular, the member would purchase Regular service credit.2. SLEP, the member would purchase SLEP service credit.3. ECO, the member would purchase ECO service credit.b. If the member is participating under two IMRF employers under different plans, e.g., under SLEPfor one employer and under the Regular for the other employer:1. The type of service credit purchased under the ERI will be determined by which employeradopts the ERI.2. If both employers adopt the program and of the member’s 20 years of total service credit he orshe has:a. Less than 15 years of SLEP service credit: he or she would purchase Regular servicecredit (4.5% per year purchased)b. 15 or more years of SLEP service credit: he or she would purchase the number of yearsdesired; the member’s cost would be calculated as follows:7.5% per year purchased x SLEP ERI final rate of earningsJanuary 2014 Page 169

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fundplus4.5% per year purchased x Regular ERI final rate of earningsc. If the member participates in the Original ECO plan and participates under two employers:1. If the member participates in Original ECO, the member will purchase ECO service creditregardless which employer adopts ERI.2. If the member participates in Revised ECO:c. If the County employer adopts ERI, the member will purchase ECO service credit.d. If the non-ECO employer adopts ERI, the member will purchase either Regular or SLEPservice credit, whichever is appropriate.d. If the member has no eligible surviving spouse when he or she retires, the member contributionrate is reduced to 3.75% for Regular IMRF, 6.75% for SLEP, and 6.75% for ECO.To estimate a member’s ERI cost for IMRF service credit, refer to tables on the following pages.Table to estimate member ERI cost for Regular service credit, Tier 1 or Tier 2Page 170 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5To use this table1. Find the monthly final rate of earnings in the first column. (For estimating purposes, divide the highest oneyear’s salary by 12.)2. Find the months of service credit (top line) the member wishes to purchase.3. The member’s approximate ERI cost will be the amount shown at the point where the earnings lines andservice columns intersect.For example:The member wishes to purchase 3 years, 6 months of Regular service and has a final rate of earningsof $900:36 months $1,4586 months $ 243Total estimated cost $1,701Table to estimate member ERI cost for SLEP service creditTo use this table1. Find the member’s monthly final rate of earnings in the first column. (For estimating purposes, divide thehighest one year’s salary by 12.)2. Find the months of service credit (top line) the member wishes to purchase.January 2014 Page 171

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund3. The member’s approximate ERI cost will be the amount shown at the point where the earnings lines andservice columns intersect.For example:The member wishes to purchase 3 years, 6 months of SLEP service and has a final rate of earnings of $1,400:36 months $3,7806 months $ 630Total estimated cost $4,410Chart to estimate member ERI cost for ECO service credit, Tier 1 or Tier 2To use this table1. Find the member’s monthly final rate of earnings in the first column. (For estimating purposes, divide thecurrent year’s salary by 12.)2. Find the months of service credit (top line) the member wishes to purchase.Page 172 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 53. The member’s approximate ERI cost will be the amount shown at the point where the earnings lines andservice columns intersect.For example:The member wishes to purchase 3 years, 6 months of ECO service and has a final rate of earnings of $900:36 months $2,4306 months $ 405Total estimated cost $2,83513. ERI Invoice for Member CostOnce IMRF receives a member’s final wages (usually one month after retirement), an ERI invoice will beforwarded to the employer detailing the member’s ERI cost.If the employer will pay the member a lump sum payment for sick, vacation, and/or personal time, theemployer must submit the net payment (gross payment less taxes, IMRF contributions, etc.) to IMRF viaFirst Data Government Solutions EFT pay-by-phone or pay online system and identify the payment asmember ERI cost.If the member’s net payment for sick, vacation, and/or personal time is greater than the member’s ERI cost,the employer would pay IMRF via First Data Government Solutions EFT an amount required to pay themember’s cost. The employer would pay the member any remaining balance of the net payment.After receiving (any) payments from the member (or 30 days from the date of the member invoice), if abalance for the member’s cost remains, IMRF will begin deducting the balance from the member’s pensionin 24 equal installments.14. Lump sum payments (sick, vacation, personal time) to members retiring under ERIIf payments for sick, vacation or personal time are to be considered IMRF earnings, they must be reportedto IMRF no later than one month after the member’s termination date.For example, if a member terminates on June 15, but is paid for sick, vacation or personal time in July,those earnings are reportable to IMRF. However, if the member’s earnings are paid in August (or later),those earnings are not reportable to IMRF.If the employer will pay the member a lump sum payment for sick, vacation, and/or personal time:a. The gross amount of the payment would be reported to IMRF as earnings, but the employerwould hold the net payment until the employer receives an invoice from IMRF for themember cost.b. The employer must forward the net payment (gross payment less taxes, IMRF contributions,etc.) to IMRF via First Data Government Solutions EFT pay-by-phone or pay online system. Thenet payment will be applied toward the member’s ERI cost.c. If the net payment for sick, vacation, and/or personal time is greater than the member’s ERI cost,the employer would pay to IMRF (via First Data Government Solutions EFT) an amount requiredto pay the member’s cost. The employer would forward to the member any remaining balance ofthe net payment.If payment for sick, vacation, and/or personal time is spread over several months, the employer must stillforward the net payment to IMRF. As long as the lump sum payment for sick, vacation, and/or personaltime is due to the member’s retirement, the net amount is payable to IMRF.January 2014 Page 173

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund15. Member payments for member ERI costs (other than cash-outs of sick and vacation pay)a. Refunds from IMRFIf the member is entitled to a refund from IMRF for surviving spouse, SLEP, or voluntary additionalcontributions, he or she may request that the refund be applied toward his or her ERI cost. If therefund is greater than the member’s ERI cost, IMRF will refund the balance to the member.b. RolloverA member may roll over funds from an IRA, another qualified pension plan, 457 or 403(b) plan topay the ERI cost.c. 24 equal installmentsA member’s contributions for the ERI can be paid in a single sum or deducted from his or herpension in 24 equal monthly installments. Interest is not charged during the 24 months. The 24-month payment period is fixed by law and cannot be extended.d. Additional member paymentsOnce deductions for the 24 equal monthly installments begin, the member can forward additionalpayments or pay off the balance of his or her ERI cost at any time.16. Return to work for an IMRF employer prohibitedOnce a member begins receiving an IMRF pension, he or she must contact IMRF before returning toemployment or compensated elected office with a unit of government that participates in IMRF. Thisapplies even if the member is considering independent contract work with a unit of government or workcovered by another retirement plan (for example, as a teacher).If a member retires under the ERI and he or she returns to work for any IMRF employer in any position(see exception below), he or she will:a. Lose the ERI enhancements andb. Pay IMRF the difference between the ERI enhanced pension and the pension the member wouldhave received without the ERI less the amount the member paid for the ERI.If the member would not have been entitled to a pension without an ERI, i.e., the member was less than age55 at retirement:a. He or she would be required to repay IMRF for all pension payments received up to age 55less the amount the member paid.b. When the member again retires, the member’s pension will be recalculated without theenhancements.In addition, if a member returns to work for an IMRF employer in a position that is covered by IMRF but isnot enrolled immediately, he or she will be required to pay IMRF any missing member contributions thatshould have been reported to IMRF from the start of his or her employment.A member may retire under ERI only once. For example, a member retires under ERI and returns to workfor an IMRF employer. If that employer adopted ERI, the member would not be eligible to retire under it.ExceptionA member who retired under ERI can hold an elected position eligible for participation in IMRF andcontinue to receive his or her ERI pension if the member chooses to not participate in IMRF and themember's pension is not based on any service earned in that position during any term of office.You can also refer to Exhibit 5R, Return to Work and Effect on Tier 1 and Tier 2 Members Chart.5.20 D. Application for Retirement PensionIMRF has developed a Retirement Application Check List to assist Authorized Agents with a member’sapplication for an IMRF pension. Refer to the IMRF Forms Chart in the front of this manual.Page 174 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5IMRF has also developed a Member Retirement Check List to assist members in the retirement applicationprocess.1. How to Apply for An IMRF PensionTo claim an IMRF pension, the following should be submitted:a. Form 5.20, “Application for IMRF Pension,” (Exhibit 5B). The application, including questionsregarding Direct Deposit of the member’s pension payment, should be completed and signed bythe member. Members can also apply for retirement via Member Access.b. Form 6.41, “Notice of Termination of IMRF Participation,” (see Section 6, Paragraph 6.30 ToClose an Account). Effective August 1, 2008, employers with Internet access are required tosubmit terminations via Online Termination in Employer Access. Employers without Internetaccess may continue to use paper Form 6.41.The member’s “Final Earnings and Contribution Report,” should accurately state the month forwhich the last earnings and contributions will be reported.c. Copy of birth certificate (if not already on file), or if the member cannot get a birth certificate,other acceptable evidence such as a baptismal certificate, school or military records, etc. Themember’s Social Security number should be printed on the birth certificate or otherevidence.d. Copy of marriage or civil union certificate, if the member was married or in a civil union withcurrent spouse at least one year prior to termination of IMRF participation. The member’s SocialSecurity number should be printed on the certificate.e. Copy of judgment of dissolution if the member was divorced while participating in IMRF.f. Final payroll report - “Monthly Report of IMRF Member Earnings and Contributions” (Web wagereport or Form 3.11) which will list the earnings and contributions of the member’s last paycheck.(Pension payments can begin before the final payroll is submitted.)If the member wishes, he or she can expedite payment of the lump sum refund by submitting a BW-60 with the retirement application. (See Exhibit 5L, Form BW-60, “Distribution/RolloverCertification”) However, IMRF will mail the member a Distribution/Rollover Certificate with aletter informing him or her of the taxable and non-taxable amounts of the refund.The member may wish to wait to complete the BW-60 after he or she knows the exact amount of therefund. Also, the member may be eligible to receive the refund as additional monthly annuitypayments. Refer to paragraph 5.20 B. 11.b. Methods of Payment.Note: If the member intends to retire under the IMRF Early Retirement Incentive (ERI), the membermust notify IMRF of his or her intention by completing IMRF Form 5.21, “Notice of Intent to RetireUnder Employer’s IMRF Early Retirement Incentive” (Exhibit 5C) (See Paragraph 5.20 C. 11.Notice of Intent to Retire Under Employer’s IMRF ERI).If the member is considering the Special Needs Annuity (refer to paragraph 5.20B 13.b), themember must submit IMRF Form 5.20R, “Application for Special Needs (Reversionary) Annuity.2. Date of ApplicationThe member’s application should be filed or the member should submit an application via Member Accessone month before the date employment terminates so the pension may start as soon as possible followingdate of termination. (For a discussion of a termination date and its impact on the pension effective date,refer to Section 6, paragraph 6.30 To Close an Account.)January 2014 Page 175

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundIf the member wants the pension to begin at a later date, the application should be sent to IMRFapproximately one month prior to the desired starting date with a letter requesting the specific starting date.If a member is not actively participating in IMRF, IMRF can backdate the member’s pension a maximumof 12 months.If a member is the minimum retirement age (Tier 1 age 55; Tier 2 age 62) or older and is not participatingin an Illinois public pension system, IMRF recommends the member apply for his or her IMRF pension.A member can receive an IMRF pension and work in a position that does not qualify for IMRFparticipation.Exception: If a member retired under the Regular Tier 2 plan, the member may not receive a pension whileworking full-time in a position covered by any other pension system under the Illinois Pension Code.(Exception for ERI, refer to paragraph 5.20C 16.)5.20 E. Pension Payment Procedures1. Effective Date And Initial Payment(Also refer to Section 6, paragraph 6.30 To Close an Account.) IMRF pensions are effective as of the firstday of the month after participation terminates (after the last date of participation as indicated on thetermination form).Examples:The member’s last day of participation indicated on the termination form is May 15—thepension effective date is June 1.The member’s last day of participation indicated on the termination form is June 1— thepension effective date will be July 1.The member’s last day of participation indicated on the termination form is May 15 but themember is paid for sick, vacation or personal time on May 30 and on June 15—the pensioneffective date is June 1. A member can be considered terminated on May 15 even though heor she is receiving compensation through June 15.However, if the member is still considered to be an employee until June 15 (that is, the lastday of participation shown on the termination form is June 15), the pension effective date willbe July 1.Note: IMRF can accept wages that are paid no later than one month after the month of termination. Forexample, if you report the member’s termination date as May 15, IMRF cannot accept wages paid later thanJune 30.The first check the member receives may be for more than one month’s payment. Payments, thereafter, arepayable on the first day of the month for that month. For example: A check dated on January l pays benefitsthrough January 31.If the member will receive a refund of surviving spouse, SLEP, or Voluntary Additional contributions,those contributions plus interest will be refunded separately. IMRF will mail the member a letter explaininghis or her options for payment of the refund.(The member may be able to receive the refund as an additional monthly annuity, see paragraph 5.20 B.11.b. Methods of Payment) Before IMRF can process a lump sum refund, the member must complete andreturn Form BW-60, “Distribution/ Rollover Certification” (Exhibit 5L).IMRF will mail the member a Distribution/Rollover Certificate with a letter informing him/her of thetaxable and non-taxable amounts of the refund.Page 176 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5The first pension payment usually is made two to three weeks after IMRF receives Form 5.20, “Applicationfor IMRF Pension,” (web or paper form) from the member and notice of termination of participation(Online Termination or paper Form 6.41) from the employer.If IMRF hasn’t received the wage report (Web or Form 3.11, “Monthly Report of IMRF Member Earningsand Contributions,”) listing the member’s last earnings and contributions, the first pension payment will bean approximate payment. The final pension payment amount will be calculated after IMRF receives themember’s final wage report.The first pension payment is always based upon IMRF’s standard payout (see Paragraph 5.20 B. 1 a and B.2. a. Pension Calculation Illustrations).If a member is eligible for the optional payout (Tier 1 member under age 62), IMRF will mail an optionletter to the member explaining his or her payment options after IMRF receives the member’s finalearnings information.The member will have 90 days in which to choose either a standard or optional payout. If the member doesnot advise us that he or she wishes to receive an optional payout, IMRF will assume the member wishes tocontinue to receive a standard payout.2. Certificate of BenefitsThe “Certificate of Benefits” (Exhibit 5M-a) explains the IMRF pension and provides information aboutsubsequent pension payments, death benefits, and income tax information. A member’s Certificate ofBenefits will not be mailed until IMRF receives the member’s final wage report.If the member is eligible for the optional plan (Tier 1 member under age 62), IMRF will mail theCertificate after the member returns the option letter indicating his or her payment choice.If the member is age 62 or older, IMRF will mail the Certificate after IMRF receives the wage report listingthe member’s last earnings and contributions.If the member retired under the Reciprocal Act, IMRF will mail the Certificate after IMRF receives thefinal wage information from the member’s reciprocal system(s).3. Direct Deposit of IMRF Pension ChecksThe member will receive his or her monthly benefit payment by Direct Deposit.Direct Deposit ensures the security of a member’s monthly pension by having the payment electronicallydeposited into the member’s checking, savings, or brokerage account.If a member does not provide Direct Deposit information with the retirement application, he or she cancomplete, IMRF Form 1199, “Application for Direct Deposit”” (Exhibit 5K). The form must be completedby the member and returned to IMRF. Benefit payments will be suspended after three months if themember does not return a completed Form 1199.5.20 F. How the IMRF Pension is Affected by Returning to WorkIf the member retired under ERI, refer to 5.20 C. 16. Return to Work for an IMRF Employer Prohibited.The retiree must contact IMRFOnce a member begins receiving an IMRF pension, he or she must contact IMRF if the member returns toemployment or compensated elected office with a unit of government that participates in IMRF. This applieseven if the member is considering independent contract work with a unit of government.January 2014 Page 177

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundPerforming work for any unit of government that participates in IMRF after a member is receiving an IMRFpension can affect his or her pension status. Failure to inform IMRF of a return to work that qualifies for IMRFparticipation could result in significant financial repercussions to the member. If the return to work results in asituation where the member is again eligible for IMRF participation, not only would the member be responsiblefor any benefit prepayments, but he or she would be required to pay IMRF any missing member contributionsthat should have been made from the start of his or her employment.A member must contact IMRF to discuss his or her individual situation and how the pension may be affected.1. When the position qualifies for IMRF coverageAs a general rule, an IMRF pension is suspended if a retiree returns to work for any IMRF employer in aposition which qualifies for IMRF coverage (see 3.20A General Requirements for IMRF Coverage (600-Hour Standard) and 3.65A General Requirements for IMRF Coverage (600 or 1,000 Hour Standard). Thepension is suspended and the retiree must again participate in IMRF (see the Exception to the Rule,below). Once the member retires again, the pension is reinstated, plus a supplemental amount for theadditional service.If the retired member previously participated with a 600-hour employer and returns to that same employerin a position exceeding 600 hours (even if the employer has changed to a 1,000-hour standard), the retiree’spension will be suspended and the retiree must again participate in IMRF.If the retired member received his or her refund of surviving spouse or SLEP contributions as additionalannuity payments, those payments will not stop when the retiree returns to work in a position that qualifiesfor IMRF participation.Public Act 98-0389 changed the rules for enrollment of retired IMRF members who return to work for anIMRF employer. Employers must enroll the retiree in IMRF once he or she actually works 600 or 1,000hours (depending on the hourly standard) in a 12-month period instead of when the retiree’s position is“normally expected” to work the hourly standard. This rule applies in all return-to-work cases, regardlessof the hourly standard the retired member earned his or her pension under.See Exhibit 5S, Public Act 98-0389 Return-to-Work Rules Chart.Exception to the RuleIf the retiree is elected to a public office, the pension may not be suspended, even if the elected position qualifiesfor IMRF coverage. The pension is suspended only if:The pension is based on any service credit earned while participating in IMRF in that elected office; or,The retiree elects to participate in IMRF while holding that elected office.Social Security return to work rules are differentThere is no relationship between the Social Security retirement test on earnings and IMRF coverage rules. TheSocial Security retirement test is based on dollar earnings, whereas the IMRF test is based solely on the hoursthat a position requires. The fact that a person can earn up to a certain dollar amount and continue to receiveSocial Security benefits does not mean that IMRF can continue to pay pension benefits.If the position qualifies for IMRF coverage, IMRF benefits are suspended, even though Social Security maycontinue to pay its benefits.2. When the position does NOT qualify for IMRF coverageMost retirees will continue to receive the IMRF pension if the position does not qualify for IMRF coverage.Exception: If the retiree worked for that same employer before it adopted the 1000-hour standard, theretiree must be reenrolled if the position requires 600 or more hours.Page 178 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 53. Employment by a Private Enterprise or Governmental Agency not Covered by IMRFA Regular Tier 1 retiree may continue to receive an IMRF pension while working for any privateenterprise, or any federal, state, or local governmental agency not covered by IMRF, or while selfemployed,regardless of the hours worked or earnings received.A Regular Tier 2 retiree may continue to receive an IMRF pension while working for any privateenterprise, or any federal agency, or while self-employed, regardless of the hours worked or earningsreceived. However, the pension will be suspended if the retiree is employed full time in a position coveredby any of the retirement systems governed by the Illinois Pension Code.Note: A recent change to the law applies different rules to members who first participate in IMRF or areciprocal retirement system on or after January 1, 2012; does not apply to SLEP members.This change provides that if a retired member performs services for his or her former IMRF employer on acontractual basis, the member’s pension will be suspended during that contractual service. The retiredmember must inform IMRF of the contract and must inform the employer that he/she is receiving an IMRFpension. If the retired member does not inform IMRF and his/her employer, the retired member will beguilty of a Class A misdemeanor and required to pay a $1,000 fine. Once the contractual work ends, theretired member’s pension will resume. See Exhibit 5R for more details.4. Reciprocal PensionsA member who retired under the Reciprocal Act will have his or her pension suspended if the memberreturns to a participating position with IMRF or the other system(s) under which he or she retired.See Exhibit 5R. Return to Work and Effect on Tier 1 and Tier 2 Members for another explanation of theprocess.5.20 G. Income Taxes on Retirement Pensions1. Additional 10% tax for members under age 59-1/2 who continue working for their IMRFemployerMember contributions to IMRF are tax-deferred as retirement savings. Tax-deferred retirement savings aresubject to a 10% early withdrawal tax when taken out of the retirement plan before the recipient is age 59½. This early withdrawal tax is in addition to the taxpayer’s marginal tax rate.There are several exceptions to the 10% early withdrawal tax. One of those exceptions is for lifetimemonthly annuity payments, beginning not earlier than age 55 (age 50 for public safety employees). To beeligible for this exception, the taxpayer must have totally separated from service with the employersponsoring the retirement savings plan.An IMRF pension is eligible for this exception to the early withdrawal penalty IF the member is no longerworking for the IMRF employer in any capacity. If a retired member under age 59 ½ continues to work forthe same IMRF employer in a non-qualifying position or in an elected position, the 10% additional tax willapply to each month’s pension payment. The tax will be owed until the member reaches age 59 ½ or leavesemployment with the IMRF employer.2. Federal Income TaxIMRF retirement pensions are subject to federal income tax. However, when most members retire, a part ofthe pension payment they receive represents their own contributions. That is, part of each pension paymentis a return of member contributions.In some cases, the member has already paid income taxes on the money used to make those contributions(“previously taxed contributions”) and in other cases, the member has not paid income taxes on the moneyused to make those contributions (“tax deferred contributions”).January 2014 Page 179

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundThat part of the pension attributable to previously taxed IMRF member contributions made before theSection 414(h) tax deferral plan are tax exempt, that is, not subject to income taxes. The part attributable totax-deferred IMRF member contributions (contributions paid under the 414(h) tax deferral plan) and toemployer contributions is taxable. Therefore, for most members who began participation in 1984 orthereafter, the entire pension is taxable.For those members whose participation began before 1984 (in some cases before 1982) a small part of thepension will be non-taxable.The taxable portion of each pension payment is computed using the IRS formula “Simplified GeneralRule.” This rule is based on the amount of the retiree’s previously taxed contributions and the number ofpension payments the retiree and spouse are expected to receive (their joint life expectancy). This formulaprovides a dollar amount of each pension payment that is excluded from income for purposes of federalincome taxes—that is, not subject to federal income taxes.IMRF’s Certificate of Benefits (Exhibit 5M-a) provides the amount of the previously taxed contributions aswell as the portion of each payment which is excluded from federal income tax (subject to federal incometax) under the Simplified General Rule (a dollar amount). The taxable amounts of IMRF pensions will varyamong retirees.When previously taxed contributions have been recovered (received by the retiree as part of his or herpension payments), the entire pension will be subject to federal income tax.3. Federal Income Tax Reporting and WithholdingUnder Section 3405 of the Internal Revenue Code, IMRF must automatically withhold federal income taxaccording to an IRS withholding schedule if the taxable portion of the monthly pension exceeds a certaindollar amount, unless the retired member elects not to have income tax withheld or to change the amountwithheld. (Refer to the Federal Taxes/Social Security Appendix for dollar amounts.)Note: The dollar amount withheld will change with future changes in income tax rates, personalexemptions, and standard deduction amounts. Refer to Section 9, Appendix A.If the taxable portion is less than the dollar limit, IMRF withholds tax only if the retiree requests it. A newretiree is sent IRS Form W-4P, “Withholding Certificate for Pension or Annuity Payments,” to requestwithholding for federal income tax purposes. Retirees who wish to change their withholding status oramount can get Form W-4P from the Internal Revenue Service or from IMRF.If the retired member elects not to have tax withheld, IMRF advises the retiree that he or she may need tofile quarterly estimated federal income tax returns and deposits in order to avoid tax penalties.IMRF reports pension payments to the Internal Revenue Service on Form 1099-R. Four copies are sent tothe retired member and one is filed with the Internal Revenue Service. For members who retired after 1973,IMRF fills in the box entitled “Taxable Amount.” For members who retired prior to 1974, IMRF does notdetermine the taxable amount. However, all of the pension payment or a portion thereof may be subject totax.4. Illinois Income Tax (Illinois Residents Only)The Illinois Income Tax Act exempts IMRF pension payments from Illinois income tax, that is, IMRFpensions are not subject to Illinois income tax. Therefore, IMRF retirees whose legal residence is in Illinoisdo not pay state income tax on their IMRF pension.Because the federally taxable portion of the pension is included in federal adjusted gross income, thefederally taxable portion will also be included on Illinois IL-1040. In order to claim the exemption on theIllinois Income Tax Return, it is necessary to follow the specific instructions provided with the IL-1040 inregard to subtractions to arrive at Illinois taxable income.Page 180 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55.30 Death BenefitsIMRF has developed a Death Benefit Application Check List to assist Authorized Agents. Refer to the forms chartin the front of this manual.5.30 A. Types and Amounts of IMRF Death BenefitsThe type and amount of benefit payable depends upon the status of the member or spouse at time of death:1. Death of a Member in Participating Status (contributing, on seasonal leave, drawing IMRFdisability benefits, or on IMRF Benefit Protection Leave)a. Lump Sum Death BenefitUpon the death of a member in participating status who has at least one year of IMRF service creditor dies because of a job related injury, the death benefit is a lump sum payment consisting of anamount equal to the member’s average annual earnings (subject to wage cap for Tier 2) plus a refundof the balance of the member’s account (IMRF member contributions with interest less any benefitprepayment). The average annual earnings are normally equal to the total earnings (subject to wagecap for Tier 2) of the member during the 12 months immediately preceding the date of death.If death is not job related and the member has less than one year of service, only a refund of allIMRF member contributions is paid (less any benefit prepayment). Job related injuries are only thosewhere an accident or incident at work was the cause of death.b. Option to Convert a Lump Sum to Monthly Installments (Beneficiary Annuity)A beneficiary may elect to receive the lump sum amount as a monthly benefit. The amount of themonthly benefit is actuarially determined by the amount of the lump sum benefit and the age of thebeneficiary.If the beneficiary chooses to receive monthly payments instead of a lump sum benefit, he or she willbe paid for life. This election cannot be revoked.c. Surviving Spouse PensionThe member’s spouse may qualify for a monthly surviving spouse pension if:• The spouse was married to or in a civil union with the member for at least one year prior to themember’s death and• The deceased member had at least eight years of Tier 1 service or 10 years of Tier 2 serviceand named the spouse as sole beneficiary for IMRF death benefits.If a surviving spouse pension is payable, the spouse has the option of choosing either the lump sumdeath benefit or the monthly surviving spouse pension. If the spouse chooses the monthly pension,the election cannot be revoked. The option to take the surviving spouse annuity is usuallyadvantageous for spouses of members with long service who die at or near retirement age.Surviving spouse pension under Tier 1The surviving spouse pension is equal to 50% of the pension earned by the deceased member as ofthe date of death.Surviving spouse pension under Tier 2The surviving spouse pension is equal to 66-2/3% of the pension earned by the deceased member asof the date of death.January 2014 Page 181

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund2. Death of Member in Non-Participating Status (Inactive member no longer participating butwith IMRF contributions on deposit)Upon the death of a person who formerly participated in IMRF Tier 1, had not withdrawn his or hermember contributions, and wasa. Less than age 55, the balance of the member’s account (member’s contributions plus interest tothe date of death less any benefit prepayment) is paid to his or her beneficiary.b. Age 55 or older and not eligible to receive a pension, the balance of the member’s account(member’s contributions plus interest to the date of death less any benefit prepayment) is paid tohis or her beneficiary.c. Age 55 or older and eligible to receive a pension, the member’s spouse or other beneficiary(ies)will receive a lump sum death benefit of $3,000 plus a refund of the member’s contributions withinterest to the date of death (less any benefit prepayment). If the spouse is the beneficiary, in lieuof the refund of member contributions, the spouse may ask to receive a monthly surviving spousepension plus the $3,000 lump sum death benefit.Upon the death of a person who formerly participated in IMRF Tier 2, had not withdrawn his or hermember contributions, and wasa. Less than age 62, the balance of the member’s account (member’s contributions plus interest to thedate of death less any benefit prepayment) is paid to his or her beneficiary.b. Age 62 or older and not eligible to receive a pension, the balance of the member’s account(member’s contributions plus interest to the date of death less any benefit prepayment) is paid to hisor her beneficiary.c. Age 62 or older and eligible to receive a pension, the member’s spouse or other beneficiary(ies)will receive a lump sum death benefit of $3,000 plus a refund of the member’s contributions withinterest to the date of death (less any benefit prepayment). If the spouse is the beneficiary, in lieu ofthe refund of member contributions, the spouse may ask to receive a monthly surviving spousepension plus the $3,000 lump sum death benefit.The surviving spouse pension is available only if the spouse was married or in a civil union for at least oneyear before the member terminated IMRF participation.3. Death of a Retiree on IMRF Retirement PensionUpon the death of a retiree, IMRF will pay a $3,000 employer death benefit to the beneficiary designatedby the deceased retiree.If a spouse survives and is eligible for a surviving spouse pension, IMRF will pay a monthly benefit. To beeligible, the spouse must have been married or in a civil union with the deceased for at least one year priorto the date the deceased terminated IMRF participation.If the retired member had an eligible spouse at retirement, but that spouse dies, a future spouse could beeligible for a surviving spouse pension.If the first spouse predeceases the member, and the surviving spouse was married or in a civil union withthe member for at least one year prior to the member’s death, and the member retired on or after March 26,1992, the second spouse will receive the surviving spouse pension.If the Member Retired under Tier 1The amount of the surviving spouse benefit is 50% of the (standard) pension (see Paragraph 5.20 B. 3.Pension Payout Plans), including post-retirement increases (see Paragraph 5.20 B. 11. Pension IncreasesAfter Retirement).Page 182 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5If the deceased was receiving retirement benefits under the optional plan (see paragraph 5.20 B. 3. PensionPayout Plans), the surviving spouse benefit will be based on the standard plan plus any post-retirementincreases that would have been paid had the standard plan been chosen.If the Member Retired under Tier 2The amount of the surviving spouse benefit is 66-2/3% of the pension (no optional pension for Tier 2),including post-retirement increases (see Paragraph 5.20 B. 11. Pension Increases After Retirement).If a Tier 1 member retired under the IMRF Early Retirement Incentive (ERI), the amount of thesurviving spouse benefit is based on 50% (see above regarding date of death) of the ERI enhanced pensionthe deceased was receiving at date of death, including post-retirement increases.If a Tier 2 member retired under the IMRF Early Retirement Incentive (ERI), the amount of thesurviving spouse benefit is based on 66-2/3% of the ERI enhanced pension the deceased was receiving atdate of death, including post-retirement increases.If a balance of the member’s ERI cost remains, the remainder will be deducted from the IMRF deathbenefit:a. If a surviving spouse pension is payable, the remainder of the 24 equal installments will bededucted from the surviving spouse pension.b. If a surviving spouse pension is not payable, the balance will be deducted from the lump sumdeath benefit payment.If the member paid more for the ERI than he or she received in an enhanced pension, the amount not paidout as a benefit will be refunded to the member’s beneficiary or estate.If the deceased chose a reversionary annuity (see Paragraph 5.20 B. 14.b Reversionary Annuity) and namedhis or her eligible surviving spouse as the reversionary annuitant, that spouse will receive another monthlyannuity in addition to the surviving spouse pension (will be paid as a single monthly benefit payment). Ifsome other individual was named, that individual will receive the reversionary annuity.4. Divorce After RetirementWhen a member retires and has a spouse eligible for a surviving spouse benefit, a joint and survivorpension is established for the member and the spouse. Even though they are divorced after retirement, thatspouse remains eligible for the surviving spouse pension if the spouse survives the retired member.If this spouse does not survive the member, then a surviving spouse pension is payable to the member’scurrent spouse if they had been married or in a civil union at least one year prior to the member’s death andthe member retired on or after March 26, 1992.5. Increase in Surviving Spouse PensionsTier 1:If the member retired under Tier 1, the surviving spouse pension is increased each January 1 by 3% of theoriginal amount. When a surviving spouse pension is awarded upon the death of an active or inactivemember, the 3% for the first year is prorated. When a surviving spouse pension is awarded upon the deathof a member receiving a pension, the full 3% is paid the next January 1.Persons receiving a surviving spouse pension are also eligible for a supplemental benefit payment each Julyif they and/or their spouses were eligible for 12 months of retirement benefits. (See Section 5.20 B. 12.Supplemental Benefit Payment to Retired Members and Surviving Spouses)January 2014 Page 183

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundTier 2:If the member retired under Tier 2, the surviving spouse pension is increased each January 1 by the lowerof 3% or one-half of the increase in the Consumer Price Index-Urban (CPI-U) for the preceding 12 monthsas of September of the original amount. If the CPI-U decreases or is zero, no increase is paid. When asurviving spouse pension is awarded upon the death of a member receiving a pension, the full annualincrease is paid the next January 1.Persons receiving a surviving spouse pension are also eligible for a supplemental benefit payment each Julyif they and/or their spouses were eligible for 12 months of retirement benefits. (See Section 5.20 B. 13.Supplemental Benefit Payment to Retired Members and Surviving Spouses) .6. Remarriage or new Civil Union of a Person Receiving a Surviving Spouse PensionRemarriage or a new civil union does not impact the surviving spouse pension.7. Death of a Person Receiving a Surviving Spouse PensionUpon the death of a person receiving a surviving spouse pension, IMRF will pay to the first namedbeneficiary of the deceased member any remainder of the IMRF member contributions, with interest to thedate of the member’s retirement, which has not been paid by IMRF as retirement and/or surviving spousepension benefits.If none of the deceased member’s first named (primary) or secondary beneficiaries survive, the remainderof contributions with interest will be paid to the member’s estate.If the total benefit payments by IMRF exceed these contributions with interest, there is no benefit of anytype paid upon the death of a person receiving a surviving spouse pension.The $3,000 death benefit, which is paid upon the death of a retired member, is not payable upon the deathof a person receiving a surviving spouse pension.8. Death of a Person Receiving a Beneficiary AnnuityUpon the death of a person receiving a beneficiary annuity, the excess (if any) of the member contributions,plus interest to date of death, less the monthly payments made, is paid to the person or persons designatedby the deceased beneficiary or, if there is no person designated, to the estate of the beneficiary receiving theannuity.9. Increase in Special Needs (Reversionary) AnnuitiesSpecial Needs (Reversionary) annuities (see paragraph 5.20 B. 14b. Special Needs [Reversionary] Annuity)are increased each January 1 by 3% of the original amount. Persons receiving a reversionary annuity arealso eligible for a supplemental benefit payment each July if they and/or the member were eligible for 12months of retirement benefits. (See Section 5.20 B. 12. Supplemental Benefit Payment to Retired Membersand Surviving Spouses)If the member retired under Regular Tier 2, annual increases paid to an individual receiving a SpecialNeeds Annuity are subject to Tier 2 increase rules. See Paragraph 5.20 B. 11. Pension Increases AfterRetirement.10. Death of a Person Receiving a Special Needs (Reversionary) Annuity or Named as aSpecial Needs (Reversionary) AnnuitantUpon the death of a person receiving a Special Needs (reversionary) annuity (see paragraph 5.20 B. 13b.Special Needs (Reversionary) Annuity), IMRF will pay to the first named beneficiary of the deceasedmember any remainder of the IMRF member contributions, with interest to the date of the member’sretirement, which has not been paid by IMRF as the member’s annuity and/or a Special Needs(reversionary) annuity.Page 184 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5If the person named as the Special Needs annuitant predeceases the member, the pension that would havebeen paid to that individual is no longer payable. The member’s pension is not adjusted.11. Orphans Annuity (under the Regular IMRF and SLEP plans)Under certain circumstances, IMRF also pays pension benefits to an orphan who is less than 18 years ofage and is unmarried and not in a civil union. These benefits are rarely paid because the lump sum paymentusually provides a larger benefit. Detailed information is furnished on an individual basis.5.30 B. Eligible Beneficiaries for Death BenefitsThe legal or designated beneficiary receives the death benefits payable when a member or beneficiary dies.1. Members can designate a BeneficiaryA member may designate any person, persons, organization or trust as the beneficiary (ies). However, toensure a spouse can select a surviving spouse pension if the member dies before retiring, (and if a survivingspouse pension is otherwise payable), the member must have a valid designation of beneficiary form on filewith IMRF naming the spouse as the only primary beneficiary.If a member names his or her spouse as co-beneficiary with other beneficiaries, the spouse would share inthe lump sum death benefit. Under this arrangement, the spouse would not be eligible for a survivingspouse pension.2. Default BeneficiariesUpon the death of a member without a valid designation on file with IMRF, the member’s estate is thebeneficiary.3. Retired Members with a spouse eligible for a surviving spouse pensionUpon the death of a retired member with a surviving spouse who is qualified to receive a surviving spousepension, the member may designate any person, persons, organization, or trust to receive the $3,000 lumpsum death benefit. The surviving spouse pension is only payable to the qualifying surviving spouse.4. Marital StatusA member who is or has been married or in a civil union remains in that status for death benefit purposesuntil a final court judgment of annulment, invalidity of marriage/civil union, or divorce. A judgment ordecree of legal separation or separate maintenance does not terminate the marriage/civil union.If when a member retires, he or she has a spouse who is eligible for a surviving spouse pension, that spouseremains eligible for the surviving spouse pension even if the member and spouse later divorce.5. Designated BeneficiariesRefer to Paragraph 6.10 B. Designation of Beneficiary for an explanation of beneficiary designation rules.5.30 C. Application for IMRF Death BenefitsIMRF has developed a Death Benefit Application Check List to assist Authorized Agents. Refer to the formschart in the front of this manual.1. Application For Death Benefitsa. Death of Member Prior to RetirementJanuary 2014 Page 185

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundSurvivors should contact IMRF directly before any applications are submitted. To apply fordeath benefits when a member dies prior to retirement, the following forms and documents shouldbe submitted (all documents submitted to IMRF should have the deceased’s Social Securitynumber printed on them):1. Form 5.30 - “Application For Death Benefit” (Exhibit 5D), from the beneficiary2. Form 6.41 - “Notice of Termination of IMRF Participation,” (Web termination orpaper form, see paragraph 6.30 To Close an Account), from the employer if thedeceased was in a participating status at the date of death (Effective August 1, 2008,employers with Internet access are required to submit member terminations via OnlineTermination in Employer Access. Employers without Internet access may continue touse paper Form 6.41)3. Copy of certified death certificate4. Copy of birth certificate of beneficiary5. Copy of marriage license or civil union certificate - if the beneficiary is the survivingspouse6. Copy of judgment of dissolution - if member was divorced at date of deathb. Death of Retired MemberIf a spouse survives, he or she should contact IMRF to determine if any documents other thanForm 5.30, “Application For Death Benefit,” and a death certificate are needed. Often the otherdocuments are already on file.Any pension payments dated after the member’s death should be returned before the death benefit ispaid.If there is no surviving spouse, the survivors should contact IMRF to determine who the memberdesignated as beneficiary(ies). IMRF will also advise what documents, if any, are needed in additionto Form 5.30, “Application For Death Benefit,” and the death certificate, and whether any pensionpayments are returnable.Before IMRF can pay a death benefit to a surviving spouse, he or she must complete and returnIMRF Form BW-60, “Distribution/Rollover Certificate.” To expedite payment, the spouse canrequest Form BW-60 from IMRF and submit it with the death benefit application. (See Exhibit 5L,Form BW-60, “Distribution/Rollover Certification”)However, IMRF will mail the member a Distribution/Rollover Certificate with a letter informing thesurviving spouse of the taxable and non-taxable amounts of the benefit.2. Delayed ApplicationsApplications for death benefits should be filed promptly. If an application is delayed, there may be a loss ofbenefits.a. Surviving spouse benefits cannot be paid retroactively more than one year from application date.b. IMRF does not pay interest on delayed payments. On a delayed lump sum payment, this loss ofinterest can be significant.5.30 D. Death Benefit Payment Procedures1. Death of Member in Participating StatusThe beneficiary is advised of the benefit options three to four weeks after IMRF receives the monthlyparticipating payroll report which lists the last earnings and contributions of the deceased.Page 186 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5The letter the beneficiary receives explains the tax treatment for each of the options. Payment is made byIMRF a few days after the benefit choice is received by IMRF.2. Death of Retiree or Member in Non-Participating (Inactive) StatusThe beneficiary is advised of any available benefit options and tax treatment within three to four weeksafter the claim is received by IMRF; payment is made by IMRF a few days after the benefit choice isreceived by IMRF.If any pension payments were issued after the date of death, those payments will be deducted from thedeath benefit unless the payments are returned.Note: If the benefit to be paid is a surviving spouse’s pension, the effective date is the first day of themonth following the date of death. Monthly payments are made at the start of each month, same asretirement pensions.For example, if the member dies on January 15, the surviving spouse pension is effective February 1.3. Certificate of BenefitsSpouses who choose a surviving spouse pension, beneficiaries who choose a beneficiary annuity, andindividuals receiving a Special Needs (reversionary) (see paragraph 5.20 B. 14b Special Needs(Reversionary) Annuity receive a Certificate of Benefits (Exhibit 5M-b) explaining the IMRF benefitpayments. The Certificate also provides information about income taxes and any death benefits which maybe payable.5.30 E. Federal Income Taxes on Death Benefits1. Death of Member In Participating Statusa. Lump Sum Death BenefitThe benefit is subject to federal income tax, except that portion attributable to previously taxedIMRF member contributions. Certain beneficiaries may be allowed to choose “forward averaging” tocompute the tax.Surviving spouses may roll over the taxable amount into a traditional IRA account, Roth IRA,qualified plan, 457 or 403(b) plan. Beneficiaries who are not a member’s spouse may also roll overthe taxable amount into an IRA. However, the IRS treats the IRA as an “inherited IRA” and specialdistribution rules will apply.(A rollover into a Roth IRA is taxable to the member or beneficiary in the year the rollover is made.)IMRF is required by federal tax law to withhold 20% of the taxable portion of the lump sum benefitpaid . The beneficiary can avoid the 20% withholding by electing to have the taxable portion directlytransferred to an account as a qualifying rollover.The non-taxable portion may be rolled over into a qualified plan. (View Exhibit 5L, Form BW-60,“Distribution/Rollover Certification.”)A beneficiary who does not ask for a direct rollover has 60 days after receipt to make a rollover to atraditional IRA, qualified plan, 457 or 403(b) plan, as provided by section 402(c) of the InternalRevenue Code.If a beneficiary is entitled to use 10-year averaging to limit tax liability, this option should beweighed against the rollover option.b. Lump Sum Death Benefit Taken In Monthly Installments (Beneficiary Annuity)January 2014 Page 187

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundThe monthly payments are subject to federal income tax, but not that portion attributable to thedeceased’s previously taxed IMRF member contributions.The amount of the monthly payment not subject to federal taxes varies depending upon the amountof the deceased’s previously taxed IMRF member contributions and the age of the beneficiary.The taxable amount of each annuity payment is computed using the same basic formula asretirement pensions.c. Surviving Spouse Pension plus $3,000The $3,000 death benefit is a taxable distribution. However, the surviving spouse can consider twooptions: having the $3,000 made payable to the spouse or rolling it over into a traditional IRA, RothIRA, qualified plan, 457 or 403(b) plan. If the $3,000 is rolled, IMRF will report a taxable amount of$0.The surviving spouse pension is subject to federal income tax but not that portion attributable to thedeceased’s previously taxed IMRF member contributions.2. Death of Member in Non-Participating (Inactive) Statusa. Return of IMRF Member Contributions and InterestReturned previously taxed IMRF member contributions are not subject to federal income tax but414(h) tax-deferred member contributions and the interest are taxable.b. Surviving Spouse AnnuityThe income tax treatment is the same as that described in subparagraph 1(c) above.3. Death of a Person Receiving an IMRF Retirement Pensiona. Surviving Spouse PensionThe surviving spouse pension is subject to the same federal income tax treatment as the IMRFretired member’s pension. The spouse may exclude from income the same dollar amount orpercentage of each pension payment that the IMRF member was allowed to exclude until allpreviously taxed member contributions have been recovered.When all the previously taxed contributions have been recovered, the entire pension will be subjectto federal income tax. IMRF will inform the spouse when the pension becomes taxable.b. Special Needs (Reversionary) AnnuityThe Special Needs (reversionary) annuity (see paragraph 5.20 B. 14b. Special Needs Annuity)income tax treatment is the same as described in 3(a) above.c. Return of Unused ContributionsIf the deceased retired member left no surviving spouse eligible for a surviving spouse pension,IMRF pays to the beneficiary the excess of the member’s contributions with interest (less any benefitprepayment) to date of retirement over the pension payments made to the date of death.The beneficiary receiving this payment may take a tax deduction equal to the amount of unrecoveredpreviously taxed IMRF member contributions.5.30 F. Illinois Income Tax on Death BenefitsSection 203(a)(2)(F) of the Illinois Income Tax Act provides that death benefit payments by IMRF are exemptfrom Illinois Income tax.Page 188 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55.40 Disability BenefitsIMRF provides two types of disability benefits:1. Temporary - Paid when a member is unable to perform the duties of any position which might reasonablybe assigned by the current IMRF employer.2. Total and permanent - Paid after temporary disability benefits have expired and if the member is unable toengage in any gainful activity for any employer.Whenever IMRF awards disability benefits, the initial classification is temporary, regardless of the severity of thedisability.If the member is participating in the Elected County Official Plan (ECO), eligibility for disability benefits andthe amounts payable under the ECO plan differ from disability benefits under the Regular or SLEP plans. Pleaserefer to relevant booklet on ECO.Checklists for Authorized AgentsIMRF has developed a Disability Procedure Checklist to assist Authorized Agents with a member’s application forIMRF disability benefits. Refer to the forms chart in the front of this manual.Disability Benefits Information for MembersIMRF has also developed a Disability Benefits Checklist, which is available on the IMRF website, www.imrf.org, tohelp members through the disability benefit process.5.40 A. Eligibility for IMRF Disability Benefits1. Temporary Disability BenefitsTemporary disability benefits are paid for a period of time equal to one-half of the member’s creditedservice, but not more than 30 months.For example: if the member has one year of IMRF service credit, six months are payable. With five or moreyears of service credit, 30 months of benefits are payable, provided the member is disabled that long.Temporary disability benefits are payable under the following conditions:a. The member must be an active employee when he or she becomes disabled.b. The member is disabled by a physical or mental condition (sickness or injury) which makes themember unable to perform the duties of any position that might reasonably be assigned by his or heremployer.Disability benefits are paid irrespective of the cause of disability, including elective surgery andpregnancy. The only exceptions are self-inflicted injury and narcotic drug addiction.c. The member must have at least 12 consecutive months of IMRF service credit since being enrolled inIMRF and he or she must have service credit in each of the 12 months immediately preceding the dateof disability.However, if the member has a one-, two-, or three-month gap in service anytime within thosepreceding 12 months, he or she may still be eligible for IMRF disability if the member:Has 12 consecutive months of service credit anytime prior to the gap in service, andParticipated with the same IMRF employer immediately before and after the gap.A member is not eligible if he or she is disabled prior to meeting these service requirements eventhough the member is carried on his or her employer’s payroll after being disabled past the firstanniversary date of participation.January 2014 Page 189

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundExceptions to the service requirement:1. If the member had 20 years or more of IMRF service credit, stopped participating in IMRF anddid not take a separation refund nor a retirement pension, he or she is immediately eligible forIMRF disability benefits once the member returns to participating status,OR2. If the member’s employer just joined IMRF, the member may be eligible without meeting theone-year service requirement, if he or she meets all of the following conditions. The member:a. Became disabled after his or her employer began participating in IMRF, andb. Was employed in a qualifying position for at least five years before his or her employerjoined IMRF. (If necessary, the member will be required to pay for enough prior serviceto have at least five years of service credit. See Paragraph 6.40. 6. Prior Service -Application for Prior Service Credit), andc. Was employed the entire year preceding the date he or she became disabled.If the member participates in IMRF as an elected official, he or she may apply for IMRF disabilitybenefits if the member meets the service credit requirements. However, if the claim is approved, beforeIMRF can pay a disability benefit the member will have to cease earning income through his or herelected office.Because elected officials are paid as long as they hold office, the member would need to resign inorder to collect IMRF disability benefits. The member would send to IMRF a copy of his or herresignation letter along with a copy of the minutes from the meeting at which the member’s Board(governing body) accepted the resignation.If the member wishes, he or she can remain in office and complete the term. If after completing theterm of office the member is still disabled, he or she will remain eligible for disability benefits. Themember could begin receiving IMRF disability benefits at that time.If the elected official is paid on a per diem basis (paid based upon actual attendance at meetings), he orshe does not need to resign the office to receive disability benefits, so long as the official does notattend any meetings and, therefore, does not receive any compensation.If the member works in a seasonal position and becomes disabled during a month in which he or sheis not working (the “off season”), the member is still eligible to file for IMRF disability benefits and isencouraged to do so. Please note: if the member elected to be paid by the IMRF employer during the“off season” months, he or she is not eligible to receive IMRF disability payments for those months.If the member works as a law enforcement officer, correctional officer, or firefighter, he or she iscovered under the Illinois Public Employee Disability Act,(5 ILCS 345/0.01 et seq.).This statute provides for the continuation of compensation for law enforcement officers, correctionalofficers, and firefighters who suffer a disabling injury in the line of duty. If the member is eligible for apay continuation under this statute, he or she is not eligible for IMRF disability benefits until thesepayments stop—provided the member continues to be disabled.However, if the member meets the other service credit requirements listed above and he or she will bedisabled for more than one year, we recommend he or she submit a disability application after sixmonths.d. The disability has existed for at least 30 consecutive calendar days and the member is no longerreceiving compensation from the employer.Temporary disability benefits begin on the 31st day following the “date of disability.”The date of disability refers to the date of the first medical treatment (the date of the first doctor visit)after the last day the member was physically present on the job.However, if the employer pays earnings which extend the period of compensation beyond the first 30days of disability, IMRF temporary disability benefits will begin on the day after payment of suchearnings has stopped.Page 190 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5For example, if a member is disabled on July 15 and receives sick or vacation pay through July 31, theIMRF disability benefit will begin on August 15. However, if the member receives earnings, sick pay,vacation pay, etc., which extend the compensation period through August 31, the IMRF disabilitybenefit will begin on September l.The 30-day waiting period is counted from the date of disability (the date of the first medicaltreatment after the last day the member was physically present on the job) and not from the last dayfor which the member is paid by the employer.The 30-day waiting period applies to all disability claims, regardless of the type of claim. The memberis not required to use up his or her sick pay or vacation pay before receiving disability benefits.Exceptions to the 30-day waiting period (Re-occurrence of disabling condition)If a member receives temporary or total and permanent disability benefits and returns to work, butwithin six months is again disabled by the same condition, the 30-day waiting period does not apply.IMRF disability benefit payments would begin the day following the last day the member receivedcompensation from his or her employer and the date disabled.Example:After being disabled for seven weeks, a member returns to work on Monday, the 5th, and worksthrough Wednesday, the 14th. He is again disabled by the same condition and does not work onThursday or Friday. He receives salary for the 5th through the 14th.IMRF disability benefit payments would begin Thursday, the 15th, assuming the member seeksmedical treatment which certifies he is disabled. He will also need to submit a new IMRF Form 5.40,“Application for Disability Benefits,” and IMRF Form 5.42, “Physician’s Statement—DisabilityJanuary 2014 Page 191

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundClaim.” In addition, his employer would need to submit a new Form 5.41, “Employer Statement—Disability Claim,” advising IMRF of the last date the member worked and the last date he was or willbe paid.Each employer establishes its own rules on the use of sick pay and vacation pay. Members whoare eligible for a pay continuation under the Public Employee Disability Act (5 ILCS 345/0.01 et seq.)are not eligible for disability benefits until these payments are terminated.e. The disability for which benefits are claimed:1. Is not the result of a self-inflicted injury or narcotic drug addiction.OR2. The member did not refuse a position offered by the employer which accommodated the member’sdisability.A physician’s report that a member is disabled may not always be sufficient reason for IMRF topay disability benefits.f. If the employer terminates the member’s employment or if an elected official completes his or her termof office, but the member remains disabled by the same condition, the member remains eligible forIMRF disability benefits.g. Temporary disability benefit payments from IMRF are terminated under certain conditions. Theprincipal reasons for the termination of benefits are as follows:1. The member has used up all temporary disability benefits, or2. The member returns to work, or3. Either the member’s physician or a physician appointed by the employer or by IMRF reportsthat the member is able to return to work, even though there may not be a position available, or4. The member’s employer accommodates physician-prescribed job restrictions but the memberrefuses to return to work.5. The member refuses to submit to a physical examination requested by IMRF, or6. The member fails to submit a medical report from his or her physician certifying continuance ofdisability.7. The member resigns from the position with the employer he or she was working for when themember became disabled. Depending on the member’s situation, benefits may continue. Themember should contact IMRF BEFORE resigning from his or her position. Also see Paragraph5.40 D. 5.If a member is no longer disabled, but does not return to work immediately and the employer wishes toprovide service credit, an IMRF Benefit Protection Leave (Form 6.32, see Paragraph 6.40. 7. Leave ofAbsence) may be awarded. Local leave policy without formal action does not protect the member.If the member will NOT return to work for his or her IMRF employer, the member must file Form 6.32immediately. If he or she does not file Form 6.32 immediately, the member may not be eligible for aBenefit Protection Leave.The total service a member can establish under the IMRF leave is limited to a maximum of 12 monthsduring the member’s lifetime, e.g., he or she may be granted a one-time leave of 12 months or severalleaves totaling no more than 12 months. To establish the service, the member must pay the membercontributions that would be due on his or her unpaid earnings.If a member’s temporary disability benefits run out and he or she is:Page 192 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 51. Eligible for IMRF total and permanent disability benefits, the member will continue to receivepayments without interruption if the member is approved prior to temporary disabilitybenefits running out. The member must also provide any updated medical information IMRFrequests.2. Participating in Tier 1 and not eligible for IMRF total and permanent disability benefits, IMRFwill notify the member in writing. If the member does not return to participating employmentand is:a. Younger than age 55 or does not have at least eight years of IMRF service credit, themember can receive a refund of his or her IMRF member contributions without interest.b. At least age 55 and has at least eight years of IMRF service credit, the member will beeligible for an IMRF pension.c. At least age 55 and has reciprocal service or past service he or she may purchase, themember may be eligible for an IMRF pension (the application for past service must befiled before the disability benefits terminate).3. Participating in Tier 2 and not eligible for IMRF total and permanent disability benefits, IMRFwill notify the member in writing. If the member does not return to participating employmentand is:1. Younger than age 62 or does not have at least 10 years of IMRF service credit, themember can receive a refund of his or her IMRF member contributions without interest.2. At least age 62 and has at least 10 years of IMRF service credit, the member will beeligible for an IMRF pension.3. At least age 62 and has reciprocal service or past service he or she may purchase, themember may be eligible for an IMRF pension (the application for past service must befiled before the disability benefits terminate).2. Total And Permanent Disability BenefitsTotal and permanent disability benefits are payable when a member who has used up all temporarydisability benefits is unable to engage in any gainful activity whatsoever, and the disability is expected toresult in death or be of long and continued duration.All total and permanent disability claims are subject to a pre-existing condition investigation unless themember has five or more years of IMRF service credit prior to the date of disability and the member didnot receive IMRF disability benefits within those five years. The investigation may include obtainingphysician and hospital records, independent medical examinations and other pertinent information.A member can receive total and permanent disability benefits only after temporary disability benefits havebeen exhausted.IMRF attempts to make a determination regarding eligibility for total and permanent disability benefits sothat the member continues to receive monthly benefit payments without interruption.Total and permanent disability benefits are payable on the first day of each month for the preceding month.A member may receive IMRF total and permanent disability benefits until the later of the following:a. Until he or she reaches Full Social Security Retirement age, assuming the member remains disabled.b. Until the last day of the month which is five years after the member becomes eligible for IMRFtemporary disability benefits, assuming the member remains disabled.January 2014 Page 193

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundIf the member receives IMRF disability benefits after becoming eligible for full Social Security retirementbenefits, his or her IMRF disability will be reduced by the amount of the member’s Social Securityretirement.Other reasons for terminating the payment of total and permanent disability benefits are as follows:a. We receive evidence of earnings that indicates the member is able to be gainfully employed, orb. A report by a physician states that the member is no longer totally and permanently disabled, orc. The member refuses to submit to a physical examination requested by IMRF, ord. The member fails to submit any requested additional information, such as a medical report fromhis or her physician to prove continuance of disability or a Social Security award letter, etc.IMRF will notify the member when her total and permanent disability benefits stop. At that time, IMRFwill advise the member of her eligibility for other IMRF benefits.5.40 B. Amount of IMRF Disability Benefits1. Amount Paid As IMRF Disability BenefitThe amount paid as an IMRF disability benefit depends on whether the member receives Social Securitybenefits, workers’ compensation (including occupational disease) benefits, or has returned to work for atrial work period.The amount of a member’s disability benefit is based upon his or her average monthly earnings subject tothe wage cap for Tier 2 members.To calculate the average monthly earnings, IMRF totals the member’s earnings for the 12 consecutivemonths prior to the month in which he or she became disabled then divides that amount by 12; the resultequals the member’s average monthly earnings subject to the wage cap for Tier 2 members.The member may receive benefits from the following sources:a. IMRF aloneb. IMRF and Social Security Disability or Social Security Retirement benefitsc. IMRF and workers’ compensation or Occupational Disease Act benefitsd. IMRF, Social Security Disability or Social Security Retirement benefits, and workers’compensatione. Outside earningsThe amount IMRF pays as a disability benefit depends on whether the member receives Social Securitybenefits, workers’ compensation (including occupational disease), and/or outside benefits. The minimumamount the member can receive from all five sources is 50% of the member’s average monthly earningssubject to the wage cap for Tier 2 members.Please note: the same formula is used to calculate the average monthly earnings for both temporary and fortotal and permanent disability benefits. The member’s average monthly earnings amount does not change ifthe member’s classification changes from temporary disability to total and permanent disability.If a member receives benefits from an outside (non-IMRF) disability insurance plan, that benefitpayment will not impact the amount of the member’s IMRF disability benefit.In addition to monthly IMRF disability payments, the member’s IMRF death and disability protectioncontinues. The member also earns service credits toward retirement as if he or she were working. Futureretirement benefits from IMRF will not be reduced because disability benefits are paid.Page 194 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5The member’s original salary subject to the wage cap for Tier 2 members, not the disability benefit amount,is used to determine the member’s final rate of earnings (FRE) and to calculate a retirement benefit. As aresult, the retirement benefit will not be affected by the amount of a member’s disability benefits.If death occurs while IMRF is paying disability benefits, the member’s beneficiary will be eligible for deathbenefit options calculated in the same way as when an active member dies.If a member works in a seasonal position, IMRF calculates the disability benefits based upon themember’s annual earnings for his or her normal seasonal year. IMRF pays the disability benefits over a 12-month period so that benefit payments will continue through the member’s “off season.” For example, amember normally works eight months a year earning $1,500 per month or $12,000 a year. IMRF will pay50% of $1,000 a month or $500.If a seasonal member chooses to receive his or her salary over 12 months, the member will not receiveIMRF disability benefits as long as he or she receives compensation. IMRF disability benefits are notpayable if a member is receiving compensation from his or her employer, whether that compensation is sickpay, vacation pay, or a seasonal salary spread over 12 months.If because of a disability, a member has reduced earnings when he or she stops working, the amount ofdisability benefits will be calculated based on the member’s salary (subject to the wage cap for Tier 2members) for the last year of regular employment.For example, if a member worked part time because of an accident or illness, and the accident or illnesseventually forces the member to go on IMRF disability, the amount of disability benefits would be basedon the member’s last year of normal full-time employment.2. Reduction of IMRF Disability Benefit For Workers’ Compensation and Social SecurityBenefitsa. Workers’ CompensationIMRF will reduce a member’s disability benefit by the amount of any weekly or lump sum paymentshe or she may receive as workers’ compensation or occupational disease benefits. IMRF disabilitybenefits are not reduced by payments for medical services or attorneys’ fees or by fixed amounts forloss of, or loss of use of, specific bodily members.The reduction of the IMRF disability benefit will be made in the first IMRF disability checkwhenever it appears that workers’ compensation or occupational disease benefits are being paid, orwill be paid. The monthly reduction is 4-1/3 times the weekly workers’ compensation oroccupational disease payments.IMRF disability benefits will be reduced whether the member’s workers’ compensation claim ispending or the member is receiving a workers’ compensation benefit.The IMRF monthly benefit is adjusted for a lump sum settlement on the basis of converting the lumpsum amount into a monthly workers’ compensation amount, until the total withheld equals theamount of the lump sum payment.If a member is receiving workers’ compensation benefits or if a member is waitingfor a decision on a workers’ compensation claim, but the member does not file adisability claim with IMRF, he or she will not earn IMRF service credit for the monthshe or she is disabled and does not receive earnings from the employer.This loss of service credit will affect the member’s eligibility for other IMRF benefits, such asretirement and death benefits. Loss of service credit will also affect eligibility for disability benefitsif the member returns to work for an IMRF employer and is again disabled.January 2014 Page 195

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundExceptions to workers’ compensation reductionAn exception exists which will allow a member to receive workers’ compensation benefits and anon-reduced IMRF disability benefit. The member must meet the following condition:The member has IMRF or reciprocal retirement system credit earned during the period from October1, 1974, through September 30, 1977. If the member has service credit earned anytime during thisperiod in effect on the date of his or her disability, the member will receive an unreduced disabilitybenefit even though he or she is also receiving workers’ compensation benefits.Signing a workers’ compensation resignation agreementIn some cases, an employer may offer to settle a workers’ compensation claim if the member agreesto resign from his or her position and give up all rights as an employee of that employer.NOTE: If a member signs such a resignation agreement, he or she also gives up any rights to IMRFdisability benefits, unless the agreement specifically states that the member is not giving up his orher right to IMRF disability benefits. Also see Paragraph 5.40 D. 5.b. Social Security BenefitsIf the member becomes disabled when he or she is under the age for Social Security fullretirement benefits:IMRF will not reduce its disability benefits by the amount the member can receive from SocialSecurity for a retirement pension. Social Security pensions can begin as early as age 62.If the member is at least age 62 but younger than his or her Social Security full retirement age,and the member becomes disabled or is receiving IMRF disability benefits:The member is required to apply for Social Security disability benefits and to obtain an officialdetermination from Social Security regarding his or her eligibility for Social Security disabilitybenefits.If the member applies online at www.socialsecurityAfter he or she completes the online process, the member should print theconfirmation/receipt page titled “What You Need To Do Now” and send it to IMRF as proofthat you applied for Social Security disability benefits. If the member applies by phone by calling 1-800-772-1213The member will receive a “Receipt of Claim” from Social Security. He or she should mailIMRF that receipt of claim as proof that the member applied for Social Security disabilitybenefits.If the member applies in person by visiting with the nearest Social Security DistrictofficeThe member should bring the IMRF Form 5.49 with him or her. The member completesSections 1 and 2 and the Social Security representative completes Section 3. The membershould mail IMRF the completed Form 5.49 as proof that he or she applied for Social Securitydisability benefits.IMRF requires the member to apply with Social Security because IMRF will reduce its disabilitybenefit by the amount that may be paid as a disability benefit by the Social Security Administration,even if the member is receiving Social Security retirement benefits.Even though Social Security retirement benefits can begin as early as age 62, IMRF will not reduceits disability benefits by the amount the member receives from Social Security for retirementbenefits until the member reaches his or her Social Security full retirement benefit age.Page 196 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5If the member is within six months of the age when he or she will become eligible for SocialSecurity full retirement benefits, or is his or her Social Security full retirement age or older,and the member becomes disabled:IMRF will reduce its disability benefit by the amount the member may be entitled to receive as aSocial Security retirement benefit, even if the member is not receiving such a benefit.Social Security does not pay disability benefits if an individual is within six months of his or her fullSocial Security retirement age. (Social Security begins paying disability benefits six months after theonset of the disability.)If the member is not receiving Social Security retirement benefits, IMRF requires an estimate of theamount the member is entitled to receive at his or her Social Security full retirement age. IMRF’sdisability benefits will be reduced based upon this amount, even if the member does not apply forthe benefit. Therefore, the member may wish to apply for Social Security retirement benefits.See the following table for more detailed information about when a member should apply for each type ofSocial Security benefit.If the memberbecomesdisabled and is:Younger thanage 62At least age 62,but not withinsix months ofmember’s fullSocial SecurityRetirement AgeWithin sixmonths ofmember’s fullSocial SecurityRetirement Ageor LaterApply for SocialSecurityDisability?Yes, if memberthinks he/she willbe disabled formore than fivemonths.Yes, if memberthinks he/she willbe disabled formore than fivemonths.No. SocialSecurity will notallow member toapply for SocialSecuritydisability.Should the MemberGet an estimate ofhis/her SocialSecurityRetirementbenefits?NoNoYes. This will allowIMRF to accuratelyreduce member’sIMRF disabilitybenefit by theamount he/she iseligible to receive.IMRF disabilitybenefit reducedby SocialSecuritydisabilityamount?Yes, after fivemonths, even ifmember doesn’tapply for SocialSecurity disabilityYes, after fivemonths, even ifmember doesn’tapply for SocialSecuritydisability.Not Applicable.Is the Member’sIMRF disabilitybenefit reduced bySocial SecurityRetirement benefits?NoNoYes, even if memberdoes not apply forSocial Securityretirement benefits,IMRF’s disabilitybenefit will be reducedby the amount he/she iseligible to receive.The table below provides the ages when a member is eligible for Social Security full retirement benefits.Year of BirthFull Retirement Age1937 or earlier 651938 65 and 2 months1939 65 and 4 months1940 65 and 6 months1941 65 and 8 months1942 65 and 10 months1943 - 1954 66January 2014 Page 197

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund1955 66 and 2 months1956 66 and 4 months1957 66 and 6 months1958 66 and 8 months1959 66 and 10 months1960 and later 67If the member is being paid a reduced IMRF benefit and a final decision on a Social Security or workers’compensation claim has not been made, IMRF will restore the benefit to the full unreduced amount (notafter the member’s age when he or she is eligible for full Social Security retirement benefits for SocialSecurity claims) provided the member signs Form 5.48, “Disability Payment Agreement” (Exhibit 5I) and:Submits Social Security “Receipt of Claim Form” (or other proof) indicating the member hasapplied for Social Security,Completes and submits IMRF Form 5.49, “Authorization to Secure Award or DisallowanceInformation,” andIf necessary, supplies an updated Form 5.42a and medical records.As long as the member remains disabled and is waiting for a final decision on the Social Security orworkers’ compensation claim, IMRF will pay the member unreduced benefits until the total of thosepayments equals 80% the total amount of member contributions he or she has on deposit.Once that occurs, IMRF will reduce its benefit payments to the minimum payment of $10 or to thedifference between the member’s anticipated Social Security disability benefit and 50% of his or heraverage monthly earnings, subject to the wage cap for Tier 2 members.The “Disability Payment Agreement” obligates the member to repay IMRF immediately for anyprepayment resulting from an award of Social Security, workers’ compensation, or occupationaldisease benefits. If the member fails to repay IMRF, the prepayment will be recovered from anyfuture benefits payable by IMRF to the member, or to his or her beneficiaries or estate.Before a member signs a Disability Payment Agreement, we strongly recommend that he or shespeak with the IMRF Disability Claims Examiner.c. IMRF Benefit Adjusted to Conform to Workers’ Compensation or Social Security BenefitWhenever an IMRF disability benefit is reduced, the amount of the monthly check will not be lessthan $10. If IMRF benefits are reduced and workers’ compensation (including occupational disease)or Social Security benefits are denied, or paid in a smaller amount than the reduction, IMRF willadjust its benefits accordingly.The member is required to repay to IMRF any prepayments when the member is paid workers’compensation, occupational disease, or Social Security benefits for which no reduction of IMRFbenefits is made.d. Increase in Total and Permanent Disability BenefitsTotal and permanent disability benefits are increased by 3% annually (not compounded) after thedisabled member has been on disability for at least 30 months. The 3% increase is payable on theJanuary 1 following the date the member has been disabled 30 months regardless of the member’splan tier. This increase is applied to the original amount before offset for Social Security or workers’compensation benefits.3. Reduction for Earnings from Outside Employment (Other Than Trial Work Period)A member who is being paid temporary disability benefits by IMRF is no longer considered disabled if themember is paid compensation from gainful employment.Page 198 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5However, under unusual circumstances, a member may receive compensation (other than from aparticipating employer) up to 25% of average monthly earnings (see Paragraph 5.40 B.1) on which thetemporary benefit is based. If the member earns more than 25% of this base pay, the temporary benefitsmay terminate or be reduced by the amount by which the outside earnings exceed 25% of base pay.The decision whether to terminate or reduce the benefit because of outside earnings or employment isbased on the facts in each individual case. The member will be required to periodically submit—at his orher own expense—medical evidence of continuing disability.Please note: when considering the compensation that reduces the IMRF disability benefit payment, IMRFapplies the net compensation after any member payments for medical and/or dental insurance. Memberpayments for medical and/or dental insurance do not reduce the IMRF benefit payment.4. Reduction of IMRF Disability Benefit for Employer Paid Earnings During a Trial WorkPeriodFor some disabling conditions, recovery is gradual and a return to work on a part-time basis is therapeutic.For other conditions, neither the member nor his or her physician can state with precision when recovery isso advanced that a full-time return to work is possible. IMRF recognizes that a member may wish to returnto work on limited basis, known as a trial work period, to see if the member can handle his or her positionagain.For a member to be eligible for a trial work period, the member must have been disabled for 30 or moredays before he or she returns to work on a limited basis.During the trial work period, the disability is deemed to continue with service credit and the earningshistory treated as though the member is disabled.Note: an employer is not required to offer a trial work period. However, if one is available, a member canwork fewer hours than his or her position requires and still receive reduced IMRF disability benefits.IMRF’s trial work period is available only if the member returns to the same employer he or she worked forwhen the member became disabled, and if that employer offers the trial work period.See Paragraph 5.40D.4.The member will remain eligible to receive IMRF disability benefits while on a trial work period until:a. He or she works the same number of hours the member worked prior to the disability,b. It is determined that the member is no longer disabled,c. The member has exhausted IMRF temporary disability benefits, ord. One year has passed.IMRF monthly disability benefits are reduced dollar-for-dollar by the trial work period monthly grossearnings. However, the minimum monthly disability benefit is $10.Please note: when considering the compensation that reduces the IMRF disability benefit payment, IMRFapplies the net compensation after any member payments for medical and/or dental insurance. Memberpayments for medical and/or dental insurance do not reduce the IMRF benefit payment.Only one trial work period is allowed for each disability occurrence. The trial work period:a. Cannot exceed 12 months for each disability occurrence. The member will be required toperiodically submit—at his or her own expense—medical evidence of continuing disability tosupport the need for a continued trial work period.b. Will end if the member returns to work for the same number of hours worked before the disabilityoccurred.January 2014 Page 199

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fundc. Will end if the disabling condition worsens preventing the member from working any hours. If themember is eligible, upon receipt and review of medical documentation, full payment of IMRFdisability benefits will resume.d. Will end if the member resigns from his or her position with the member’s IMRF employer. If amember is considering resigning his or her IMRF position, the member should contact IMRFfirst! Depending on the member’s situation, benefits may or may not continue.5.40 C. Application for Disability BenefitsIMRF has developed a Disability Procedure Checklist to assist Authorized Agents with a member’s applicationfor IMRF disability benefits. Refer to the forms chart in the front of this manual.IMRF has also developed a Disability Benefits Checklist, which is available on the IMRF website,www.imrf.org, to help members through the disability benefit process.1. Temporary Disability BenefitsTemporary disability benefits may be claimed by submitting the following forms and records to IMRF:a. Form 5.40, “Application for Disability Benefits,” (Exhibit 5E)The member should complete Form 5.40. Members can also apply for disability benefits viaMember Access.If the member is unable to complete the application, a relative or other representative can completethe form. However, that individual should call IMRF and tell us that the member is unable to signthe application or other disability-related IMRF documents.The member’s relative or other representative would sign the forms on the member’s behalf, e.g.,Mary Smith for John Smith. If the benefit is approved, IMRF will mail the member’s relative orother representative a Representative Payee form for him or her and the member’s attendingphysician to complete.If the member’s relative or other representative has “power of attorney” for the disabled member,he or she should forward a copy of the power of attorney to IMRF for review by our LegalCounsel.IMRF will accept agency designation under a power of attorney for property if it conforms withthe requirements of the Illinois Power of Attorney Act. A copy of the entire designation must besubmitted for our review. If the original designation is more than a year old, we will send theagent an affidavit that he or she must complete, sign, have notarized, and then return to our officein order for the power of attorney to be accepted.IMRF will accept a power of attorney for property; a health care power of attorney is notacceptable. IMRF will allow a designated agent to act for the member in all aspects excluding theability to sign a beneficiary form.b. Form 5.41, “Employer Statement—Disability Claim,” (Exhibit 5F) The employer’s AuthorizedAgent should complete Form 5.41.While completing Form 5.41, please note:1. Last date the member actually worked is the last date the member was physically on the job.2. Last date paid is the last date the member will receive compensation from the employer,including sick and vacation pay, etc. This date does not refer to the date of the last check.Note: the employer should submit form 5.41 whether or not the disabled member applies for IMRFdisability benefits.c. Form 5.42, “Physician Statement—Disability Claim,” (Exhibit 5G) A licensed and practicingphysician who has examined the member and can verify the nature and extent of disability shouldPage 200 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5complete Form 5.42 and submit it to IMRF along with associated office visit notes/medicalrecords.Diagnosis, treatment dates, services rendered and dates of disability are required to process themember’s claim. The member should also ensure that the first treatment date is noted on theform. IMRF cannot accept doctor’s statements that certify a disability for a date prior to themember’s visit or for a date in the future.d. Birth certificate or other acceptable evidence of birthdate must be submitted. The member’sSocial Security number should be printed on the birth certificate or other evidence ofbirthdate.e. IMRF may also request that the member complete Form 5.40A, “Disability Claim Data,” Form5.46, “Authorization for Disclosure of Health Information,” Form 5.48, “Disability PaymentAgreement,” Form 5.49, “Authorization to Secure Award or Disallowance Information,” Form5.49R, Authorization to Secure Social Security Retirement or Disallowance Information, Form5.42A, Form 5.42B, Form 5.42E, or psychiatric/physical forms. (If such forms are required, IMRFwill mail them directly to the member).If any form is incomplete, it may delay a decision on the disability claim. The membershould provide as much medical information as possible when he or she submits the forms.2. Total and Permanent Disability BenefitsA member can receive total and permanent disability benefits only after temporary disability benefits havebeen exhausted.A member does not have to apply for total and permanent disability benefits. Prior to temporary disabilitybenefits ending, IMRF automatically reviews the member’s claim to determine if he or she is totally andpermanently disabled as defined by the IMRF law. IMRF may require additional medical informationbefore a determination can be made.3. Delayed Applications May Cause Loss of BenefitsA member may lose one or more monthly payments by failing to apply for IMRF disability benefitspromptly. Disability payments cannot be paid retroactively for more than six months from the date anapplication is filed with IMRF.Filing late may also result in gaps in the member’s service credit which could affect his or her eligibility forother IMRF benefits.4. When to File an Application for IMRF Disability BenefitsThe employer should file Form 5.41, “Employer Statement—Disability Claim,” as soon as the memberstops working and is expected to be disabled for more than 30 consecutive days from the date the disabilityoccurred. The employer should file Form 5.41 even in cases of disability when the member has filed aclaim for workers’ compensation.At the same time the member should file IMRF Form 5.40, “Member’s Application for DisabilityBenefits,” (member can also apply for disability benefits via Member Access) and give each of his/hercurrent physicians a blank Form 5.42, “Physician’s Statement,” to complete. The member application oremployer certification should not be filed in “anticipation of disability” if the member is still able to work.When compensation, such as sick pay and vacation pay, is continued for more than 30 days, the memberapplication and employer certification should be submitted immediately if the disability is expected toextend beyond the last day for which earnings will be paid.January 2014 Page 201

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundThe chart below illustrates when a member would apply for disability benefits.Member receives surgeryDoes member apply?on August 1stMember returns to work on August 28. No, the member is not disabled more than 30 days.Member will be off from work for sixweeks. Yes, the member applies for disability benefits the firstday he or she is disabled - on August 1. Member does not apply in advance, even though he/sheknows they will be disabled more than 30 days. The disability effective date will be August 31st - 30days after the date of disability.Member will be off from work forthree months, AND the employer paysthe member for the first 60 days5. Investigation Process for Disability BenefitsYes, the member applies for disability benefits the firstday he or she is disabled (August 1) because themember knows he or she will be disabled beyond thelast day employer pays the member compensation. The disability effective date will be September 30th -the day after the compensation ends.Claim investigations may include obtaining medical and hospital records, independent medicalexaminations and other pertinent information. The length of time required to investigate (and therefore,approve or deny a claim) varies with each claim, depending on the circumstances.a. Extent/degree of disability testAll disability claims are subject to an extent or degree of disability test—regardless of the number ofyears of service credit the member had when he or she became disabled.An extent or degree of disability investigation may include requesting hospital records and gettingadditional medical information from the member’s attending physician(s) or possibly having themember examined by a physician chosen and paid for by IMRF.If the claim appears to involve an extent or degree of disability condition, an IMRF Claims Examinerwill review the claim. If the Claims Examiner determines that the member’s disability does not preventhim or her from performing the duties and responsibilities of any position that might reasonably beassigned by the current IMRF employer, the member will be advised that the claim for disabilitybenefits is being denied.In some cases, IMRF compiles a written summary of the member’s medical history for review byIMRF’s rehabilitative medicine/occupational psychiatric consultant.If the member applied for temporary disability benefitsIf it is the rehabilitative medicine/occupational psychiatric consultant’s opinion that themember’s disability prevents him or her from performing the duties and responsibilities ofany position that might reasonably be assigned by the current IMRF employer, the claim willbe returned to a disability claims examiner for payment processing (assuming the member iscurrently receiving IMRF temporary disability benefits).If it is the rehabilitative medicine/occupational psychiatric consultant’s opinion that themember’s disability does not prevent him or her from performing the duties andresponsibilities of any position which might reasonably be assigned by the current IMRFemployer, the claim is denied and the member is so advised.If the member’s claim is being reviewed for total and permanent disability benefitsIf it is the rehabilitative medicine/occupational psychiatric consultant’s opinion that themember’s disability prevents him or her from working in any gainful activity for anyPage 202 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5employer, the claim will be returned to a disability claims examiner for payment processing(assuming the member is currently receiving IMRF temporary disability benefits).If it is the rehabilitative medicine/occupational psychiatric consultant’s opinion that themember’s disability does not prevent him or her from working in any gainful activity for anyemployer, the claim is denied and the member is so advisedb. Medical certificationMedical certification refers to the member’s attending physician’s statement (IMRF Form 5.42,“Physician’s Statement, ” Exhibit 5G). IMRF may also require Form 5.40A, “Disability Claim DataInstruction Sheet,” Form 5.42A, “Disability Claim Data,” or Form 5.42B, “Physician’s Statement –Total and Permanent Disability Claim.” If any of these forms are required, IMRF will mail the form(s)directly to the member. Members of the Elected County Official Plan must submit two medicalcertifications: Form 5.42 and Form 5.42E, “Physician’s Statement—Disability Claim for ElectedCounty Officials.”When a member first applies for disability benefits, he/she should ensure the physician’s statementindicates any office visits or services rendered after the date the member became disabled. IMRF willsend a letter to the member’s attending physician requesting office visit and treatment notes.If the member is approved for disability benefits and begins receiving benefit payments, the IMRF lawrequires that members periodically submit—at their own expense—medical evidence of continuingdisability.The evidence is required to determine if the member remains eligible for IMRF disability payments. Ifthe member fails to submit current medical evidence of the disabling condition, IMRF must stopdisability benefit payments.c. Pre-existing condition investigations for total and permanent disability claimsWhether a pre-existing condition investigation is done depends on how much IMRF service credit themember has on the date the disabling condition occurred.The member had FIVE OR MORE YEARS of service creditThe member’s claim is not investigated for a pre-existing condition if, prior to the date of disability themember has at least five years of IMRF service credit, excluding service credit earned while receivingIMRF disability benefits.The member had FEWER THAN FIVE YEARS of IMRF service creditA pre-existing condition investigation will be done if the member has fewer than five years of servicecredit on the date he or she became disabled.IMRF will request information to determine if the member had the disabling condition beforebecoming an IMRF participant.This investigation includes having the member complete Form 5.42A, “Disability Claim Data,” andForm 5.46, “Authorization For Disclosure of Health Information,” which gives IMRF permission torequest hospital records and to write to the member’s attending physician(s).If the member’s claim appears to involve a pre-existing condition, an IMRF Claims Examiner willreview the claim. If the Claims Examiner determines the member’s disability is the result of a preexistingcondition, the member will be advised that the claim for IMRF total and permanent disabilitybenefits is being denied. If the member disagrees with that decision, he or she can request a hearingbefore the Benefit Review Committee of the IMRF Board of TrusteesIn some cases, IMRF compiles a written summary of the member’s medical history for review byIMRF’s rehabilitative medicine/occupational psychiatric consultant. If it is IMRF’s rehabilitativemedicine/occupational psychiatric consultant’s opinion that the disability is not the result of a preexistingcondition, the claim will be returned to the disability claim examiner for payment processing.January 2014 Page 203

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundIf it is the opinion of the IMRF staff and of the IMRF rehabilitative medicine/occupational psychiatricconsultant that the disability is the result of a pre-existing condition, the member will be advised thatthe claim for IMRF total and permanent disability benefits is being denied. The member will also beadvised of his or her right to request a hearing before the Benefit Review Committee of the IMRFBoard of Trustees if the member disagrees with the denial. (See paragraph 5.70 Appeal Rights forfurther discussion of appeal rights.)6. Appeal of DenialIf IMRF denies a member’s claim for disability benefits, IMRF will inform the member of that decision. Atthis point if the member has either additional evidence of disability or other compelling argument thatmeets the Pension Code’s definition of disability, he or she may request a hearing before the Board ofTrustee’s Benefit Review Committee.To request a hearing, the member must complete Form 5.70, “Request for a Hearing.” This form is sent tothe member when he or she is notified of the disability claim denial. The completed form must include aStatement of Claim; a detailed statement of why the member believes that the decision to deny/terminatedisability benefits is incorrect.The completed request for a hearing form must be submitted to IMRF within 63 days of the date of thedenial letter. Additional information regarding the procedures and deadlines for filing information is statedin the letter of denial and on Form 5.70. (See Paragraph 5.70 Appeal Rights for further discussion .)5.40 D. Disability Benefit Payment Procedures1. Temporary Disability Benefit Payment Proceduresa. Effective Date of PaymentsIMRF disability benefits are not paid for the first 30 consecutive calendar days of disability.Disability benefits begin on the 31st day following the date of disability, provided pay from theemployer has stopped. For more information on the 30-day waiting period, see Paragraph 5.40A.1.c.1. Effect of Sick Pay, Vacation Pay, Etc. - Sick pay, vacation pay, etc., are IMRF earnings andsubject to IMRF deductions. If sick leave or vacation pay continues beyond the initial 30-daywaiting period, the benefit will begin on the day such earnings stop.Once the employer pays the member sick leave or vacation pay, such payment cannot bereversed. The member cannot return the payment to the employer in an effort to change thedates used to determine the effective date of the benefit.IMRF does not require that a member use up all vacation or sick pay before receivingdisability benefits. This is governed by local personnel policies. However, if at some later date,while the member is receiving IMRF disability benefits, the employer pays vacation or sick pay,IMRF will adjust the disability benefit.2. Exception to 30-Day Waiting Period - If a member receives temporary or total and permanentdisability benefits and then returns to work, but within six months is again disabled by the samecondition, the 30-day waiting period does not apply. IMRF disability benefit payments wouldbegin the day after the last day the member receives compensation from his or her employer.For example: After being disabled for seven weeks, a member returns to work on Monday, the5th, and works through Wednesday, the 14th. She is again disabled by the same condition anddoes not work on Thursday nor Friday. She receives salary for the 5th through the 14th.Her IMRF disability benefit payments would begin Thursday, the 15th, assuming she seeksmedical treatment which certifies she is disabled. She will also need to submit a new IMRFForm 5.40, “Application for Disability Benefits,” and IMRF Form 5.42, “Physician’sStatement—Disability Claim.” In addition, her employer would need to submit a new Form5.41, “Employer Statement—Disability Claim,” advising IMRF of the last date the memberworked and the last date she was or will be paid.Page 204 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5You can also refer to the chart at Paragraph 5.40A.1.(c) that illustrates the 30-day disabilitywaiting period.b. Payment of Disability BenefitsIf the member is receiving monthly temporary disability benefits, he or she will receive a “Report ofDisability” form attached to each check. The “Report of Disability” form explains this procedure.The member needs to complete and submit the “Report of Disability” form only when reporting achange in his or her situation. For example, the member:Was released to return to work, orReceived income from a source he or she did not previously report to IMRF, orWas awarded or denied Social Security disability benefits, orReceived workers’ compensation weekly benefits, or a lump sum settlement contract, or themember’s claim was denied.Disability benefits for conditions with a “pre-determined” time periodMany different conditions have “pre-determined” time periods when the disabling condition isexpected to end, such as pregnancy/childbirth (six to eight weeks following the date of delivery), abroken toe (four weeks after the treatment date), a hysterectomy (six to eight weeks after theprocedure), or a broken arm (six to eight weeks after the treatment date).Conditions with “pre-determined” time periods are also said to have a “maximum allowable” period.However, even though the member becomes disabled by a condition that is “pre-determined” to lasta certain number of weeks, benefits would be payable for a shorter period of time if the:Member’s attending physician releases the member to return to work earlier than themaximum number of weeks, orEmployer pays the member compensation beyond the first 30 days of disability.A member may be eligible for additional disability benefits if he or she has complications during thepre-determined time period. IMRF must receive sufficient medical evidence from the attendingphysician describing the complications which prevent the member’s release to return to work.IMRF advises the member when he or she is being paid the last disability benefit payment, thismessage is printed on the check stub: “This is your last payment, unless you submit medicalevidence that results in approval of additional benefits.”Please note: Disability benefits are payable after childbirth as a result of the member’s physicalcondition. IMRF disability benefits are not payable as a result of the newborn’s condition eventhough the physician may recommend that the member does not return to work.January 2014 Page 205

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund* Each employer establishes its own rules on the use of sick pay and vacation pay. As a result, IMRF’sdisability plan does not require the member to use all of his or her sick or vacation pay before receivingdisability benefits.2. Total and Permanent Disability Benefit Payment ProceduresA member can receive total and permanent disability benefits only after his or her temporary disabilitybenefits have been exhausted.After temporary disability benefits are exhausted and provided IMRF has made a determination, themember will continue to receive monthly benefit payments without interruption.Total and permanent disability benefits are payable on the first day of each month for the preceding month.Page 206 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 53. Periodic Medical Reports and ExaminationsPeriodically, IMRF will ask the member to submit (at his or her expense) medical reports to verifytreatment dates and services rendered (office and office visit notes may be requested). These will berequired to determine the member’s eligibility for continued disability benefit payments.If special examinations by IMRF appointed physicians are required to determine the member’s eligibilityfor continued disability benefit payments, such special exams will be conducted at IMRF’s expense.4. Employer’s Notice of Trial Work Period, Termination of Disability Benefits, Other BenefitsIMRF should be advised immediately if a member starts a trial work period or returns to work. Use Form5.45, “Employer’s Notice of Termination of Disability or Trial Work / Light Duty Period or,” (Exhibit 5H)If payment of disability benefits stops, the member is not eligible for IMRF total and permanent disabilitybenefits, and does not return to IMRF participating employment:If the member is participating in Tier 1 and isa. Younger than age 55 or does not have at least eight years of IMRF service credit, he or she canreceive a refund of his or her IMRF member contributions without interest.b. At least age 55 and has at least eight years of IMRF service credit, he or she will be eligible for anIMRF pension.c. At least age 55 and has reciprocal service or past service he or she may purchase, the member maybe eligible for an IMRF pension. (Note: the application for past service must be made beforedisability benefits stop.)If the member is participating in Tier 2 and isa. Younger than age 62 or does not have at least 10 years of IMRF service credit, he or she canreceive a refund of his or her IMRF member contributions without interest.b. At least age 62 and has at least 10 years of IMRF service credit, he or she will be eligible for anIMRF pension.c. At least age 62 and has reciprocal service or past service he or she may purchase, the member maybe eligible for an IMRF pension. (Note: the application for past service must be made beforedisability benefits stop.)If the member is no longer disabled but does not return to work immediately and the employer has notterminated the member's employment, he or she may be eligible for an IMRF Benefit Protection Leave(IMRF Form 6.32, “IMRF Benefit Protection Leave”).If the employer wishes to provide the member with IMRF service credit and IMRF disability and deathbenefit protection when IMRF disability benefits terminate and the member is not working, the employer’sgoverning body would grant and file with IMRF an IMRF Benefit Protection Leave (IMRF Form 6.32,“IMRF Benefit Protection Leave”).The total service a member can establish under the IMRF leave is limited to a maximum of 12 monthsduring the member’s lifetime, e.g., he or she may be granted a one-time leave of 12 months or severalleaves totaling no more than 12 months. To establish the service, the member must pay the membercontributions that would be due on his or her unpaid earnings.Local leave policy without formal action on the part of the governing body does not protect the member.Without Form 6.32 being filed, the member’s future IMRF benefits can be affected.January 2014 Page 207

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund5. Resignations of Disabled IMRF MembersIt is very important that a member who is receiving IMRF disability benefits understand the impact ofresigning from his or her position.The act of resignation is a two-part process. First the member resigns, and then the employer accepts theresignation and terminates the member.Voluntary ResignationIf a disabled member resigns voluntarily, IMRF disability benefits will stop on the effective date of theresignation.Termination vs. ResignationIf a member has a choice of being terminated or resigning and chooses to resign, IMRF will continue to paythe member disability benefits. Because the only choice was termination or resignation, IMRF treats thosemembers as terminated by the employer and the member remains eligible for disability benefits for thedisabling condition.IMRF must receive documentation of the resignation in writing, e.g., a letter from the member to theemployer or an acknowledgement letter from the employer to the member.Different Position vs. ResignationIn some cases, a disabled member has a choice between resigning OR accepting a different position at thesame IMRF employer to accommodate his or her medical restrictions. In most situations like this, IMRF isaware that the member’s physician has placed restrictions on the member returning to his or her originalposition.If the member chooses to resign, IMRF will verify whether or not the member was offered a “reasonable”alternative position prior to resigning. If we determine that the member was offered a reasonable alternativeposition and chose to resign, IMRF disability benefits will stop on the effective date of the resignation. Allverification documentation must be in writing, e.g., a letter from the member to the employer or anacknowledgement letter from the employer to the member.Workers’ Compensation and ResignationIn another type of member resignation, the member has filed a Workers’ Compensation claim. Duringnegotiations to settle the Workers’ Compensation claim, the employer may offer to settle the Workers’Compensation matter if the member resigns from his or her IMRF position and agrees to give up all rightsas an employee of that employer.When the member signs such a resignation agreement, the member gives up the right to receive IMRFdisability benefits unless the agreement specifically states that the member is not giving up his or her rightto IMRF disability benefits. This is true even if the agreement mentions that the member is resigning due toa health condition. The reasoning is that by signing such an agreement, the member is separating fromservice.Unless the agreement specifically states that the member is NOT giving up his or her rights to IMRFdisability benefits, such benefits will stop on the effective date of the resignation. Before any Workers’Compensation settlement is drawn up, the member’s attorney should contact the IMRF legal department.5.40 E. Cost of IMRF Disability BenefitsThe entire cost of the IMRF disability plan, and the cost of continuing service credit and death benefit coveragefor a disabled member, is paid by the employer.Member contributions are not used to fund disability benefits.Page 208 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 55.40 F. Income Taxes on Disability Benefits1. Federal Income TaxAny IMRF disability benefit payments a member receives will be subject to federal income tax, but a taxcredit may be claimed by some disabled members.For more information on this tax credit, the member can:Call 1-800-TAX-FORM (1-800-829-3676) and request IRS Publication 524, “Credit for theElderly or the Disabled,”Download and print IRS Publication 524, “Credit for the Elderly or the Disabled,” orContact a tax advisor.IMRF disability benefit payments are not subject to Illinois state income tax. If the member is a resident ofanother state, the member should check with his or her state’s Department of Revenue to learn whether heor she will pay that state’s income tax on IMRF disability benefits.IMRF will report the disability benefit payments as income to the Internal Revenue Service. We also willsend the member the appropriate forms for completing his or her income tax return.2. Retirement Income Credit Available To Disabled Membersa. Disabled Members Under Age 65If the disabled member is totally and permanently disabled, the member may be able to claimretirement income credits.For tax purposes, a person is deemed to be permanently and totally disabled if unable to engage inany substantial gainful activity by reason of a medically determinable impairment (physical ormental) that (1) can be expected to result in death, or (2) has lasted or can be expected to last for acontinuous period of at least 12 months.In general, the credit is limited to a base amount which is the lesser of (1) the disability income or(2) $5,000 if single; $7,500 if both spouses are disabled and file a joint return; $3,750 if marriedfiling a separate return.This base amount is reduced by non-taxable Social Security benefits and other non-taxable pensionincome, such as railroad retirement, and by workers’ compensation used to compute Social Securitypayment amounts.In addition, if adjusted gross income exceeds a specified dollar limit, the base amount is furtherreduced by half of the excess.The dollar limits are $7,500 for a single person; $10,000 for married individuals filing a joint return;and $5,000 for married individuals filing separate returns.b. Disabled Members Age 65 or OverMembers age 65 or over in the taxable year may be able to claim retirement income credit whetheror not considered permanently and totally disabled.In general, the exclusion is limited to a base amount of $5,000 for single individuals and marriedindividuals filing a joint return if one spouse is eligible; $7,500 for married individuals bothqualifying and filing a joint return; and $3,750 for married individuals filing a separate return.This base amount is reduced by non-taxable Social Security benefits and other non-taxable pensionincome, such as railroad retirement, and by workers’ compensation used to compute Social Securitypayment amounts.January 2014 Page 209

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundIn addition, if adjusted gross income exceeds a specified dollar limit, the base amount is furtherreduced by half of the excess.The dollar limits are $7,500 for a single individual; $10,000 for married individuals filing a jointreturn; and $5,000 for married individuals filing separate returns.c. How to Claim Retirement Income CreditIn order to claim retirement income credit, the disabled member should report the disability incomeon IRS Form 1040 and claim the retirement income credit on Schedule R to Form 1040.A married individual who has lived with his or her spouse for all or any part of the taxable year mustfile a joint return in order to claim the credit.3. Tax Withholding and ReportingA member applying for a disability benefit can elect whether or not federal income tax should be withheldfrom the disability benefit payment. Form W-4P, “Federal Income Tax Withholding Certificate,” isincluded with Form 5.40, “Application for Disability Benefits.”Internal Revenue Service regulations require IMRF to issue IRS Form 1099-R reporting disabilitypayments. Copies of the forms are sent to the member and one copy is filed with the Internal RevenueService. IMRF’s classification of disability benefits and the reporting form are not to be interpreted asadvice as to taxability of the benefit or qualification for the retirement income credit before age 65.Generally, disability payments are reported on the line “Wages” on the IRS 1040 or 1040A form, until themember reaches retirement age. After retirement age, the payments should be reported on the pension lineof the IRS tax form.4. Illinois Income Tax (Illinois Residents Only)The Illinois Income Tax Act exempts IMRF disability payments from Illinois income tax.If the disability payments are included in federal adjusted gross income, the disability payments are alsoincluded on Illinois IL-1040. In order to claim the exemption on the Illinois Income Tax Return, IL-1040, itis necessary to follow the specific instructions provided with the IL-1040 concerning subtractions to arriveat Illinois taxable income.If the disability payments are not included in federal adjusted gross income, the disability payments are notincluded on Illinois IL-1040. In that case, the disabled member should not claim an exemption on IllinoisIL-1040.5.50 ReciprocityThe Illinois Municipal Retirement Fund is one of 13 public employee retirement systems covered by the IllinoisRetirement Systems’ Reciprocal Act - Article 20 of the Pension Code. The other 12 systems covered by theReciprocal Act are:County Employees’ Annuity & Benefit Fund of Cook County33 North Dearborn Street - Room 1000Chicago, Illinois 60602-3116Phone No. 312-603-3103www.cookcountypension.com/Forest Preserve District Employees’ Annuity & Benefit Fund of Cook County33 North Dearborn Street - Room 1100Chicago, Illinois 60602-3103Phone No. 312-603-1200www.cookcountypension.com/Page 210 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5General Assembly Retirement System2101 South Veterans ParkwayP.O. Box 19255Springfield, Illinois 62794-9255Phone No. 217-782-8500www.state.il.us/srs/GARS/home_gars.htmJudges’ Retirement System2101 South Veterans ParkwayP.O. Box 19255Springfield, Illinois 62794-9255Phone No. 217-782-8500www.state.il.us/srs/Judges/home_jrs.htmLaborers’ Annuity and Benefit Fund321 No. Clark Street - Suite 1300Chicago, Illinois 60654-4739Phone No. 312-236-2065www.labfchicago.org/Metropolitan Water Reclamation District Retirement Fund111 East Erie Street - Suite 330Chicago, Illinois 60611Phone No. 312-751-3222www.mwrdrf.org/Municipal Employees’ Annuity and Benefit Fund of Chicago321 North Clark Street - Suite 700Chicago, Illinois 60654-4767Phone No. 312-236-4700www.meabf.orgPark Employees’ Annuity and Benefit Fund of Chicago55 East Monroe Street - Suite 2720Chicago, Illinois 60603Phone No. 312-553-9265www.chicagoparkpension.org/Public School Teachers’ Pension and Retirement Fund of Chicago203 N. LaSalle Street - Suite 2600Chicago, Illinois 60601Phone No. 312-641-4464www.ctpf.org/State Employees’ Retirement System2101 South Veterans Parkway, P.O. Box 19255Springfield, Illinois 62794-9255Phone No. 217-785-7444www.state.il.us/srs/Chicago Office:Michael A. Bilandic Building160 N. LaSalle Street, Suite N725Chicago, Illinois 60601312-814-5853January 2014 Page 211

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundTeachers’ Retirement System2815 W. Washington Street, P.O. Box 19253Springfield, Illinois 62794-9253Phone No. 217-753-0311http://trs.illinois.gov/Lisle Office:4200 Commerce Court - Suite 200Lisle, Illinois 60532-36111-800-877-7896State Universities Retirement System1901 Fox Drive, P.O. Box 2710Champaign, Illinois 61825-2710Phone No. 217-378-8800www.surs.org/Local police and fire pension funds are not covered by the Retirement Systems’ Reciprocal Act. There is noreciprocity between police and fire pension funds and IMRF. Also, reciprocal service credit cannot be used in thecalculation of a SLEP or ECO pension.5.50 A. Purpose of Reciprocal ActThe purpose of the Reciprocal Act is to provide for the continuity and preservation of service credit in the case ofmembers transferring employment from one governmental unit to another, resulting in pension coverage. Use ofthe provisions of the Reciprocal Act is optional with the member.For example: A member participated under IMRF for 12 or more months but left participation and kept his or hercontributions on deposit. The member then went on to participate in one or more of the reciprocal systems. Whenthat member retires, all of his or her service credit would be combined to calculate the amount of a pensionfrom each system. This calculation is explained in more detail later in this section.Please note: a member must have 12 or more months of service with a reciprocal retirement system for themember to use that service in the calculation of a reciprocal pension.Exception: Certain former paraeducators (teacher’s aide) in a school district who transferred to a positioncovered by the Teachers’ Retirement System (TRS) with less than 12 months of IMRF service credit may applythat service toward a reciprocal pension.If a former paraeducator took a refund of his or her IMRF contributions, he or she can repay the refund andreinstate the service credit. See Paragraph 6.40 Past Service, Reinstatement5.50 B. Form of the Reciprocal ActReciprocity is a method whereby a member who has established at least one year of service credit in anyretirement system that is covered by the Reciprocal Act may use the combined service from all such systems forthe purpose of meeting the qualifying conditions for a pension from each system.The combined service credit of the member must be sufficient to meet the longest qualifying period of serviceunder any of the retirement systems concerned.Example:1. Both the State Employees’ Retirement System (SERS) and IMRF’s Regular Tier 1 Plan require a minimumof eight years of service to qualify for a formula pension.Page 212 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 52. Assuming a member has established two years of service credit with SERS, and retires under IMRF'sRegular Tier 1 Plan after six years of service, the combined SERS and Regular Plan service totals eightyears, and thereby meets the minimum qualifying conditions of each system.3. The member is entitled to a proportional annuity from each system.5.50 C. Proportional AnnuitiesAt the time of retirement, each retirement system in which the member has service credit computes aproportional retirement annuity for the amount of credit earned in that system, based upon its own pensionformula, and the highest average earnings in any of the systems in which the member has participated.Survivor annuity benefits are determined in a like manner.Example:1. A member has established 12 years of service with System A, terminates from System A but leaves his orher contributions on deposit.2. The member later establishes 20 years of service credit with IMRF.3. The member’s final average earnings under System A were $800 per month and under IMRF Tier 1 were$1,200 per month.4. Both System A and IMRF require eight years of service credit to vest for a pension and both base the finalaverage earnings on the highest consecutive 48 months of earnings credit.Pension amounts calculated separatelyWithout reciprocity, the calculation of the pensions would be as follows:System A - 12 years of service credit, $800 final wagesSystem A has a step rate formula of 1.67% for each of the first 10 years and 1.9% for each of the next 10 years.10 years x 1.67% = 16.7000%2 years x 1.9% = 3.8000%20.5000% x $800.00 = $164.00 per monthIMRF - 20 years of service credit, $1,200 final wagesIMRF has a step rate formula of 1.67% for each year of the first 15 years and 2% for each year over 15.15 years x 1.67% = 25.0500%5 years x 2.0% = 10.0000%35.0500% x $1200.00 = $420.00 per monthThe total pension payments from System A and IMRF would be $584.00 per month.January 2014 Page 213

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundPension amounts calculated under reciprocityIf the member elects the provisions of the Reciprocal Act,1. Both pensions would be based on the final average earnings of IMRF (because those final wages arehigher), and2. The step rates would be computed on the basis of the combined service as follows (note how the step ratesused under IMRF reflect the greater service):System A (service years 1 through 12)10 years x 1.67% = 16.7000%2 years x 1.9% = 3.8000%20.5000% x $1200.00 = $246.00 per monthIMRF (service years 13 through 32)3 years x 1.67% = 5.0000%17 years x 2.0% = 34.0000%39.0000% x $1200.00 = $468.00 per monthUnder reciprocity, the total pension payments from System A and IMRF would be $714.00 per month, $130more than available individually from each system.5.50 D. Concurrent reciprocal serviceIf a member has concurrent reciprocal service at the time of retirement, that concurrent service can be used tomeet the one-year minimum service credit requirement for a reciprocal pension.However, how the concurrent service is treated in the calculation of a reciprocal pension depends on the amountof concurrent service. In all cases, the member earns only one month of service for each calendar month.If a member has concurrent reciprocal service, the member should request a pension estimate fromeach of his or her reciprocal systems.Member has six months or less of concurrent reciprocal serviceThe system under which the member has either earned the most service or will receive the largest pensionincludes the concurrent reciprocal service in its pension calculation. The member’s other system(s) removes theconcurrent service from its pension calculation.Example:Member’s service credit:12 years with System A (includes 4 months concurrent service)2 years with System B (includes 4 months concurrent service)The member will receive the larger pension from System A. Therefore, System A includes the four concurrentmonths in its pension calculation; System B does not.For pension calculation purposes:Member’s service with System A remains at 12 yearsMember’s service with System B is reduced to 1 year, 8 monthsEach retirement system computes a proportional retirement annuity based upon its own pension formula and thehighest average earnings in any of the systems in which the member has participated.Page 214 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5Member has more than six months of concurrent reciprocal serviceThe concurrent service credit will be divided between/among the member’s reciprocal retirement systems. Eachsystem will use part of the concurrent service in its pension calculation.Each system reduces the concurrent service based upon a formula that includes the member’s final rate ofearnings under the system, the member’s combined final rate of earnings from all systems, and the total amountof concurrent service:Example:Member has 6 years of concurrent serviceMember’s final rate of earnings in the systemxMember’s concurrent service÷Member’s combined final rate of earnings=The concurrent service used by the system in its pension calculationSystem A:$50,000 final rate of earnings14 years of service (includes 6 years concurrent service)System B:$30,000 final rate of earnings8 years of service (includes 6 years concurrent service)Using the formula above:Final rateofearningsIn eachsystemTotalConcurrentServiceCombined finalrate ofearningsfrom allsystemsReducedconcurrentservice used inpensioncalculationSystem A $50,000 x 6.00 years = $300,000 ÷ $80,000 = 3.750System B $30,000 x 6.00 years = $180,000 ÷ $80,000 = 2.250For pension calculation purposes:Member’s service with System A is reduced to 11.750 yearsMember’s service with System B is reduced to 4.250 yearsEach retirement system computes a proportional retirement annuity based upon its own pension formula and thehighest average earnings in any of the systems in which the member has participated.5.50 E. Reciprocal ApplicationsIn order to retire under the Reciprocal Act, the member must retire under all systems at the same time.The member must submit separate applications to the systems in which the member has established credits.Each system will pay its own proportionate pension and the member will receive separate checks from thesystems involved.January 2014 Page 215

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundThe member should submit the first application to the system he or she participated in last. For example, if themember is retiring from IMRF, but participated in SERS previously, the member would submit the firstretirement application to IMRF and then submit an application to SERS.Also, the member should advise each system that he or she plans to retire under the Reciprocal Act.If the reciprocal systems a member will retire under have different age requirements, as a general rule, themember can begin receiving only that portion of the pension he or she earned from the system with the earlierage requirement.Once the member reaches the minimum age requirement of his or her other system(s), the member would thenreceive a pension from that system(s).For example, if a member was retiring under IMRF Tier 1 (which has a minimum retirement age of 55) andanother system with a minimum retirement age of 60, the member could receive the IMRF portion of thereciprocal pension at age 55, and the portion of the pension earned under the other plan when the memberreached age 60.5.50 F. Repayment of RefundsA member who has forfeited pension credits by accepting a refund of member contributions may reinstate the creditsunder the Reciprocal Act after returning to work for another system for at least two years after the refund isreceived, provided that the rules of the first system permit reinstatement.5.50 G. Return to WorkIf a member who retired under reciprocity returns to a qualifying position with one of the systems from which he orshe is drawing benefits, the reciprocal pension will be suspended by both systems. It will be suspended for as long asthe member is in a qualifying position. Once the member retires again, the reciprocal pension will be adjusted ifnecessary and restored by both systems.If the member retired under the IMRF Early Retirement Incentive additional penalties apply. Please refer toparagraph 5.20 C. 16. Return to Work for an IMRF Employer Prohibited.5.60 Verification of IMRF Benefit PaymentsRetired or disabled members, or persons receiving survivor benefits, often need verification from IMRF of themonthly payment amounts in connection with credit applications, housing eligibility, public aid, etc.IMRF requires written authorization from the member or surviving spouse before releasing the information to theorganization requesting the verification.5.70 Appeal RightsIMRF has different appeal procedures depending upon the type of decision an IMRF member or employer isappealing. For example, a member who is appealing a decision in which disability benefits were denied would use adifferent appeal procedure than a member who was appealing a decision about Past Service credit. IMRF’s appealprocedures are:Appeal Procedure for denied claims – DisabilityAppeal Procedure for denied claims – Non-DisabilitySummary of Appeal Procedures - DisabilityIf IMRF staff denies or terminates a member’s claim for disability benefits, we will inform the member in writing ofthat decision. At this point if the member has either additional evidence of disability or other compelling argumentthat meets the Pension Code’s definition of disability, he or she may request a hearing before the IMRF Board ofTrustees’ Benefit Review Committee.Page 216 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5To request a hearing, the member must complete the “Request for a Hearing,” Form 5.70. This form is enclosed withthe denial letter advising the member of the disability claim denial. The completed request for a hearing form mustbe received by IMRF within 63 days of the date of the staff denial letter. Additional information regarding theprocedures and deadlines for filing information is stated in the denial letter and on the Request for a Hearing form.The hearings are held in IMRF’s Oak Brook offices. The member may appear personally with or without anattorney. If the member is unable to attend, a representative or attorney may appear for the member. Hearings mayalso be held via videoconference from our Springfield office or via telephone conference at the member’s request.The member may also present a written appeal without a personal appearance.The Benefit Review Committee will make a recommendation to the full IMRF Board of Trustees. The decision ofthe Board of Trustees, after a Benefit Review Committee hearing, constitutes its final administrative decision andIMRF will take no further action regarding the claim. However, review of the Board of Trustees’ finaladministrative decisions is provided under Article III of the Illinois Code of Civil Procedure [735 ILCS 5/3-101 etseq. (West 2012)]. If a member wishes to pursue a claim, he or she must file an action for Administrative Review inthe Circuit Court of either DuPage or Sangamon County, Illinois or the county where the member’s employer’smain office is located, within 35 days of the date of the notice of the Board’s decision.Read the complete Appeal Procedures for Disability Benefits on the IMRF website atwww.imrf.org/info/appeals/appeals_procedures.htmSummary of Appeal Procedures – Non-DisabilityIf any person or employer receives an administrative staff determination not related to a disability claim, they mayrequest a hearing before the Board of Trustees’ Benefit Review Committee.To request a hearing, the person or employer must submit a written petition. This petition may be in any format andcan simply state the request for a hearing. The petition should be directed to the Associate General Counsel in theIMRF Oak Brook office and must be received by IMRF within 63 days after the date of the staff determinationletter. The Associate General Counsel will then send the petitioner an acknowledgement of the petition and informthe petitioner that a formal Statement of Claim must be filed.After the Statement of Claim is received by IMRF, the Associate General Counsel will add the petitioner’s claim tothe agenda of the next available Benefit Review Committee meeting. Once scheduled, the petitioner will beprovided a written notice of the date, time, place, and subject matter of the hearing.The hearings are held in the IMRF offices. The petitioner may appear personally with or without an attorney. If thepetitioner is unable to attend, a representative or attorney may appear for the petitioner. Hearings may also be heldvia videoconference from our Springfield office or via telephone conference at the petitioner’s request. Thepetitioner may also present a written appeal without a personal appearance.The Benefit Review Committee will make a recommendation to the full IMRF Board of Trustees. The decision ofthe Board of Trustees, after a Benefit Review Committee hearing, constitutes its final administrative decision andIMRF will take no further action regarding the claim. However, review of the IMRF Board of Trustees’ finaladministrative decisions is provided under Article III of the Illinois Code of Civil Procedure [735 ILCS 5/3-101 etseq. (West 2012)]. If a member wishes to pursue a claim, he or she must file an action for Administrative Review inthe Circuit Court of either DuPage or Sangamon County, Illinois or the county where the member’s employer’smain office is located, within 35 days of the date of the notice of the Board’s decision.Read the complete Appeal Procedures for Non-Disability Benefits on the IMRF website atwww.imrf.org/info/appeals/appeals_procedures.htm.5.80 Health Insurance ContinuationIMRF does not have a health insurance plan for its participating employers or members. However, an employer maybe required to continue health insurance coverage for a retiring, terminating, or disabled IMRF member as requiredby federal or state legislation.January 2014 Page 217

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund5.80 A. Continued Health Insurance Under COBRAThe Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) is federal legislation covering healthinsurance continuation. It applies to employers with 20 or more employees.Under federal COBRA legislation, the employer must allow a covered employee to continue his or her healthinsurance for a minimum of 18 months after employment ends. However, an employer can choose to offer healthinsurance for a period of time longer than that required by this legislation.If the covered employee is not yet age 65 (Medicare eligible) when the COBRA continuation begins, theemployee can continue the insurance for 18 months or until age 65, whichever occurs sooner. When the coveredemployee becomes eligible for Medicare, he or she is no longer eligible for health insurance continuation. If thecovered employee is already eligible for Medicare when employment ends, the COBRA continuation cancontinue for 18 months.However, COBRA spells out several “qualifying events” which will allow the covered employee’s spouse anddependent children to extend the health insurance for an additional 18 months. One such qualifying event is whenthe covered employee qualifies for Medicare after COBRA continuation began. Therefore, even though theemployee is no longer covered under the former employer’s health insurance, his or her spouse and dependentscan be. Their coverage will continue for an additional 18 months after the employee’s coverage ends.5.80 B. Continued Health Insurance Under Section 367j of the Illinois Insurance CodeSection 367j of the Illinois Insurance Code requires IMRF employers who offer health insurance to their activeemployees to offer the same health insurance to disabled members, retirees, and surviving spouses at the samepremium rate for active employees. It does not require IMRF employers to provide health insurance which is notalready provided. Section 367j applies to insurance carriers writing policies in Illinois and self-insuredemployers.The same coverage, provisions, deductibles, etc. which apply to active employees apply to individuals receivingcontinued insurance coverage. This includes coverage for dependents of members who are insured under thepolicy on the day immediately before the day the member retires or becomes disabled.Over the years, IMRF has attempted to provide guidance to IMRF employers on Section 367j. However, theofficial interpretation of the law comes from the Illinois Department of Insurance, and if their opinion conflictswith IMRF’s advice, the Department of Insurance prevails. If you have questions regarding health insurancecontinuation, you should contact the Department of Insurance, Consumer Service Division, your health insuranceprovider or consultants, or your attorney.Questions about specific situations or the intricate details of the law must be directed to the Department ofInsurance, or to your insurance consultants or provider, or your attorney. If your unit of government self-insures,belongs to an insurance pool, or contracts with an HMO, you must consult with your insurance consultants oryour attorney to determine what, if anything, you are required to offer under the provisions of Section 367j.1. EligibilitySection 367j was written so that continued insurance coverage is available only if benefits are payable byIMRF. Unless you are certain of eligibility, you may wish to verify through IMRF whether the member iseligible for retirement benefits, disability benefits, or surviving spouse benefits. Eligibility for continuedIMRF benefits can be verified in writing if desired. IMRF will not notify an employer’s insurance carrier ofeligibility.To be eligible for health insurance continuation under Section 367j, the IMRF member must be insuredunder the provisions of the employer’s policy on the day immediately before the day the member retires orbecomes disabled. Members electing to continue insurance coverage remain subject to the provisions of theemployer’s policy.Page 218 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 5a. Retired membersOnly active employees participating in IMRF and eligible for an IMRF pension are entitled tocontinued insurance coverage. Employees not eligible to participate in IMRF (those working lessthan the 600-hour or 1,000-hour standard) are not entitled. An IMRF member who quits work but isnot entitled to an immediate receipt of an IMRF pension is not entitled to continued insurancecoverage. An employer may voluntarily extend coverage under the group health plan to itsemployees not enrolled in IMRF.b. Disabled membersOnly active employees participating in IMRF who are eligible for an IMRF disability benefit areentitled to continued insurance coverage under Section 367j. Employees not eligible to participate inIMRF (those working less than the 600-hour or 1,000-hour standard) are not entitled. An employermay voluntarily extend coverage under the group health plan to its employees not eligible for IMRFdisability benefits.c. Dependent CoverageIf the IMRF member had dependent coverage the day before he or she was removed from theemployer’s payroll due to retirement or disability, continued insurance coverage must be offered tothe retiree’s or disabled member’s dependents. If the IMRF member had individual coverage at thetime the retirement or disability period begins to run, the Illinois legislation only requires theemployer to offer a continuation of individual coverage.d. Surviving spouses of deceased membersWhether a surviving spouse is eligible for continued insurance coverage under Section 367j dependsupon three factors: 1. the status of the deceased member (contributing, disabled, retired); 2. whetherthe spouse is considered to be a surviving spouse for IMRF benefit purposes; and 3. whether thespouse elects to receive an IMRF surviving spouse pension.Status of member at time of deatha. ContributingIf a member contributing to IMRF dies (including seasonal members and those on anIMRF Benefit Protection Leave of Absence), the surviving spouse is not entitled tocontinued insurance coverage under Section 367j. These spouses may be eligible forcontinuation coverage under COBRA.b. Disabled/RetiredIf a disabled member (someone receiving an IMRF disability benefit) or retiree dies andthe member or retiree had not reached Medicare eligibility but did have spouse healthinsurance coverage prior to death, the surviving spouse may be entitled to continuedinsurance coverage under Illinois Public Act 86-1444. Whether the spouse is entitled tocoverage depends on whether he or she satisfies the following criteria:i. The surviving spouse must be eligible for the IMRF surviving spouse pension.ii.The eligible surviving spouse of a disabled member may select either a lump sumdeath benefit or a monthly pension. Only if the surviving spouse selects an IMRFpension is he or she eligible for continued insurance coverage under Section 367j.Again, his or her COBRA continuation coverage is a separate right, independent ofthis legislation.When a retiree dies, an eligible surviving spouse will receive a surviving spouse’spension. The spouse does not have an option between a lump sum payment or a monthlypension. Therefore, he or she is entitled to continued insurance coverage.January 2014 Page 219

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement Fund2. Employer implementation under Section 367jOnce an IMRF member is removed from the payroll due to retirement or disability, the employer has 15days to give its insurance carrier written notice that the member is eligible to elect continued insurancecoverage under Section 367j.The employer would notify the insurance company by certified mail, return receipt requested. The noticewould include the member’s name, address, and beginning date of retirement, disability, or the date ofdeath (surviving spouses). Within 15 days after the employer notifies its insurance company, the insurancecompany is to notify the retiree, disabled member, or surviving spouse of his or her eligibility for continuedinsurance coverage. The individual electing continued insurance coverage notifies the insurance companyof his or her decision. For a self-insured plan, the individual would submit election directly to theemployer.3. Insurance premiums under Section 367jThe disabled member, retiree, or surviving spouse may be required by the employer to pay both theemployer and member portions of the premiums. As a general rule, Public Act 86-1444 does not requireIMRF employers to pay all or any portion of the premium for this group.An employer may charge no more than the premium rate charged for other employees. Unlike COBRA,which allows the employer to charge an extra 2% of premiums, the Illinois law prohibits charging retirees,disabled members, or surviving spouses any higher premiums than those charged for the employer’s otheremployees.a. Collective bargaining agreementsSection 367j does not affect collective bargaining agreements.If a collective bargaining agreement requires partial or total premium payments for retirees, disabledmembers, or surviving spouses, this legislation does not affect the agreement’s provisions, and theemployer must continue to make such payments.b. Premium collectionThree methods for premium payments are provided for in the statute:1. The member pays premiums to the employer, who remits payment with other premiumpayments.2. The insurance company can require the member to make payment directly to it.3. The member may request IMRF to deduct the premiums from his or her IMRF benefits andremit payment to the former employer. The member and employer would complete IMRF Form7.10 “Health Insurance Continuation through Employer Premium Deduction Authorization,”(Exhibit 5J).c. Deduction from IMRF benefit paymentIMRF will remit premiums deducted from benefit payments only to employers because the retiree,disabled member, or surviving spouse will be covered under the employer’s group insurance policy.The employer is responsible for remitting all premiums to the insurance carrier. The employer willknow immediately when premiums, carriers, or coverage change.IMRF will deduct premiums and remit them to employers using the following guidelines only:1. IMRF benefit payments must be greater than the premiums. If premiums increase faster thanIMRF benefits, premium deductions by IMRF will cease.2. IMRF will not deduct premiums from temporary disability benefit payments because theeligibility for each payment is determined on a month-by-month basis; benefits fluctuate asworkers’ compensation and Social Security benefits are considered, and the benefit may be paidfor a short period of time.Page 220 January 2014

Illinois Municipal Retirement Fund Member Benefits / Health Insurance Continuation / SECTION 53. IMRF will deduct premiums from recurring benefit payments (the regular and usual amount).Please note: a member’s or surviving spouse’s first recurring benefit payment may representmore than one month of IMRF benefits. However, IMRF will deduct only one month’s premiumfor health insurance from that payment.4. IMRF will not deduct more than one month’s premium. It will not make up several months ofpremiums. It is the benefit recipient’s responsibility to make arrangements to pay premiumsuntil such time as IMRF can begin remitting payments.5. If there are gaps in coverage, IMRF will not bridge the gap by paying premiums. For example,if a retiree dies, IMRF will terminate paying premiums. If subsequently a surviving spouse iseligible for continued coverage, IMRF will remit premiums on behalf of the surviving spouseonly after the spouse enrolls in the insurance program.6. Disabled or retired members and employers will be required to complete IMRF Form 7.10“Health Insurance Continuation through Employer Premium Deduction Authorization,” (Exhibit5J).7. After IMRF deducts the premiums, it will remit them to the employer. IMRF will mail theemployer a check, or the employer can elect to have the premium payment electronicallydeposited into its checking or savings account. The employer would use IMRF Form 3.01,Change Account for Electronic Payments from IMRF," (Exhibit 5P) to advise IMRF of theaccount information or to change account information.5.80 C. Pension Protection Act: Deduction of insurance premiums from IMRF benefit paymenton a pre-tax basisThe Internal Revenue Code allows a retired or disabled public safety employee to take a tax deduction of up to$3,000 from their federal income taxes for health insurance or long-term care insurance premiums deducted fromtheir pension payment and paid by IMRF to the insurance company or employer.The member must have held a public safety position when he or she terminated IMRF participation forretirement or when he or she became totally and permanently disabled. The disabled member must be receivingIMRF disability benefits.Public safety employees include the following:An individual involved in crime and juvenile delinquency control or reduction, or enforcement of thecriminal laws (including juvenile delinquency), including, but not limited to police, corrections, probation,parole, truant officers, and judicial officers;Professional firefightersOfficially recognized or designated public employee members of a rescue squad or ambulance crewOfficially recognized or designated members of a legally organized volunteer fire departmentOfficially recognized or designated chaplains of volunteer fire departments, fire departments, and policedepartmentsA maximum of a $3,000 tax deduction can be taken annually on the member’s federal tax return. IMRF reducesthe amount of federal income tax withholding to reflect the lower taxable amount of your pension. However,your 1099-R tax statement will show your full pension payments before the deduction for insurance premiums.You take the deduction by reducing the taxable amount of your pension by the amount you paid for insurancepremiums when completing Form 1040 or Form 1040A, “U.S. Individual Income Tax Return.”The health insurance or long-term care insurance coverage can include the member, spouse, and dependents.However, this tax deduction is available only to the member. It is not available to surviving spouses.January 2014 Page 221

Member Benefits / Health Insurance Continuation / SECTION 5Illinois Municipal Retirement FundDisabled or retired members will be required to complete:IMRF Form 7.12D, “Election For Deductions for Health or Long Term Care Insurance Premiums PaidDirectly to Insurer” (Exhibit 5N) if he or she is paying premiums directly to the insurance company orIMRF Form 7.12E, “Election For Deductions for Health or Long Term Care Premiums Paid throughEmployer or Endorsed Plan Administrator” (Exhibit 5O) if he or she is paying premiums throughHis or her former employer because the member is continuing insurance through theemployer, orDoyle Rowe Ltd. because the member is enrolled in an IMRF-endorsed plan.5.80 D. MedicareAccording to an opinion issued by the Department of Insurance, Section 367j continuation must continue pastMedicare eligibility. However, the Department also says that the employer may reduce the insurance benefits forretirees, disabilitants, and surviving spouses who become eligible for Medicare.This opinion from the Department contradicts the advice IMRF has previously given. Because the InsuranceCode is enforced and interpreted by the Department, their opinion prevails.If you are interested, please contact the Department of Insurance for advice on how to design a plan for insuredson continuation who become eligible for Medicare. Or you may want to contact your insurance consultants oryour attorney about insurance for Medicare eligible annuitants.5.80 E. When Health Insurance Coverage EndsHealth insurance coverage under Section 367j ends when the first to occur takes place:1. The retiree, disabled member, or surviving spouse fails to pay premiums;2. The retiree or disabled member returns to IMRF covered employment;3. The retiree or disabled member is convicted of a job-related felony;4. The retiree or disabled member dies (Certain surviving spouses of deceased terminated employees areentitled to continuation, see Paragraph 5.80 B.1d Surviving Spouses of Deceased Members);5. The disabled member takes a refund of IMRF contributions;6. The surviving spouse dies;7. The employer terminates health insurance coverage for all employees (actives and those on continuation).5.80 F. Public Safety Employee Benefits Act (820 ILCS 320/1 et seq.)An employer must allow a fulltime public safety officer who suffers a catastrophic injury in the line of duty tocontinue on the employer’s insurance at no cost to the officer. The officer’s spouse and minor children areincluded in this no cost mandate.If the officer is killed in the line of duty, the officer’s spouse and minor children must be allowed the no-costcontinuation.Page 222 January 2014

APPLICATION FOR SEPARATION REFUNDIMRF Form 5.10 (Rev. 01/2013)Exhibit 5APage 1 of 6SEPARATION REFUNDS• This application is for a total refund of your IMRF membercontributions. You should file this form ONLY if you are nolonger working, in any position, for the employer withwhom you made these contributions AND if you are nolonger working for any employer in an IMRF-qualifyingposition.• By accepting a refund, you forfeit your right to all IMRFbenefits including a future IMRF pension. However,you can reinstate forfeited pension credits by repaying therefund with interest. To be eligible to repay the refund, youmust return to work for at least two years under IMRF orone of the other Reciprocal Act public pension systemsin Illinois. If you participate in IMRF’s SLEP plan, you canrepay the refund after you have completed 1,000 hours ofcontributing IMRF service under SLEP.• You are NOT eligible for a refund if:• you change from participation with one IMRFemployer to participation with another IMRFemployer. If you continue IMRF participation withanother employer, IMRF combines your contributionsand pension credits in your IMRF account and will baseany benefit payment on the total.• you stop participating in IMRF but continue workingfor your employer. For example, you work for a schooldistrict as a teacher’s aide and accept a certificatedteaching position with the same school district. Or, youwork for a city as a dispatcher and accept a position as apolice officer or firefighter with the same city.• you are age 55 or older (age 50 for SLEP) and yourservice qualifies you for a monthly pension of $30or more. Exception: you can receive a refund only ifyou will roll it over into another defined benefit plan topurchase qualifying service credit.OPTIONS FOR SUBMITTING FORM 5.10:• eForm — You may submit Form 5.10 online by signinginto your IMRF Member Access account and selecting“Secure Online Forms” under the “Tools” tab. To create aMember Access account, visit www.imrf.org/myimrf.• Enterable PDF — You may enter information onto thePDF Form 5.10 at www.imrf.org. Print, sign, and mail orfax the form to IMRF (contact information below).• Paper form — You may request a paper form be mailedto you by calling 1-800-ASK-IMRF (1-800-275-4673)INSTRUCTIONS FOR COMPLETING THIS FORMSection 1 — Member informationEnter the requested information.Section 2 — CertificationPayments directly to youIf you are having your entire refund paid directly to you, check the box for “Roll over nothing.” Because the refund will bepaid directly to you, federal law requires IMRF to withhold 20% of the taxable portion of your refund. The 20% withholding isnot required if you directly roll over the taxable portion directly to an IRA or some other qualified retirement plan. (See nextparagraph.)Direct RolloversIf you are having all of your refund directly rolled over to an Individual Retirement account or other eligible plan, checkthe box “Roll over entire taxable amount.” If you are having part of your refund rolled over, indicate EITHER a percentageOR dollar amount in the space provided. The refund will be mailed to you, but the check will be made payable to thecustodian of your account or plan. If you indicate anything less than the full amount of your refund, the balance — lessthe 20% withholding on the taxable portion — will be distributed directly to you.Section 3 — Rollover account information (This section required for direct rollovers only.)Take this form to your financial institution or the custodian of your account or plan and have its representative completeSection 3. If you wish, you may instead attach a completed rollover request form from your financial institution.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax (630) 706-4289www.imrf.orgIMRF Form 5.10 (Rev. 01/2013)

ADDITIONAL TAX INFORMATION• The taxable amount of most refunds will be subject tofederal income tax and a 10% additional tax. The additionaltax does not apply if you:a) roll over your refund directly to an IRA or other qualifiedretirement plan; 401(a), 401(k), 457, or 403(a) or 403(b).b) are age 59-1/2 or older when you take your refund;c) are age 55 or older (50 or older if you are a police officer,firefighter or emergency medical personnel) in the yearyou terminate employment with your IMRF employer; ord) roll over the taxable portion of your refund to an IRA orother qualified retirement plan within 60 days of receiptof the refund. Please note: You must also add the20% withheld by IMRF to this rollover or pay the 10%additional tax on that withheld amount.• For most IMRF members, contributions made beforeJuly 1, 1984, were already taxed (“previously taxed,” seecolumn at right). When received as a refund, they are notsubject to federal income tax.• Contributions made after June 30, 1984, were not taxed andare subject to federal income tax when received as a refund.• All member contributions received as a refund are notsubject to Illinois income tax.• Each January, IMRF issues tax statements for paymentsmade the previous year. We will send your tax statement tothe address shown on this form. If you change your mailingaddress, you should notify IMRF in writing of the change.• Effective 1/1/2008, members may also elect to roll overtheir refund into a Roth IRA account. This rollover istreated as if you rolled your IMRF refund into a TraditionalIRA account and then converted the IRA to a Roth IRA.To be eligible, you must have a modified adjusted grossincome (MAGI) on your tax return of $100,000 or less. Inaddition, married taxpayers cannot file separately from theirspouse. Please note: IMRF does not determine if you areeligible for a rollover (convert) to a Roth account.Exhibit 5APage 2 of 6A rollover to a Roth IRA is taxable in the year of therollover. The amount rolled over does not maintain the taxdeferredstatus of your IMRF contributions. The amountsrolled over to a Roth IRA account will not be subject to the10% additional tax (where applicable).If you are considering a rollover to a Roth IRA account,we strongly suggest you review your choice with yourtax advisor to ensure you have the correct withholding orestimated tax payments during the year to cover your taxliability.• This distribution must be reported on your tax returneven if a portion or all of it is rolled over to anotherqualified plan or IRA.PREVIOUSLY TAXED CONTRIBUTIONS• Generally, member contributions since 1984 have been“tax-deferred” (the money used to pay those contributionshas not been subject to federal income tax). However,some members have “previously taxed” contributions (alsoknown as “after-tax contributions”—the money used to paythose contributions had already been subject to federalincome tax). Contributions made prior to 1984 or fundsused to purchase past service are often previously taxed. Ifyour IMRF account contains previously taxed contributions,they are shown separately on your IMRF MemberStatement of Account.• When you are refunded previously taxed contributions,those contributions are not taxable to you, and they arenot subject to any income tax withholding. While mostmembers choose to have these amounts refunded directlyto them, tax laws allow you to roll over your previouslytaxed contributions into an IRA or a qualified employerretirement plan.• If your IMRF member account contains previously taxedcontributions and you wish to roll over these contributionsinto an IRA or a qualified employer retirement plan, pleaserequest IMRF Form 5.10B, “Previously Taxed RolloverRequest.” Complete the form and return it to IMRF alongwith this form. Form 5.10B is available at IMRF Online(www.imrf.org) or you can call 1-800-ASK-IMRF(1-800-275-4673), Monday through Friday, from 7:30 a.m.to 5:30 p.m. to request it.IMRF Form 5.10 (Rev. 01/2013)

APPLICATION FOR SEPARATION REFUNDIMRF Form 5.10 (Rev. 01/2013)Exhibit 5APage 3 of 6PLEASE PRINTSECTION 1 — MEMBER INFORMATIONMEMBER’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBERHOME STREET (MAILING) ADDRESS CITY COUNTYSECTION 2 — CERTIFICATION____________ - ________ - ____________STATE AND ZIP (+4 if known) DATE OF BIRTH DAYTIME TELEPHONE NO. (with Area Code)NAME OF LAST IMRF EMPLOYERMY LAST POSITION UNDER IMRF WAS AS A PUBLIC SAFETY EMPLOYEE(See Special Tax Notice)NOTE: You may also submit Form 5.10 online via IMRF Member Access.Log on to www.imrf.org/myimrf to create your IMRF Member Access account today.Mary A. Member 000 00 0000123 Main Street AnywhereIllinois 60000-0000 9/3/1980 (000) 000-0000City of AnywhereLAST DAY OF EMPLOYMENT WITH YOUR IMRF EMPLOYERIn order for IMRF to process your refund, you must choose one of the following. I direct IMRF to:XNOYESFebruary 29, 2008XRoll over nothing and make the entire distribution payable to me, less the 20% withholding.*See NOTE below.Roll over entire taxable amount and make payable to the IRA, 401k, or eligible retirement plan asnamed below.Roll over___________% or $___________________ of the taxable amount(Enter either a percentage or a dollar amount. The percentage OR dollar amount indicated will berolled over to the IRA, 401k, or eligible retirement plan named below.)I certify that I no longer work, in any capacity, for the employer with whom I made these contributions AND I am not workingfor any employer in an IMRF-qualifying position. I further certify that the account named below is an individual retirementplan or an eligible employer plan, and is eligible to receive this rollover distribution. I hereby waive my right to 30 days priornotice of the tax consequences of this distribution and demand immediate payment.*NOTE: IMRF is required by federal law to withhold 20% of the taxable portion of your refund not directly rolled over to anI.R.A. or other qualified retirement plan. This withholding requirement is limited to the taxable portion of your refund. Anyportion that was previously taxed will be paid directly to you without withholding.Member Signature (write; do not print)I acknowledge if I accept this refund, I am giving up my IMRF pension (if any) as well asany IMRF disability or death benefits.XSECTION 3 — ACCOUNT INFORMATION (This section required for direct rollovers only.)Financial organization: These funds are currently in a qualified retirement plan (QRP) under section 401(a) ofthe IRC. Member will be mailed a check made payable to the financial institution named below.NAME OF FINANCIAL ORGANIZATION CHECK IS TO BE MADE PAYABLE TODEPOSIT ACCOUNT NUMBER (OPTIONAL)TELEPHONE NUMBER (include area code)ACCOUNT IS: (SELECT ONE)TRADITIONAL IRADEFERRED COMPENSATION PLAN (457 OR 403B)ROTH IRADateFebruary 29, 2008RETIREMENT PLAN (re IRC 401)OTHER ________________________________________Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax (630) 706-4289www.imrf.orgIMRF Form 5.10 (Rev. 01/2013)

YOUR ROLLOVER OPTIONSExhibit 5APage 4 of 6You are receiving this notice because all or a portion of apayment you are receiving from IMRF (the “Plan”) is eligibleto be rolled over to an IRA or an employer plan. This noticeis intended to help you decide whether to do such a rollover.Rules that apply to most payments from a plan are described inthe “General Information About Rollovers” section. Special rulesthat only apply in certain circumstances are described in the“Special Rules and Options” section.GENERAL INFORMATION ABOUT ROLLOVERSHow can a rollover affect my taxes?You will be taxed on a payment from the Plan if you do notroll it over. If you are under age 59½ and do not do a rollover,you will also have to pay a 10% additional income tax on earlydistributions (unless an exception applies).If you do a rollover to a traditional IRA or an eligibleemployer plan, you will not have to pay tax until you receivepayments later from the IRA or plan, and the 10% additionalincome tax will not apply if those payments are made after youare age 59½ (or if an exception applies).If you do a rollover to a Roth IRA, you will be taxed onthe amount rolled over (reduced by any after-tax amount).However, if you are under age 59½ at the time of the rollover,the 10% additional income tax will not apply. See the section onthe following page titled “If you roll over your payment to a RothIRA” for more details.Where may I roll over the payment?You may roll over the payment to either an IRA (anindividual retirement account or individual retirement annuity) oran employer plan [a tax-qualified plan, section 403(b) plan, orgovernmental section 457(b) plan] that will accept the rollover.The rules of the IRA or employer plan that holds the rollover willdetermine your investment options, fees, and rights to paymentof the rolled over amount in the future. Further, the amountrolled over will become subject to the tax rules that apply to theIRA or employer plan.How do I do a rollover?There are two ways to do a rollover. You can do either adirect rollover or a 60-day rollover.(1) If you do a direct rollover, the Plan will make thepayment directly to your IRA or an employer plan. Youshould contact the IRA sponsor or the administrator ofthe employer plan for information on how to do a directrollover.(2) If you do not do a direct rollover, the Plan is required towithhold 20% of the payment for federal income taxes.You may still do a rollover by making a deposit into anIRA or eligible employer plan that will accept it. You willhave 60 days after you receive the payment to makethe deposit. This means that, in order to roll over theentire payment in a 60-day rollover, you must use otherfunds to make up for the 20% withheld. If you do not rollover the entire amount of the payment, the portion notrolled over will be taxed and will be subject to the 10%additional income tax on early distributions if you areunder age 59½ (unless an exception applies).How much may I roll over?If you wish to do a rollover, you may roll over all or part ofthe amount eligible for rollover. Any payment from the Plan iseligible for rollover except:• Certain payments spread over a period of at least 10years or over your life or life expectancy (or the lives orjoint life expectancy of you and your beneficiary)• Required minimum distributions after age 70½ (or afterdeath).The Plan administrator or the payor can tell you what portion ofa payment is eligible for rollover.If I don’t do a rollover, will I have to pay the 10% additionalincome tax on early distributions?If you are under age 59½, you will have to pay the 10%additional income tax on early distributions for any paymentfrom the Plan (including amounts withheld for income tax) thatyou do not roll over, unless one of the exceptions listed belowapplies. This tax is in addition to the regular income tax on thepayment not rolled over.The 10% additional income tax does not apply to thefollowing payments from the Plan:• Payments made after you separate from service if you willbe at least age 55 in the year of separation.• Payments that start after you separate from service ifpaid at least annually in equal or close to equal amountsover your life or life expectancy (or the lives or joint lifeexpectancy of you and your beneficiary).• Payments from a governmental defined benefit pensionplan made after you separate from service if you are apublic safety employee and you are at least age 50 in theyear of separation.• Payments made due to disability.• Payments made after your death.• Payments made directly to the government to satisfy afederal tax levy.• Payments made under a qualified domestic relations order(QDRO).• Payments up to the amount of your deductible medicalexpenses.If I do roll over to an IRA, will the 10% additional income taxapply to early distributions from the IRA?If you receive a payment from an IRA when you are underage 59½, you will have to pay the 10% additional income taxon early distributions from the IRA, unless an exception applies.In general, the exceptions to the 10% additional income tax forearly distributions from an IRA are the same as the exceptionslisted above for early distributions from a plan. However, thereare a few differences for payments from an IRA, including:• There is no exception for payments after separation fromservice that are made after age 55.• The exception for qualified domestic relations orders(QRDOs) does not apply (although a special ruleapplies under which, as part of a divorce or separationIMRF Form 5.10 (Rev. 01/2013)

agreement, a tax-free transfer may be made directly to anIRA of a spouse or former spouse.• The exception for payments made at least annually inequal or close to equal amounts over a specified periodapplies without regard to whether you have had aseparation from service.• There are additional exceptions for:(1) payments for qualified higher education expenses,(2) payments up to $10,000 used in a qualified first-timehome purchase, and(3) payments after you have received unemploymentcompensation for 12 consecutive weeks (or would havebeen eligible to receive unemployment compensation butfor self-employed status).Will I owe State income taxes?This notice does not describe any State or local income taxrules (including withholding rules).SPECIAL RULES AND OPTIONSIf your payment includes after-tax contributionsAfter-tax contributions included in a payment are not taxed.If a payment is only part of your benefit, an allocable portionof your after-tax contributions is generally included in thepayment.You may roll over to an IRA a payment that includes aftertaxcontributions through either a direct rollover or a 60-dayrollover. You must keep track of the aggregate amount of theafter-tax contributions in all of your IRAs (in order to determineyour taxable income for later payments from the IRAs). If youdo a direct rollover of only a portion of the amount paid fromthe Plan and a portion is paid to you, each of the payments willinclude an allocable portion of the after-tax contributions. If youdo a 60-day rollover to an IRA of only a portion of the paymentmade to you, the after-tax contributions are treated as rolledover last. For example, assume you are receiving a completedistribution of your benefit which totals $12,000, of which$2,000 is after-tax contributions. In this case, if you roll over$10,000 to an IRA in a 60-day rollover, no amount is taxablebecause the $2,000 amount not rolled over is treated as beingafter-tax contributions.You may roll over to an employer plan all of a paymentthat includes after-tax contributions, but only through a directrollover [and only if the receiving plan separately accounts forafter-tax contributions and is not a governmental section 457(b)plan]. You can do a 60-day rollover to an employer plan of partof a payment that includes after-tax contributions, but only upto the amount of the payment that would be taxable if not rolledover.If you miss the 60-day rollover deadlineGenerally, the 60-day rollover deadline cannot be extended.However, the IRS has the limited authority to waive thedeadline under certain extraordinary circumstances, suchas when external events prevented you from completing therollover by the 60-day rollover deadline. To apply for a waiver,Exhibit 5APage 5 of 6you must file a private letter ruling request with the IRS. Privateletter ruling requests require the payment of a nonrefundableuser fee. For more information, see IRS Publication 590,“Individual Retirement Arrangements (IRAs).”If you were born on or before January 1, 1936If you were born on or before January 1, 1936 and receive alump sum distribution that you do not roll over, special rules forcalculating the amount of the tax on the payment might apply toyou. For more information, see IRS Publication 575, “Pensionand Annuity Income.”If you are an eligible retired public safety officer and yourpension payment is used to pay for health coverage orqualified long-term care insuranceIf the Plan is a governmental plan, you retired as a publicsafety officer, and your retirement was by reason of disabilityor was after normal retirement age, you can exclude from yourtaxable income plan payments paid directly as premiums to anaccident or health plan (or a qualified long-term care insurancecontract) that your employer maintains for you, your spouse,or your dependents, up to a maximum of $3,000 annually.For this purpose, a public safety officer is a law enforcementofficer, firefighter, chaplain, or member of a rescue squad orambulance crew.If you roll over your payment to a Roth IRAYou can roll over a payment from the Plan made beforeJanuary 1, 2010 to a Roth IRA only if your modified adjustedgross income is not more than $100,000 for the year thepayment is made to you and, if married, you file a joint return.These limitations do not apply to payments made to you fromthe Plan after 2009. If you wish to roll over the payment to aRoth IRA, but you are not eligible to do a rollover to a Roth IRAuntil after 2009, you can do a rollover to a traditional IRA andthen, after 2009, elect to convert the traditional IRA into a RothIRA.If you roll over the payment to a Roth IRA, a special ruleapplies under which the amount of the payment rolled over(reduced by any after-tax amounts) will be taxed. However,the 10% additional income tax on early distributions will notapply (unless you take the amount rolled over out of the RothIRA within 5 years, counting from January 1 of the year of therollover). For payments from the Plan during 2010 that arerolled over to a Roth IRA, the taxable amount can be spreadover a 2-year period starting in 2011.If you roll over the payment to a Roth IRA, later paymentsfrom the Roth IRA that are qualified distributions will notbe taxed (including earnings after the rollover). A qualifieddistribution from a Roth IRA is a payment made after you areage 59½ (or after your death or disability, or as a qualified firsttimehomebuyer distribution of up to $10,000) and after youhave had a Roth IRA for at least 5 years. In applying this 5-yearrule, you count from January 1 of the year for which your firstcontribution was made to a Roth IRA. Payments from the RothIRA that are not qualified distributions will be taxed to the extentof earnings after the rollover, including the 10% additionalincome tax on early distributions (unless an exception applies).You do not have to take required minimum distributions from aIMRF Form 5.10 (Rev. 01/2013)

Roth IRA during your lifetime.You cannot roll over a payment from the Plan to a designatedRoth account in an employer plan.For more information, see IRS Publication 590, “IndividualRetirement Arrangements (IRAs).” You should consult your taxadvisor if you are interested in rolling over your distribution to aRoth IRA.IF YOU ARE NOT A PLAN PARTICIPANTPayments made after the death of the participantIf you receive a distribution after the participant’s death thatyou do not roll over, the distribution will generally be taxed inthe same manner described elsewhere in this notice. However,the 10% additional income tax on early distributions and thespecial rules for public safety officers do not apply, and thespecial rule described under the section, “If you were born onor before January 1, 1936” applies only if the participant wasborn on or before January 1, 1936.If you are a surviving spouse. If you receive a paymentfrom the Plan as the surviving spouse of a deceasedparticipant, you have the same rollover options that theparticipant would have had, as described elsewhere in thisnotice. In addition, if you choose to do a rollover to an IRA,you may treat the IRA as your own or as an inherited IRA.An IRA you treat as your own is treated like any other IRAof yours, so that payments made to you before you are age59½ will be subject to the 10% additional income tax onearly distributions (unless an exception applies) and requiredminimum distributions from your IRA do not have to startuntil after you are age 70½.If you treat the IRA as an inherited IRA, payments from theIRA will not be subject to the 10% additional income tax onearly distributions. However, if the participant had startedtaking required minimum distributions, you will have toreceive required minimum distributions from the inheritedIRA. If the participant had not started taking requiredminimum distributions from the Plan, you will not have tostart receiving required minimum distributions from theinherited IRA until the year the participant would have beenage 70½.If you are a surviving beneficiary other than a spouse.If you receive a payment from the Plan because of theparticipant’s death and you are a designated beneficiaryother than a surviving spouse, the only rollover option youhave is to do a direct rollover to an inherited IRA. Paymentsfrom the inherited IRA will not be subject to the 10%additional income tax on early distributions. You will haveto receive required minimum distributions from the inheritedIRA.options the participant would have (for example, you may rollover the payments to your own IRA or an eligible employerplan that will accept it). Payments under the QDRO will not besubject to the 10% additional income tax on early distributions.If you are a nonresident alienIf you are a nonresident alien and you do not do a directrollover to a U.S. IRA or U.S. employer plan, instead ofwithholding 20%, the Plan is generally required to withhold 30%of the payment for federal income taxes. If the amount withheldexceeds the amount of tax you owe (as may happen if youdo a 60-day rollover), you may request an income tax refundby filing Form 1040NR and attaching your Form 1042-S. SeeForm W-8BEN for claiming that you are entitled to a reducedrate of withholding under an income tax treaty. For moreinformation, see also IRS Publication 519, “U.S. Tax Guidefor Aliens,” and IRS Publication 515, “Withholding of Tax onNonresident Aliens and Foreign Entities.”Other special rulesYou may have special rollover rights if you recently servedin the U.S. Armed Forces. For more information, see IRSPublication 3, “Armed Forces’ Tax Guide.”NOTICE PERIODGenerally, payment cannot be made from the Plan untilat least 30 days after you receive this notice. Thus, youhave at least 30 days to consider whether or not to haveyour payment rolled over. If you do not wish to wait until this30-day notice period ends before your election is processed,you may waive the notice period by making an affirmativeelection indicating whether or not you wish to make a directrollover. Your payment will then be processed in accordancewith your election as soon as practical after it is received bythe Plan administrator.FOR MORE INFORMATIONExhibit 5APage 6 of 6You may wish to consult with the Plan administrator orpayor, or a professional tax advisor, before taking a paymentfrom the Plan. Also, you can find more detailed informationon the federal tax treatment of payments from employerplans in: IRS Publication 575, “Pension and Annuity Income”;IRS Publication 590, “Individual Retirement Arrangements(IRAs)”; and IRS Publication 571, “Tax-Sheltered AnnuityPlans [403(b) Plans].” These publications are available froma local IRS office, on the web at www.irs.gov, or by calling1-800-TAX-FORM.Payments under a qualified domestic relations order.If you are the spouse or former spouse of the participantwho receives a payment from the Plan under a qualifieddomestic relations order (QDRO), you generally have the sameIMRF Form 5.10 (Rev. 01/2013)

Applying for Your IMRF PensionCongratulations on your upcoming retirement!Please use this checklist when applying for IMRF retirement benefits.Exhibit 5BPage 1 of 41. File this form one month before your retirement date.• Include required documents (copies not originals) with your application.Print your Social Security number on all documents you attach to thisform.• Married or in a civil union for at least one year: your BirthCertificate and your Marriage Certificate or Civil Union Certificate.• Divorced: your Birth Certificate and your Judgment of Dissolutionof Marriage/Civil Union (Divorce Decree) - first page and Judge’ssignature page only.• Widowed, never married, or never in a civil union: yourBirth Certificate.• If you do not have all the required documents, submit your completedapplication without them. Send any missing documents to IMRF as soonas possible.• You may mail or fax the form and materials to IMRF. Fax # (630) 706-42892. This form contains Form 5.20 and Form 1199:Form 5.20 Application for IMRF Pension and Form 1199 Applicationfor Direct Deposit. Please complete both Form 5.20 and Form 1199 andreturn both forms together at the same time.*• Be sure to sign both forms.• Direct Deposit of your monthly benefit payment is mandatory.Your payment must be directly deposited into your checking, savingsor a brokerage account.3. Next steps:• After we receive your application, you will receive an IMRFRetirement Packet, which contains:• Insights for Retiring Members booklet• IMRF Form 6.11A, “Designation of Beneficiary for Annuitants”(Return immediately.*)• IMRF Form W4-P, “Withholding Certificate for Pension or AnnuityPayments” (Return immediately.*)• Health Insurance Continuation Form (paper format only)• Self-addressed return envelope*NOTE: You can submit Forms 5.20, 1199, 6.11A and W4-P online viaMember Access. See following page for more information regardingIMRF’s Member Access.Illinois Municipal Retirement Fund2211 York Road, Suite 500, Oak Brook, Illinois 60523-2337Member Services Representatives: 1-800-ASK-IMRF (1-800-275-4673) FAX: 630-706-4289www.imrf.orgIMRF Form 5.20 (Rev. 06/2012)_DATE FORM MAILED/FAXED TO IMRFDOCUMENTS INCLUDED:(Check box if mailed/faxed with form.Fill in date next to item if mailed/faxedlater.)o Birth Certificateo Marriage Certificateo Civil Union Certificateo Judgment of Dissolution ofMarriage/Civil Union (DivorceDecree) - first page and Judge’ssignature page only.FORM 5.20/1199 COMPLETION:(Check these key boxes to ensure youhave completed the paper form fully.*)o Member information providedo Spouse/marital status informa-_tion provided, if applicableo Reciprocal service informationprovided, if applicableo Both forms signed by Membero Direct Deposit informationprovidedADDITIONAL FORMS SUBMITTED:(Check box and fill in date next to item ifform was mailed, faxed, or electronicallysubmitted via Member Access.)o IMRF Form 6.11Ao Form W4-Po Health InsuranceContinuation FormBe sure to create aMember Accessaccount so you canhave 24/7 accessto yourIMRF records!www.imrf.org/myimrf

Frequently Asked QuestionsExhibit 5BPage 2 of 4Q When will I receive my first pension payment?A For the typical member who leaves his or her IMRF employer and is immediately eligible to drawtheir pension, the effective date will be the first of the month following your last day of work. Eventhough the pension is effective on a certain date does not mean that a member will receive apayment on that date. To release your payment, we need to have a properly-completed Form 5.20(Application for IMRF Pension) from you and Form 6.41 (Notice of Termination) from youremployer stating that you are no longer an employee. Once we have these two items, it generallytakes about two weeks to direct deposit your first pension payment.Q How do I choose the Optional Plan (the plan that pays more money up front and, at age 62,is reduced)?A Typically, an Option Letter is mailed to you about six or eight weeks after you receive your finalpaycheck. The letter asks you to choose between the Standard Plan and the Optional Plan. In themeantime, you will start receiving your pension based on the Standard Plan. If you choose theOptional Plan, IMRF will issue an adjusting payment to you for the difference between theStandard and Optional Plan for the pension payments you have already received. It generallytakes approximately two weeks to process this adjusting payment.Q Is the time frame for receiving the Option Letter the same for a member retiring under theReciprocal Act (the coordination of your IMRF service with another public retirementsystem in Illinois)?A It generally takes longer to process retirements this way due to the coordination between IMRFand the Reciprocal retirement system(s).Q Since my pension payment will be direct deposited, how will I know how much money isbeing deposited into my account?A You will receive a notice for the first payment that is direct deposited. Thereafter, you will receive anotice three times a year, advising you of the amount being deposited. These notices are sent inJanuary, July (with the “13th payment,” once eligible), and in December. If at any other time duringthe year your deposit amount changes, we will send you a notice. Federal withholding or healthinsurance deductions are the most common reasons for mid-year changes to a member’s depositamount. You may also find your monthly deposit amount via your IMRF Member Access account.See below for more information.Create a Member Access account...Using your IMRF Member Access account will be a great help when completing your retirement process.You will also be able to:• Register for an IMRF Retiree Workshop• View and change your beneficiary information• Change your Direct Deposit information (1199)• Change your personal information securely• Submit forms (5.20, 6.11A and W4-P) online• Access annual 1099-R tax forms• Change your withholding information (W4-P)• Review your annual Retiree Benefit StatementLog on to www.imrf.org/myimrf to create your Member Access account today.

APPLICATION FOR IMRF PENSIONIMRF Form 5.20 (Rev. 06/2012)PLEASE PRINT OR TYPEMEMBER’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBERMEMBER’S MAILING ADDRESSCITY STATE ZIP+4 GENDERExhibit 5B Page 3 of 4You can complete and submit this formelectronically via Member Access. You can printpaper forms from www.imrf.org.Richard A. Roe 000 00 0000123 Spruce Street_______________ - ________ - _______________Anywhere IL 60000-0000 XMALEFEMALEMEMBER’S BIRTH DATE (MM/DD/YY) DAYTIME TELEPHONE NO. LAST DAY OF WORK (MM/DD/YY)9/3/1950 (000) 000 - 0000 6/1/2012MARITAL STATUSNEVER MARRIED MARRIED CIVIL UNIONDIVORCEDGENDER OF SPOUSESPOUSE’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SPOUSE’S SOCIAL SECURITY NUMBERDATE OF MARRIAGE/CIVIL UNION (MM/DD/YY)XWIDOWED_______________ - ________ - _______________SPOUSE’S DATE OF BIRTH (MM/DD/YY)SERVICE WITH OTHER ILLINOIS PUBLIC RETIREMENT SYSTEMS (SUCH AS STATE EMPLOYEES’, STATE TEACHERS’, ETC.)IF YOU ARE ALREADY RECEIVING RETIREMENT BENEFITS FROM THE SYSTEM, PLEASE DO NOT LIST IT HERE.DATESNAME OF SYSTEM FROM TOMALEFEMALEJane M. Smith 000 00 00006/14/1982 8/1/1953State Employee’s Retirement System (SERS) 6/2/1984 6/30/1986XIF YOU WILL RETIRE UNDER IMRF EARLY RETIREMENT INCENTIVE, SUBMIT FORM 5.21, “NOTICE TO RETIRE UNDER ERI.”INDICATE THE YEARS / MONTHS YOU WISH TO PURCHASE:__________ YEARS _________ MONTHSI CERTIFY THAT THE ABOVE INFORMATION IS CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.XMEMBER’S SIGNATURE (WRITE; DO NOT PRINT OR TYPE)May 1, 2012Completed form may be mailed to: Illinois Municipal Retirement Fund2211 York Road, Suite 500, Oak Brook, Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) FAX: 630-706-4289www.imrf.orgIMRF Form 5.20 (Rev. 06/2012)DATE

APPLICATION FOR DIRECT DEPOSITIMRF Form 1199 (07/07) - Included with Form 5.20This form should be completed by the Benefit Recipient(IMRF Member or the person receiving the IMRF benefit payment).Exhibit 5B Page 4 of 4You can complete and submit this formelectronically via Member Access. You can printpaper forms from www.imrf.org.MEMBER/ANNUITANT’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBERRichard A. Roe 000 00 0000ACCOUNT INFORMATIONImportant: The name of the person who will receive the IMRF benefit payments must be on this account. Pleaseprovide the information requested below. If you are unsure of any of the requested information, contact the financial institutionwhere you have your account. (See the bottom of this page for more information.)NAME OF FINANCIAL INSTITUTIONBRANCH TELEPHONE NUMBERFirst Bank of Anywhere (000) 000 - 0000BRANCH ADDRESS (NUMBER, STREET) CITY STATE ZIPACCOUNT NUMBERFINANCIAL INSTITUTION ROUTING NUMBER (SEE BELOW)_______________ - ________ - _______________123 Main Street Anywhere IL 6000011223344551 2 3 4 5 6 7 8 9 XTYPE OF ACCOUNTCHECKINGSAVINGSI authorize and request the Illinois Municipal Retirement Fund to direct IMRF recurring payments for crediting to my accountat the financial organization designated above. This authorization is not an assignment of my right to receive payment andrevokes all prior payment direction notifications applicable to these payments. I understand that the financial organizationdesignated reserves the right to cancel this agreement by notice to me; however, this authorization will remain in effect withIMRF until cancelled by notice from me or by my death. Further, I understand and agree that IMRF will stop direct deposit ifI fail to keep IMRF informed of my current address. I also permit the release by the bank or financial institution of my currentaddress to IMRF. I understand that a new form 1199 is required if I change my financial institution, my account number ormy name.X_________________________________________________________Signature of Benefit Recipient, Power of Attorney*, or Guardian**Attach court documents if not already submitted______________________________May 1, 2012DateFINANCIAL INSTITUTION ROUTING NUMBERA routing number is a nine-digit number,and is a completely separate number fromyour account number.If you have a savings or brokerageaccount, you should call the financialinstitution where you have your account toobtain the correct routing number.If you have a checking account, see thesample at right for how to get your accountnumber and the correct routing numberfrom your blank checks. (Note: If you havetemporary checks, call the financialinstitution where you have your account toobtain the correct routing number.)Completed form may be mailed to: Illinois Municipal Retirement Fund2211 York Road, Suite 500, Oak Brook, Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) FAX: 630-706-4289www.imrf.orgForm 1199 (07/07) -Included with Form 5.20

INSTRUCTIONSExhibit 5CNOTICE OF INTENT TO RETIRE UNDER EMPLOYER’SIMRF EARLY RETIREMENT INCENTIVEIMRF Form 5.21 (Rev. 1/2013)• IMRF employers can adopt by resolution the IMRF Early Retirement Incentive (ERI) program.• If your employer has adopted the IMRF ERI and you intend to retire under the ERI, you may file this form at anytime, but no later than when you file your application for retirement (IMRF Form 5.20).• This Notice of Intent does not guarantee your eligibility for the ERI nor for an IMRF pension.• Your last date of employment will be determined by your employer. However, you may request to retire before June30 so you will be eligible to receive the following year’s Supplemental Benefit Payment (“13th payment”).• To claim an IMRF pension, you must file IMRF Form 5.20, “Application for Retirement Annuity.” Form 5.20 may alsobe submitted online via IMRF Member Access. Log on to www.imrf.org/myimrf to create your IMRF MemberAccess account today.• To estimate your cost for the ERI, refer to the IMRF Early Retirement Incentive Booklet.• If you do not receive acknowledgement of your Notice of Intent within three weeks, CONTACT IMRF.PLEASE PRINT -- USE BLACK INKMember’s First Name Middle Initial Last Jr., Sr., II, etc. Social Security Number__ __ __ __ __ __ __ __ __Richard A. RoeStreet (mailing) address123 Spruce Street AnywhereState and Zip + 4DECLARATIONI elect to participate in the IMRF early retirement incentive program.ACKNOWLEDGEMENTSI have read, understand, and have been allowed to inquire regarding the following conditions of this early retirementincentive:• I must contribute my usual member contributions (Regular 4.50%, SLEP 7.50%, ECO 7.50%) for each yearand month of IMRF service credit I wish to purchase. (Cost is reduced by 0.75% if member has no eligiblespouse.)• I will pay a percentage of the highest 12 consecutive months used in calculating my final rate of earnings.• My IMRF service credit and age will be increased by the years and months I purchase.• If I return to work for any IMRF employer in any position (including as an independent contractor),my IMRF pension will be suspended (from the date of employment), and I will repay IMRF any enhancedpension I received from this early retirement incentive. Exception: you can hold an elected position andcontinue to receive your ERI pension if you choose to not participate in IMRF and your pension is not basedon any service earned in that position during any term of office.• To claim an IMRF pension, I must submit IMRF Form 5.20, “Application for Retirement Annuity,” within oneyear of the effective date of my employer’s IMRF ERI program. I understand that if I retire after one yearfrom the effective date of my employer’s IMRF ERI program, I will be unable to retire under the ERI.CityDate of Birth (MM/DD/YYYY)IL 60000-1234 09/03/1950_______________________________________________Signature of Member____________________________________01/11/2013Date (MM/DD/YYYY)IMRF Form 5.21 (Rev. 1/2013)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.org

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APPLICATION FOR DEATH BENEFITIMRF Form 5.30 (Rev. 07/11) PLEASE PRINT OR TYPEExhibit 5DBENEFITSPLEASE PRINT MEMBER’S SOCIAL SECURITY NUMBER ON ALL DOCUMENTS; DO NOT ATTACH DOCUMENTS IF PREVIOUSLY SUBMITTED TO IMRFSECTION 1 — DECEASED INFORMATIONDECEASED’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. SOCIAL SECURITY NUMBERJohn S. Roe 0 0 0 0 0 0 0 0 0________________ - ________ - ________________DATE OF BIRTH (MM/DD/YY)DATE OF DEATH (ATTACH COPY OF DEATH CERTIFICATE*)06/02/1949 06/25/2006SECTION 2 — APPLICANT INFORMATIONAPPLICANT’S FIRST NAME MIDDLE INITIAL LAST JR., SR., II, ETC. GENDERJane M. Roe X MALE FEMALEHOME STREET (MAILING) ADDRESS CITY STATE AND ZIP (+4 IF KNOWN)123 Poplar Street Anywhere IL 60000HOME TELEPHONE NO.DAYTIME TELEPHONE NO. (IF DIFFERENT FROM HOME NO.)(0 0 0) 0 0 0 - 0 0 0 0 (1 1 1) 1 1 1 - 1 1 1 1RELATIONSHIP OF APPLICANT TO DECEASEDSOCIAL SECURITY NO. OR FEDERAL EMPLOYER ID NO. (FEIN) FOR TAX PURPOSESWife 0 0 0 - 1 1 - 2 2 2 2APPLICANT’S DATE OF BIRTH (MM/DD/YY)DATE OF MARRIAGE/CIVIL UNION IF APPLICANT IS SURVIVING SPOUSE OF DECEASED04/20/1951 09/10/1970SECTION 3 — WORKERS’ COMPENSATION OR OCCUPATIONAL DISEASE BENEFITSNAME OF INSURER(A) Was the deceased receiving Workers’ Compensation or Occupational Disease Benefits? YES NO(B) Have you applied, or will you apply, for Workers’ Compensation or Occupational YESDisease survivor benefits? NOXXINSURER’S MAILING ADDRESSCITYSTATE AND ZIP (+4 IF KNOWN)TELEPHONE NUMBER WITH AREA CODE(C)If you received, or are receiving, Worker’s Compensation or OccupationalDisease survivor benefits, give benefit amount below:$ _________________ per week $ _________________ lump sumSECTION 4 — OTHER SERVICE OF CREDITService of deceased with other Illinois public retirement systems (such as State Employees, State Teachers, State Universities, Judges, CookCounty, Chicago Municipal, etc).NAME OF SYSTEMDATES OF SERVICEI certify that the above information is correct to the best of my knowledge and belief.APPLICANT’S SIGNATURE (PLEASE WRITE - DO NOT PRINT!)DATEXIMRF Form 5.30 (Rev. 07/11)June 30, 2006Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) www.imrf.org*PLEASE PRINT MEMBER’S SOCIAL SECURITY NUMBER ON ALL DOCUMENTS; DO NOT ATTACH DOCUMENTS IF PREVIOUSLY SUBMITTED TO IMRF

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Application for IMRF Disability BenefitsIMRF Form 5.40 (Rev. 6/2012)Please use this checklist when applying for IMRF disability benefits.Exhibit 5EPage 1 of 3As soon as you stop working and you feel you will be disabled more than 30 days. . .1. File an Application for Disability Benefits (IMRF Form 5.40) with IMRF.We recommend you submit your application directly to IMRF.• You can also fax your application to IMRF at 630-706-4289.• File the form even if you filed a worker’s compensation claim.• Print your Social Security number on all documents you enclose withthe form.2. Call your employer and ask them to file an Employer’s Statement withIMRF (IMRF Form 5.41). Your employer should have the form. If not, theycan download the form from www.imrf.org.• Write down the name of the person you spoke with and the date.• Ask when the employer thinks the form will be submitted to IMRF.3. Provide your physician(s) (the first physician who examined you for thisdisabling condition) with a Physician’s Statement of Disability Claim(IMRF Form 5.42) and have your physician(s) submit the documentationto IMRF, with copies of your medical records from the date ofdisability.• Write down the name of the person you spoke with and the date.• Ask when the physician(s) will complete the form and submit it to IMRF.MAILEDFAXED____________________________________________DATE YOU FILED____________________________________________PERSON YOU SPOKE WITH____________________________________________DATE____________________________________________DATE EMPLOYER WILL SUBMIT____________________________________________PERSON YOU SPOKE WITH____________________________________________DATE____________________________________________DATE PHYSICIAN WILL SUBMIT4. IMRF will acknowledge receipt of your claim in writing. Call IMRF at1-800-ASK-IMRF (1-800-275-4673) if you have not heard anything within10 business days after the date of your acknowledgement letter. IMRFwill request additional medical information, if needed, directly from yourmedical providers (you will receive a copy of any such request).5. When IMRF receives any of the above three forms, we will mail you anacknowledgment letter and an IMRF Disability Benefits booklet. We willalso request any missing forms.See the reverse side of this checklist for instructions on how to complete the attached form.PLEASE NOTE:• You should contact IMRF if you are considering RESIGNING from your current position. Resigning yourposition may impact your eligibility for IMRF disability benefits.• Please be advised that IMRF disability payments are paid at the beginning of the month for the previous month.IMRF Form 5.40 (Rev. 6/2012)Illinois Municipal Retirement Fund2211 York Road, Suite 500, Oak Brook Illinois 60523-2337Member Services Representatives PH 1-800-ASK-IMRF (1-800-275-4673) • FX 630-706-4289 • www.imrf.org

Who does what in this process?• You need to print your Social Security number on alldocuments you send to IMRF (e.g., your birth certificate).• Your employer needs to file an Employer’s Certificate ofDisability (IMRF Form 5.41).• Your physician(s) needs to file a Physician’s Statement ofDisability (IMRF Form 5.42). You must provide the physician(s)with the form.• If your doctor releases you to return to work on a part-timebasis, you should refer to “Trial Work Period” in the IMRFDisability Benefits booklet.Exhibit 5EPage 2 of 3Instructions for completing Questions 1 - 11Q 1A, 1B, 1C Enter the requested information. If you do notanswer question 1B, you will delay processing of yourclaim. If appropriate, answer question 1C.Q 2Enter the last date you worked. Do not file this claimif you are still working. If you will be disabled due to aplanned event (e.g., elective surgery, pregnancy), submitthis form after your last day at work. If you do notanswer question 2, you will delay processing of your claim.Q 3A, 3B, 3C If appropriate, enter the requested information.Q 4Q 5Answer either yes or no.Answer yes or no and, if appropriate, enter the requestedinformation.Q 6Q 7Q 8Answer either yes or no. And, if appropriate, indicate statusof claim—check all that apply.Answer either yes or no.Answer yes or no and, if appropriate, enter the requestedinformation.Q 9, 9A Answer yes or no and, if appropriate, enter the requestedinformation.Q 10 Enter the name, address, and phone number of eachdoctor you saw and the date of each visit.Q 11 Enter the name, address, phone number, and dates oftreatments for each hospital in which you were treated.Question 12 - W-4P Federal Income Tax Withholding Certificate informationThis question serves as a substitute IRS Form W-4P.IMRF disability benefits are subject to federal income tax.IMRF must withhold income tax unless you elect on line 12a notto have tax withheld.If you elect to have income tax withheld, complete line 12b.If you complete line 12b and also want an additional amountwithheld from your monthly disability benefit payments, enter thisamount on line 12c.CAUTION: Remember that there are penalties for not payingenough tax during the year. For more information, please seeIRS Publication 505, “Tax Withholding and Estimated Tax,”available from most IRS offices or from www.irs.gov.• You may use IRS Form W-4P in lieu of Question 12.Form W-4P is available online at www.irs.gov and at mostIRS offices.PurposeUnless you elect otherwise, federal income tax will bewithheld from your disability benefit. The law requires that unlessyou tell IMRF otherwise, tax will be withheld on IMRF monthlypayments as if you are married and claiming three withholdingallowances. To view the tax amount to be withheld under currentregulations, read “Tax Letter #13,” at www.imrf.org under“Publications.”IMRF Form 5.40 (Rev. 6/2012)You can use this certificate (Question 12) to instruct IMRF todo any of the following:• To withhold no tax from your disability payments.• To withhold taxes based on the number of allowances andmarital status you indicate.• To withhold an additional amount you specify from eachpayment.Your tax withholding instruction stays in effect until youchange or revoke it. IMRF must notify you each year of yourright to elect to have no tax withheld or to revoke your election.Statement of income tax withheldfrom your disability paymentsBy January 31 of next year, you will receive a statement(1099-R) from IMRF showing the total amount of your disabilitypayments and the total income tax withheld during the year.Any IMRF disability payments you receive will be subject tofederal income tax, but not to Illinois state income tax. If youare a resident of another state, please check with your state’sDepartment of Revenue to learn whether you will pay that state’sincome tax on IMRF disability benefits.If you are totally and permanently disabled, you may beeligible for a tax credit. For additional information about the taxcredit, you can contact a tax advisor or call 1-800-TAX-FORM(1-800-829-3676) and request IRS publication 524 “Creditfor the Elderly or the Disabled;” this IRS publication may bedownloaded at www.irs.gov.

MEMBER’S APPLICATION FOR DISABILITY BENEFITSIMRF Form 5.40 (Rev. 6/2012) Please Print or Type – Use Black InkExhibit 5EPage 3 of 3Member’s Last Name First Middle Initial Social Security NumberRowe James J. ________________ 000 - ________ 00 - ________________0000Street (Mailing) AddressCity, State and ZIP123 Green Street Anywhere, IL 60000Telephone: Cell Phone: Email:( 000 ) 000 - 0000 ( 000 ) 000 - 0000 jrowe@anywhere.comFILING GUIDELINES• Do not file this claim if you are still working.• If you will be disabled due to a planned event (e.g., elective surgery,pregnancy), submit this form after your last day at work.• You should file this application if you expect to be disabled for morethan 30 days.• File this form even if you plan to file a workers’ compensation and/oroccupational disease claim.1A. Nature of illness or injurybroken hip_________________________________1B. Date of first treatment for this disability (i.e.,date of first doctor visit)March 1, 2006_________________________________1C. If claiming disability benefits because ofpregnancyExpected delivery date _______________Actual delivery date _________________2. Date you last workedMarch 1, 2006_________________________________3A. Was this injury caused by an accident?NoYes3B. If yes, how and where accident happened:__________________________________________________________________First & Main Streets3C. Did you visit an emergency roomor Urgent Care facility?No Yes XIf yes, attach copy of Discharge Summary.4. Within the past six months, have you beenoff work for the same injury or illness?NoYesATTACHMENT GUIDELINES• A copy of your birth certificate should be filed with this application.If that document is delayed, file this application without it.• Please print your Social Security number on all documents youenclose with this form.IF YOU RETURN TO WORK ON A PART-TIME BASIS• Refer to “Trial Work Period” in the IMRF Disability Benefits booklet.5. Has your disability ended?No XYes Date_____________________6. Are you applying for workers’ compen sationand/or occupational disease benefits?No X YesStatus of claim (check all that apply)ApprovedDeniedPendingAppealed7. Have you participated in the IMRF ElectedCounty Officials Plan (ECO)?8. Are you currently employed by an employer outside IMRF?9. Do you own a business? No YesNo X Yes _ If yes, give name, address and telephone of employer: If yes, do you work for the business? No Yes____________________________________________________________________________________________________________If yes, give name, address and telephone of business:________________________________________________________________________________________________________________________________________________________________________________________________________________________9A. Do you perform any work or other activities for which you receive payment? No X Yes If yes, please explain:_____________________________________________________________________________________________________________________10. Name and address of all physicians consulted and date of consultation(Attach additional sheet if needed. Each physician needs to complete IMRF Form 5.42, Physician’s Statement)Name of doctor Phone Address City/State/Zip Date of Consultation____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________11. Name and address of all hospitals where you were treated, including facility from question 3C (Attach additional sheet if needed.)Name of hospital Phone Address City/State/Zip Date of Consultation____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________12. Form W-4P Federal Income Tax Withholding Certificate (substitute form)—Complete the following applicable lines:12a. I elect to have no income tax withheld from my disability payments. (Do not complete lines 12b or 12c.).....................................................12b. I want my withholding from each periodic disability payment to be calculated using the number of allowancesand marital status shown. (You may also designate an amount on line 12c.)............................................................................. ____________Single Married Married, but withheld at higher single rate.(number of allowances)12c. I want the following additional amount withheld from each periodic disability payment...............................................................$___________To all employers, insurance companies, workers’ compensation carriers and all other agencies:I authorize the Illinois Municipal Retirement Fund, or its representatives, to obtain or view a copy of all employment records, and/or workers’compensation records. A photostatic copy of this authorization shall be considered as effective and valid as the original. Do not completeprior to your last day of work.Signature XDate March 9, 2006Completed form may be mailed to: Illinois Municipal Retirement Fund 2211 York Road, Suite 500, Oak Brook Illinois 60523-2337Member Services Representatives PH 1-800-ASK-IMRF (1-800-275-4673) • FX 630-706-4289 • www.imrf.orgIMRF Form 5.40 (Rev. 6/2012)motorcyle accidentXJames Medic 630-123-4567 8415 Main Street Anywhere, IL 60000 March 2, 2006Anwhere Medical Ctr. 630-000-1234 8400 Main Street Anywhere, IL 60000 March 1, 2006XNoXXYesX

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EMPLOYER STATEMENT—DISABILITY CLAIMIMRF Form 5.41 (Rev. 02/2013)Exhibit 5FPage 1 of 2Instructions for Employer:By furnishing this information, you make NO representation regarding the validity of themember’s claim for disability benefits.1. Complete this form:a. As soon as the member has stopped working and is expected to remain disabled for thirty(30) days or more.b. Whether the disabling condition is work-related or not.2. "Last date the member actually worked" refers to the last day the member was physically present athis or her job. This does not include sick or vacation time.3. "Last date the member was or will be paid" refers to the last day for which the member will receivewages (or compensation), including sick and vacation time.4. The Authorized Agent’s signature is required for all claims.5. Print the member’s Social Security Number (or IMRF Member ID, if known) on all documentsyou enclose with this form.6. Do not return this Instruction sheet; return the form only.Disability benefit payments can be reduced or terminated if the member:Receives wages (or compensation) in any month he or she is disabled.Resigns. Please refer to the IMRF Authorized Agent Manual, Section 5.40D(5), “Resignations ofDisabled IMRF Members.” If the member resigns, forward a copy of the resignation letter and supporting documents.Include meeting minutes accepting the resignation.NOTE: Please provide complete and accurate information.Incomplete or inaccurate information may delay claims processing.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form 5.41 Instructions (Rev. 02/2013)

Please provide complete and accurate information. Incomplete or inaccurate information may delay claims processing.EMPLOYER NAMEEMPLOYER IMRF ID NUMBERMEMBER’S NAMEEMPLOYER STATEMENT—DISABILITY CLAIMIMRF Form 5.41 (Rev. 02/2013)City of Anywhere 0 0 0 0 0DATE OF BIRTH (MM/DD/YYYY)Last date member actually worked (MM/DD/YYYY)(Not including Sick or Vacation days.)SOCIAL SECURITY NUMBER (OR IMRF MEMBER ID, IF KNOWN)James J. Rowe 0 0 0 - 0 0 - 0 0 0 002/23/1962 CustodianOCCUPATION (ATTACH COPY OF JOB DESCRIPTION)03/02/2009 04/15/2009Within the past 6 months, has the member been off work for the same injury or illness? .............. NoWas a claim made for workers' compensation or occupational disease benefits? .................... No YesIf a claim has been made, what is the status of the claim: Approved Denied Pending AppealedIf the claim was approved, what is the weekly benefit amount? $ ___________ per week. Benefits start date: ________________(MM/DD/YYYY)If workers’ compensation or occupational disease benefits have ceased, provide termination date of benefits: ________________(MM/DD/YYYY)Name of workers’ compensation carrierDaytime Telephone Number (with Area Code)( )AddressCity, State and ZIP YesTO BE COMPLETED FOR MEMBERS WITH LESS THAN FIVE YEARS OF IMRF SERVICE CREDITDid the member undergo a pre-employment medical examination? ............................................ No Yes03/02/2009 04/15/2009(If yes, attach a copy of doctor's report to this form and print the member’s Social Security number or IMRF Member ID, if known on the report)Is the member an Elected Official? ................................................................................................ No YesIf yes, does the member participate in the ECO Plan ................................................................ No Yes(If yes, complete “To be completed for ECO Members Only” below)TO BE COMPLETED FOR ECO MEMBERS ONLYPlease enter the dates for the ECO member’s term of office ..........................If the member is not currently in office, provide dates for LAST elected county office held FROM (MM/DD/YYYY) TO (MM/DD/YYYY)Please enter the member’s final annual salary earned as a member of the ECO Plan . . . . . . . . . . .$ __________________________Please enter the member’s annual stipend(s) as a member of the ECO Plan . . . . . . . . . . . . . . . . .$ __________________________Is the member a seasonal employee ............................................................................................ NoIf yes, did the member elect to be paid over 12 months? .......................................................... NoPlease Print (Use Black Ink)Last date member was/will be paid wages or compensation (MM/DD/YYYY)(Including Vacation Pay, Sick Pay, etc.) NOT the date of the member's paycheck. Yes YesExhibit 5FPage 2 of 2Has the member returned to work? .............................................................................................. No YesIf yes, please indicate the date (MM/DD/YYYY) ________________________________ and attach the Physician’s Release.If no, give reason: __________________________________________________________________________________________In rehabilitation.Has the member been terminated? ................................................................................................ No YesIf yes, please indicate the date (MM/DD/YYYY) ________________________________If yes, give reason: _________________________________________________________________________________________XXXXXXXAuthorized Agent’s Signature (Required for all claims)Daytime Telephone Number. (with Area Code)( )Date (MM/DD/YYYY)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form 5.41 (Rev. 02/2013)Email0 0 0 0 0 0 - 0 0 0 0 aagent@anywhere.com05/01/2013

PHYSICIAN’S STATEMENT – DISABILITY CLAIMIMRF Form 5.42 (Rev. 05/11)Please print or type (use Black Ink)Do NOT submit this form if the patient is still able to work.Office visit notes/medical records must be attached to completed form.Patient’s Last Name First Middle InitialStreet (Mailing) AddressBirth DateCity, State and ZIPSocial Security NumberRowe James J. 0 0 0 0 0 0 0 0 0Phone Number123 Oak Street Anywhere, IL 60000-1234 ( 0 0 0 ) 1 1 1 - 0 0 2 2June 1, 1962Maintenance ManagerMANDATORY INFORMATIONThis section in the red box MUST be completed fully. If this information is not provided the form will not be processed.Diagnosis and concurrent conditions.ICD 9 Code(s)Report of Treatments or Services. (Failure to attach Office Notes will delay processing of this claim.)DateXXXXX00000-0000-0Place (give name and address ofhospital) - also list office visitsPatient’s/Employee’s OccupationDescription of Surgical orMedical Services RenderedExhibit 5GMarch 2, 2006Anywhere Medical Center123 Linden StreetAnywhere, IL 60000Open reduction and internalpixitro of transverse fractureDate of next evaluation:Patient was continuously disabled (unable to work) NOTE: Please be advised that this form is INVALID without a “From” Date belowFROM March 2, 2006 THROUGH Present dateIs condition due to: Injury or sickness arising out of patient’s employment? Yes NoIs disability due to an accident? X Yes No If yes, date of accident: March 1, 2006Did you recommend this person stop working?Date symptoms first treatedMarch 2, 2006XYes No If yes, indicate date:Describe any complications:XMarch 2, 2006Patient ever had same or similar condition?YesXNoIf yes, indicate date(s) and describe:Is patient now able to return to work in full duty capacity or with work restrictions?List any restrictions/limitations:Patient is unable to walk without crutches.If still disabled, what is principal cause of disability?XYes, Full Duty Yes, w/Restrictions NoApril 25, 2006If yes, indicate return date ___________________Physician’s SignaturePhysician’s NameDr. Joe MedicStreet (Mailing) AddressIMRF Form 5.42 (Rev. 05/11)MANDATORY/VALID SIGNATURE, by licensed, practicing physician only.(NOTE: Form will not be processed without Mandatory/Valid signature.)Degree/SpecialtyM.D.City, State and ZIP123 Pine Street Anywhere, IL 60000Illinois Municipal Retirement FundSuite 500, 2211 York Road, Oak Brook, Illinois 60523-2337Member Services Representatives PH: 1-800/ASK-IMRF (1-800-275-4673) FX: (630) 706-4289DateTelephone Number ( )Fax Number ( )Email Address:March 5, 20060 0 0 0 0 0 - 0 0 0 00 0 0 0 0 0 - 0 0 0 0jmedic@anywhere.comwww.imrf.org

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EMPLOYER’S NOTICE OF TERMINATION OF DISABILITY ORTRIAL WORK/LIGHT DUTY PERIODExhibit 5HIMRF Form 5.45 (Rev. 05/2013)NOTE: You may also submit Form 5.45 online via IMRF Employer Access.MEMBER’S LAST NAME FIRST NAME MIDDLE INITIAL (JR.SR.II,ETC) SOCIAL SECURITY NUMBEREMPLOYER NAMEThis form to be submitted promptly when a member returns to work or begins a trial work/light duty period.Rowe James J. 0 0 0 0 0 0 0 0 0City of Anywhere 0 0 0 0 0SECTION 1 - PHYSICIAN’S RELEASE_______________ - ________ - ________________EMPLOYER IMRF I.D. NUMBERA physician, Dr. _________________________________________________, certified that the member was able to return to workPHYSICIAN’S NAME6/26/2013Joe Medicon ____________________________. Copy of the Physician’s return to work release form MUST be attached to form.(MM/DD/YYYY)IMRF Member returned to work to (check one):XFULL DUTY (With no restrictions and normal working hours.Do NOT fill out Section 2. Proceed to Section 3.)TRIAL WORK/LIGHT DUTY Period/OTHER (Section 2 MUST be filled out.)SECTION 2 - RETURN TO WORK INFORMATION (Please select ONE option below and provide information as needed.)TRIAL WORK PERIOD: Member returned to work on a trial basis; the member is working a reduced or modifiedschedule in terms of work hours or days per week. Provide trial work period start date below.Member started Trial Work Period on ____________________________.(MM/DD/YYYY)LIGHT DUTY PERIOD: Member returned to work on a light duty basis; the member is working normal/full workinghours, but has medical restrictions.Member started Light Duty Period on ____________________________.(MM/DD/YYYY)MEMBER NO LONGER EMPLOYED/NO RETURN TO WORK: Member no longer working for the IMRF employer named above.Member started working for another employer on: _____________________________________(MM/DD/YYYY)OTHER: Please describe below the return-to-work situation for the member, if it does not fit into one of the options listed above.______________________________________________________________________________________________________SLEP MEMBER: Sheriffs’ Law Enforcement Member is returning to work in a (check one):_____ SLEP Position_____ NON-SLEP PositionSECTION 3 - AUTHORIZED AGENT’S CERTIFICATIONAUTHORIZED AGENT’S NAME (Please print.)Alice AgentDAYTIME TELEPHONE NUMBER (with Area Code)EMAIL ADDRESSSIGNATURE OF AUTHORIZED AGENTXIMRF Form 5.45 (Rev. 05/2013)TITLEBusiness ManagerFAX NUMBER (with Area Code)(0 0 0) 0 0 0 - 0 0 0 0 (0 0 0) 1 1 1 - 2 2 2 2aagent@cityofanywhere.comDATE (MM/DD/YYYY)06/26/2013NOTE: Provide complete and accurate information. Incomplete or inaccurate information may delay claims processing.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.org

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DISABILITY PAYMENT AGREEMENTSExhibit 5IPage 1 of 3Details are provided on the actual Agreement, Page 2.• Your IMRF disability payment was reduced because you have a pending SocialSecurity, workers’ compensation and/or occupational disease claim.• You have asked IMRF to increase your disability benefit to the full monthlydisability benefit amount. You will receive the full monthly disability benefit for aspecific number of months. At that time, your benefit will be reduced again.• Continued payment of your full IMRF monthly disability benefit is not aloan. It is a prepayment of future benefits.• When you receive your first payment for Social Security, workers’compensation and/or occupational disease benefit(s), you must repay IMRF forprepayment of future benefits.• IMRF will withhold payment of any benefits (future disability, death,retirement, refund, etc.) up to the amount of any prepayment you have notrepaid to IMRF.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form 5.48 (Rev. 02/2013) Page 1

DISABILITY PAYMENT AGREEMENTIMRF Form 5.48 (Rev. 02/2013)Income Tax Information on Reverse SideExhibit 5IPage 2 of 3MEMBER’S LAST NAME FIRST MIDDLE INITIAL MEMBER IDRowe James J.1. IMRF FULL MONTHLY 2. REDUCTION DATE 3. REDUCTION AMOUNT 4. REDUCTION TYPE 5. IMRF FULL MONTHLYDISABILITY BENEFIT (DATE FULL BENEFIT (AMOUNT FULL BENEFIT DISABILITY BENEFIT$600.00WILL BE REDUCED) WILL BE REDUCED BY) WILL BE PAID UNTIL5/01/2013 $590.00 Social Security 5/31/2015If you are awarded Social Security disability and/or workers’ compensation or occupational disease benefits, thisPrepayment Agreement must be corrected before we can issue future checks.This Prepayment Agreement is entered into between IMRF and the member named above.You (the member) have been awarded disability benefits by IMRF in the amount indicated in Box 1 above.If you receive Social Security Administration and/or workers’ compensation or occupational disease benefits, IMRF reducesits disability benefit. IMRF has estimated that, if awarded, your Social Security, workers’ compensation and/or occupationaldisease benefit(s) would equal the monthly amount indicated in Box 3 above.You have filed a claim for Social Security Administration and/or workers’ compensation or occupational disease benefits(as indicated in Box 4), but no final determination on that claim has been made. You have asked IMRF not to reduce itsdisability benefit payments until a determination is made on your claim for Social Security Administration and/or workers’compensation or occupational disease benefits.It is agreed by IMRF and you (the member):A. IMRF will pay you the full monthly disability benefit shown in Box 1 above. This payment consists of IMRF’s full monthlydisability benefit (after any reduction for Social Security disability or worker’s compensation) plus an amount considered a“prepayment” of future IMRF benefits. IMRF agrees pay the full monthly disability benefit until the earliest of the following:a. You are no longer disabled or no longer entitled to IMRF disability benefits,b. A final determination is made on your Social Security, workers’ compensation and/or occupational diseasebenefit(s) claim, orc. The date indicated in Box 5 above (the date IMRF benefit payments equal your member contributions, less 20% federaltaxes, on deposit). On that date IMRF must again reduce your disability benefit payment even if a final determinationhas not been made on your Social Security, workers’ compensation and/or occupational disease benefit(s) claim.B. You agree that if you are awarded disability benefits under your Social Security, workers’ compensation and/oroccupational disease benefit(s) claim, when you receive your first payment you will send documents notifying IMRF andreturn to IMRF the amount of the prepayment of future benefits.C. You understand and agree that IMRF will withhold payment of any benefits (future disability, death, retirement, refund,etc.) payable to you or to your beneficiaries up to the amount of any prepayment you have not repaid to IMRF.D. This agreement will become effective once you sign this form and it is received at IMRF’s office. IMRF’s payment ofdisability benefits as provided in this agreement will establish its official acceptance of this agreement.E. If you return to work on a trial basis, the monthly disability benefit from IMRF will be reduced dollar for dollar by theamount of earnings you receive during the trial work period.Member’s SignatureXDate (MM/DD/YYYY)08/15/2013Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289IMRF Form 5.48 (Rev. 02/2013)www.imrf.orgPage 2

InstructionsExhibit 5IPage 3 of 31. Once IMRF receives this form and has evidence that you (the member) have applied for Social Security Administrationand/or workers’ compensation or occupational disease benefits (or that your claim is under consideration orappeal), IMRF will reinstate your IMRF disability benefit to the amount indicated in Box 1. Payment of the reinstated(unreduced) amount establishes IMRF’s official acceptance of this agreement.2. If you have a claim pending for Social Security and/or workers’ compensation or occupational disease benefitsbenefits, IMRF will pay you unreduced disability benefits until Social Security makes a decision regarding your claimOR until the date indicated in Box 5, which is limited to the earliest of:a. The date your member contributions with IMRF have been exhausted (the benefit payments you received equalyour member contributions, less 20% for federal taxes) orb. The date you are no longer disabled and entitled to disability benefits, orc. The month you reach your age for Social Security full retirement benefits, pending a determination on your claimfor Social Security disability benefits.3. If you are awarded the Social Security Administration and/or workers’ compensation or occupational disease disabilitybenefits as indicated in Box 6, this may result in overpayment/prepayment to you by IMRF. The prepayment must becorrected before we can issue future checks.If you fail to pay IMRF for the benefit prepayment, IMRF will withhold the amount from future benefit payments toyou or to your beneficiary.Continued payment of your full IMRF monthly disability benefit is not a loan. It is a prepayment of futurebenefits.4. Inform IMRF immediately ifa. You are awarded Social Security benefits or if the Social Security Administration has denied your request forreconsideration or appeal orb. You are awarded workers’ compensation or occupational disease benefits or if your claim is denied.Federal Income Tax InformationPlease be aware that by agreeing to this Disability Payment Agreement you may pay more federal income taxthan you would have had you not accepted IMRF’s unreduced disability benefit.Please refer to the attached, “When you make repayments to IMRF” for more information. You can also refer the IRSPublication 525, Taxable and Non-Taxable Income.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form 5.48 (Rev. 02/2013) Page 3

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HEALTH INSURANCE CONTINUATION THROUGH EMPLOYER -PREMIUM DEDUCTION AUTHORIZATIONExhibit 5JIMRF Form 7.10 (Rev. 08/2013)INSTRUCTIONS• Please submit this form no later than the 10th of the month prior to the month additions or changes are to take effect,e.g., submit the form no later than March 10th for the deductions to begin with the April payment.• If you are adding a member’s deduction, the member’s signature is required.• If you are changing the amount of an existing deduction authorization, the member’s signature is not required.SECTION 1 - MEMBER’S INFORMATIONPLEASE PRINTMEMBER’S LAST NAME FIRST NAME MIDDLE INITIAL (JR.SR.II,ETC) SOCIAL SECURITY NUMBERMember Maureen L.HOME STREET (MAILING) ADDRESS1234 Main StreetCITY, STATE AND ZIPSECTION 2 - MEMBER AUTHORIZATION (required to add a member’s deduction)0 0 0 - 0 0 - 0 0 0 0_______________ - ________ - ________________DAYTIME TELEPHONE NUMBER (with Area Code)Anywhere, IL 60000 (000)( 000 ) - 0000I authorize and request the Illinois Municipal Retirement Fund (IMRF) to deduct insurance premiums from my IMRFbenefit payment and to remit the amount deducted to the employer offering insurance. I authorize IMRF to releaseinformation to the employer offering insurance or its insurance carrier in order to ensure proper handling of premiums. Iunderstand IMRF will adjust deductions in response to changes in the premiums. I further understand IMRF will notdeduct more than one premium from a benefit payment (IMRF will not make-up back premiums), and that IMRF willcease making any deduction if the premiums exceed my IMRF benefit amount.This authorization is not an assignment of my right to receive payment. This authorization will remain in effect withIMRF until cancelled by written notice from me or until my former employer notifies IMRF that a premium deduction isno longer required.X___________________________________________________SIGNATURE (Check appropriate box below.)DATE (MM/DD/YYYY)* Member signs if member is receiving benefit payment; spouse signs if spouse is receiving surviving spouse benefit.XMEMBERIMRF Form 7.10 (Rev. 08/2013)SURVIVING SPOUSESECTION 3 - AUTHORIZED AGENT’S CERTIFICATION (required to add or change a member’s deduction)EMPLOYER NAMECity of AnywhereSTREET (MAILING) ADDRESSCity Hall - 123 Main Street_____________________________11/21/2013THE REMITTANCE WILL BE SENT TO THE EMPLOYER IN ALL CASESEMPLOYER IMRF I.D. NUMBERCITY, STATE AND ZIPPOLICY NUMBER MONTHLY PREMIUM MONTH & YEAR DEDUCTION TO BEGIN (MM/YYYY)1234-5AUTHORIZED AGENT’S NAME (Please print.)Annie AgentDAYTIME TELEPHONE NUMBER (with Area Code) FAX NUMBER (with Area Code) EMAIL ADDRESSEMPLOYER CONTACT, IF OTHER THAN AUTHORIZED AGENTSIGNATURE OF AUTHORIZED AGENTXFOR IMRFUSE ONLYDATE ENTEREDDATE EFFECTIVE0 0 0 0 0Anywhere, IL 60000$ 100.00 01/2014(000) 000 - 0000 ( 000 ) 000-0000 aagent@cityofanywhere.comTITLEBusiness ManagerDAYTIME TELEPHONE NUMBER (with Area Code)( )DATE (MM/DD/YYYY)11/21/2013Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.org

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Application for Direct DepositIMRF Form 1199 (Rev. 07/07)This form should be completed by the Benefit Recipient (IMRF member or personreceiving the IMRF benefit payment).NameSocial Security NumberExhibit 5KRichard A. Roe 004 04 1111_____________ — ________ — _____________Address (Number, Street) City State Zip123 Spruce St., Anywhere, IL 60000Is this a new address?Telephone NumberYes No ( )Account Information—Important: The name of the person who will receive the IMRFbenefit payments must be on this account. Please provide the information requestedbelow. If you are unsure of any of the requested information, contact the financialinstitution where you have your account. (See the back of this form for more information.)Name of Financial InstitutionBranch Telephone Number( )Branch Address (Number, Street) City State ZipAccount Number8888-7777-93X 000 000-12341st National Bank of Anywhere 000- 123-4567101 Main Street, Anywhere, IL 60000Financial Institution Routing NumberType of Account9 9 9 9 9 9 9 9 9 XCheckingSavingsI authorize and request the Illinois Municipal Retirement Fund to direct IMRF recurring payments for crediting to my accountat the financial organization designated above. This authorization is not an assignment of my right to receive payment andrevokes all prior payment direction notifications applicable to these payments. I understand that the financial organizationdesignated reserves the right to cancel this agreement by notice to me; however, this authorization will remain in effect withIMRF until cancelled by notice from me or by my death. Further, I understand and agree that IMRF will stop direct depositif I fail to keep IMRF informed of my current address. I also permit the release by the bank or financial institution of mycurrent address to IMRF. I understand that a new Form 1199 is required if I change my financial institution, my accountnumber or my name.5/15/2007X_______________________ _________Signature of Benefit Recipient, Power of Attorney*, or Guardian**Attach court documents if not already submittedFax your completed form to IMRF at 630-368-5398 or mail it to:Illinois Municipal Retirement Fund, 2211 York Road Suite 500, Oak Brook IL 60523-2337Member Service Representatives 1-800-ASK-IMRF (1-800-275-4673)www.imrf.orgIMRF Form 1199 (Rev. 07/07)Date

Required Account InformationImportant: The name of the person who will receive the IMRF benefit paymentsmust be on this account.IMRF needs you to provide specific account information on the reverse side of this formin order to set up Direct Deposit:• Name of your financial institution• Phone number of the branch you use• Address of the branch you use• Your account number• Your financial institution’s routing number• Type of accountA routing number is a nine-digit number, and is a completely separate number from youraccount number.If you have a savings or brokerage account, you should call the financial institutionwhere you have your account to obtain the correct routing number.If you have a checking account, see the sample below for how to get your accountnumber and the correct routing number from your blank checks. (Note: If you havetemporary checks, call the financial institution where you have your account to obtainthe correct routing number.)Mary Member 9676John Member123 Main Street Date _______________________Anywhere, IL 60606SAMPLEPay to theOrder of _____________________________________________________________ $_______________________________________________________________________________DollarsBank of AnywhereAnywhere, IL 00000Nine-digitRouting NumberFor______________________________________AccountNumberI:123456789I: 1122334455 II 9676Do not includethe check numberas part of your accountnumber. (The check___________________________________number is generallyprinted immediatelyafter your accountnumber.)Member Service Representatives 1-800-ASK-IMRF (1-800-275-4673)www.imrf.orgIMRF Form 1199 (Rev. 07/07)

DISTRIBUTION/ROLLOVER CERTIFICATIONIMRF Form BW-60 (Rev. 09/2013)Exhibit 5L - Page 1 of 5INSTRUCTIONS FOR COMPLETING THIS FORMSection 1 — Member informationEnter the requested information. Be sure to indicate the type of distribution you are receiving from IMRF. Ifyou are receiving more than one (e.g., a refund of surviving spouse contributions and voluntary additionalcontributions), please complete a separate distribution/rollover certification for each.Section 2 — Distribution TypeIf you are receiving more than one distribution (e.g., Refund of surviving spouse contributions and refund ofvoluntary additional contributions) you must complete a separate BW-60 for each type of distribution.Section 3 — CertificationPayments directly to youIf you are having your entire distribution paid directly to you, check the box provided. Because thedistribution will be paid directly to you, federal law requires IMRF to withhold 20% of the taxable portion ofyour distribution. The 20% withholding is not required if you roll over the taxable portion directly to an IRAor some other qualified retirement plan (See next paragraph).Transfers (rollovers)If you are having all of your distribution directly rolled over to an Individual Retirement Account or othereligible plan, check the box provided. If you are having part of your distribution rolled over, indicate EITHERa percentage OR a dollar amount in the space provided. The distribution will be mailed to you but thecheck will be made payable to the custodian of your account or plan. If you indicate anything less than thefull amount of your distribution, the balance — less the 20% withholding on the taxable portion — will bedistributed directly to you.Section 4 — Account information (This section required for direct rollovers only.)Take this form to your financial institution or the custodian of your account or plan and have itsrepresentative complete Section 3. If you wish, you may instead attach a completed transfer form from yourfinancial institution.Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form BW-60 (Rev. 09/2013) Page 1 of 5

DISTRIBUTION/ROLLOVER CERTIFICATIONIMRF Form BW-60 (Rev. 09/2013)Exhibit 5L - Page 2 of 5PLEASE PRINTSECTION 1 — MEMBER INFORMATIONMEMBER’S LAST NAME FIRST NAME MIDDLE INITIAL JR., SR., II, ETC. SOCIAL SECURITY NUMBERDoe Robert A. 0 0 0 0 0 0 0 0 0YOUR INFORMATION (if different from above)LAST NAME FIRST NAME MIDDLE INITIAL JR., SR., II, ETC. SOCIAL SECURITY NUMBER____________ - _________ - ____________SECTION 2 - DISTRIBUTION TYPEIF YOU ARE RECEIVING MORE THAN ONE DISTRIBUTION (e.g., Refund of Surviving Spouse Contributions and Refund ofVoluntary Additional Contributions) YOU MUST COMPLETE A SEPARATE BW-60 FOR EACH TYPE OF DISTRIBUTION.IMPORTANT: OF THE SIX CHOICES BELOW, CHECK ONLY ONE.____________ - _________ - ____________RETIREMENT:REFUND OF SLEP CONTRIBUTIONSREFUND OF VOLUNTARYADDITIONAL CONTRIBUTIONSREFUND OF SURVIVING SPOUSECONTRIBUTIONSREFUND:REFUND OF VOLUNTARYXADDITIONAL CONTRIBUTIONSSEPARATION REFUNDDEATH:IMRF DEATH BENEFITSECTION 3 - CERTIFICATIONIn order for IMRF to process your payment, you must choose one. I direct IMRF to:Roll over nothing and make the entire distribution payable to me, less the 20% withholding.XRoll over the entire amount and make payable to the IRA, 401k, oreligible retirement plan as named below.Roll over___________% OR $___________________(Enter EITHER a percentage OR a dollar amount. The percentage OR dollar amount indicated will be rolledover to the IRA, 401k, or eligible retirement plan named below.)I certify that this account is an individual retirement plan or a qualified plan, and is eligible to receive this rolloverdistribution. I hereby waive my right to 30 days prior notice of the tax consequences of this distribution and demandimmediate payment.Note: IMRF is required by federal law to withhold 20% of the taxable portion of your distribution not directly rolled overto an I.R.A. or other qualified retirement plan. This direct rollover is limited to the taxable portion of your lump sumdistribution. Any portion that was previously taxed will be paid directly to you without withholding unless you submitIMRF Form 5.10B with additional instructions.SIGNATURE (WRITE - DO NOT PRINT)XSECTION 4 - ACCOUNT INFORMATION (REQUIRED FOR DIRECT ROLLOVERS ONLY)Financial organization: These funds are currently in a qualified retirementplan (QRP) under section 401(a) of the IRC. IMRF will mail the member acheck made payable to the financial institution named below.NAME OF FINANCIAL ORGANIZATION CHECK IS TO BE MADE PAYABLE TO:First National Bank of AnywhereDEPOSIT ACCOUNT NUMBER (OPTIONAL)PERSON TO CONTACT AT FINANCIAL ORGANIZATIONTELEPHONE NUMBER (with Area Code)Francis Financial (000) 000 - 0000DATE (MM/DD/YYYY)11/21/2013ACCOUNT IS: (SELECT ONE)TRADITIONAL IRAROTH IRARETIREMENT PLAN (re IRC 401)DEFERRED COMPENSATION PLAN(457 OR 403B, ETC.)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgOTHER_________________________IMRF Form BW-60 (Rev. 09/2013) Page 2 of 5X

YOUR ROLLOVER OPTIONSExhibit 5L - Page 3 of 5You are receiving this notice because all or a portionof a payment you are receiving from IMRF (the “Plan”) iseligible to be rolled over to an IRA or an employer plan.This notice is intended to help you decide whether to dosuch a rollover. Rules that apply to most payments froma plan are described in the “General Information AboutRollovers” section. Special rules that only apply in certaincircumstances are described in the “Special Rules andOptions” section.GENERAL INFORMATION ABOUT ROLLOVERSHow can a rollover affect my taxes?You will be taxed on a payment from the Plan if you donot roll it over. If you are under age 59-1/2 and do not do arollover, you will also have to pay a 10% additional incometax on early distributions (unless an exception applies).If you do a rollover to a traditional IRA or an eligibleemployer plan, you will not have to pay tax until you receivepayments later from the IRA or plan, and the 10% additionalincome tax will not apply if those payments are made afteryou are age 59-1/2 (or if an exception applies).If you do a rollover to a Roth IRA, you will be taxed onthe amount rolled over (reduced by any after-tax amount).However, if you are under age 59-1/2 at the time of therollover, the 10% additional income tax will not apply. Seethe section on the following page titled “If you roll over yourpayment to a Roth IRA” for more details.Where may I roll over the payment?You may roll over the payment to either an IRA (anindividual retirement account or individual retirement annuity)or an employer plan [a tax-qualified plan, section 403(b)plan, or governmental section 457(b) plan] that will acceptthe rollover. The rules of the IRA or employer plan that holdsthe rollover will determine your investment options, fees, andrights to payment of the rolled over amount in the future.Further, the amount rolled over will become subject to thetax rules that apply to the IRA or employer plan.How do I do a rollover?There are two ways to do a rollover. You can do either adirect rollover or a 60-day rollover.(1) If you do a direct rollover, the Plan will makethe payment directly to your IRA or an employerplan. You should contact the IRA sponsor or theadministrator of the employer plan for information onhow to do a direct rollover.(2) If you do not do a direct rollover, the Plan is requiredto withhold 20% of the payment for federal incometaxes. You may still do a rollover by making adeposit into an IRA or eligible employer plan that willaccept it. You will have 60 days after you receivethe payment to make the deposit. This means that,in order to roll over the entire payment in a 60-dayrollover, you must use other funds to make up forthe 20% withheld. If you do not roll over the entireamount of the payment, the portion not rolled overwill be taxed and will be subject to the 10% additionalincome tax on early distributions if you are under age59-1/2 (unless an exception applies).IMRF Form BW-60 (Rev. 09/2013)How much may I roll over?If you wish to do a rollover, you may roll over all or part ofthe amount eligible for rollover. Any payment from the Planis eligible for rollover except:• Certain payments spread over a period of at least 10years or over your life or life expectancy (or the lives orjoint life expectancy of you and your beneficiary)• Required minimum distributions after age 70-1/2 (orafter death).The Plan administrator or the payor can tell you what portionof a payment is eligible for rollover.If I don’t do a rollover, will I have to pay the 10%additional income tax on early distributions?If you are under age 59-1/2, you will have to pay the 10%additional income tax on early distributions for any paymentfrom the Plan (including amounts withheld for income tax)that you do not roll over, unless one of the exceptions listedbelow applies. This tax is in addition to the regular incometax on the payment not rolled over.The 10% additional income tax does not apply to thefollowing payments from the Plan:• Payments made after you separate from service if youwill be at least age 55 in the year of separation.• Payments that start after you separate from serviceif paid at least annually in equal or close to equalamounts over your life or life expectancy (or the livesor joint life expectancy of you and your beneficiary).• Payments from a governmental defined benefit pensionplan made after you separate from service if you are apublic safety employee and you are at least age 50 inthe year of separation.• Payments made due to disability.• Payments made after your death.• Payments made directly to the government to satisfy afederal tax levy.• Payments made under a qualified domestic relationsorder (QDRO).• Payments up to the amount of your deductible medicalexpenses.If I do roll over to an IRA, will the 10% additional incometax apply to early distributions from the IRA?If you receive a payment from an IRA when you are underage 59-1/2, you will have to pay the 10% additional incometax on early distributions from the IRA, unless an exceptionapplies. In general, the exceptions to the 10% additionalincome tax for early distributions from an IRA are the sameas the exceptions listed above for early distributions froma plan. However, there are a few differences for paymentsfrom an IRA, including:• There is no exception for payments after separationfrom service that are made after age 55.• The exception for qualified domestic relations orders(QRDOs) does not apply (although a special ruleapplies under which, as part of a divorce or separationPage 3 of 5

agreement, a tax-free transfer may be made directly toan IRA of a spouse or former spouse.• The exception for payments made at least annuallyin equal or close to equal amounts over a specifiedperiod applies without regard to whether you have hada separation from service.• There are additional exceptions for:(1) payments for qualified higher education expenses,(2) payments up to $10,000 used in a qualified firsttimehome purchase, and(3) payments after you have received unemploymentcompensation for 12 consecutive weeks (or wouldhave been eligible to receive unemploymentcompensation but for self-employed status).Will I owe State income taxes?This notice does not describe any State or local incometax rules (including withholding rules).SPECIAL RULES AND OPTIONSIf your payment includes after-tax contributionsAfter-tax contributions included in a payment are nottaxed. If a payment is only part of your benefit, an allocableportion of your after-tax contributions is generally included inthe payment.You may roll over to an IRA a payment that includesafter-tax contributions through either a direct rollover ora 60-day rollover. You must keep track of the aggregateamount of the after-tax contributions in all of your IRAs (inorder to determine your taxable income for later paymentsfrom the IRAs). If you do a direct rollover of only a portion ofthe amount paid from the Plan and a portion is paid to you,each of the payments will include an allocable portion of theafter-tax contributions. If you do a 60-day rollover to an IRAof only a portion of the payment made to you, the after-taxcontributions are treated as rolled over last. For example,assume you are receiving a complete distribution of yourbenefit which totals $12,000, of which $2,000 is after-taxcontributions. In this case, if you roll over $10,000 to anIRA in a 60-day rollover, no amount is taxable because the$2,000 amount not rolled over is treated as being after-taxcontributions.You may roll over to an employer plan all of a paymentthat includes after-tax contributions, but only through a directrollover [and only if the receiving plan separately accountsfor after-tax contributions and is not a governmentalsection 457(b) plan]. You can do a 60-day rollover to anemployer plan of part of a payment that includes after-taxcontributions, but only up to the amount of the payment thatwould be taxable if not rolled over.If you miss the 60-day rollover deadlineGenerally, the 60-day rollover deadline cannot beextended. However, the IRS has the limited authorityto waive the deadline under certain extraordinaryExhibit 5L - Page 4 of 5circumstances, such as when external events preventedyou from completing the rollover by the 60-day rolloverdeadline. To apply for a waiver, you must file a private letterruling request with the IRS. Private letter ruling requestsrequire the payment of a nonrefundable user fee. Formore information, see IRS Publication 590, “IndividualRetirement Arrangements (IRAs).”If you were born on or before January 1, 1936If you were born on or before January 1, 1936 andreceive a lump sum distribution that you do not roll over,special rules for calculating the amount of the tax on thepayment might apply to you. For more information, see IRSPublication 575, “Pension and Annuity Income.”If you are an eligible retired public safety officerand your pension payment is used to pay for healthcoverage or qualified long-term care insuranceIf the Plan is a governmental plan, you retired as a publicsafety officer, and your retirement was by reason of disabilityor was after normal retirement age, you can excludefrom your taxable income plan payments paid directly aspremiums to an accident or health plan (or a qualified longtermcare insurance contract) that your employer maintainsfor you, your spouse, or your dependents, up to a maximumof $3,000 annually. For this purpose, a public safety officeris a law enforcement officer, firefighter, chaplain, or memberof a rescue squad or ambulance crew.If you roll over your payment to a Roth IRAYou can roll over a payment from the Plan made beforeJanuary 1, 2010 to a Roth IRA only if your modified adjustedgross income is not more than $100,000 for the year thepayment is made to you and, if married, you file a jointreturn. These limitations do not apply to payments madeto you from the Plan after 2009. If you wish to roll over thepayment to a Roth IRA, but you are not eligible to do arollover to a Roth IRA until after 2009, you can do a rolloverto a traditional IRA and then, after 2009, elect to convert thetraditional IRA into a Roth IRA.If you roll over the payment to a Roth IRA, a special ruleapplies under which the amount of the payment rolled over(reduced by any after-tax amounts) will be taxed. However,the 10% additional income tax on early distributions will notapply (unless you take the amount rolled over out of theRoth IRA within 5 years, counting from January 1 of the yearof the rollover). For payments from the Plan during 2010that are rolled over to a Roth IRA, the taxable amount canbe spread over a 2-year period starting in 2011.If you roll over the payment to a Roth IRA, later paymentsfrom the Roth IRA that are qualified distributions will notbe taxed (including earnings after the rollover). A qualifieddistribution from a Roth IRA is a payment made after youare age 59-1/2 (or after your death or disability, or as aqualified first-time homebuyer distribution of up to $10,000)and after you have had a Roth IRA for at least 5 years. Inapplying this 5-year rule, you count from January 1 of theyear for which your first contribution was made to a RothIRA. Payments from the Roth IRA that are not qualifiedIMRF Form BW-60 (Rev. 09/2013) Page 4 of 5

Exhibit 5L - Page 5 of 5distributions will be taxed to the extent of earnings after therollover, including the 10% additional income tax on earlydistributions (unless an exception applies). You do not haveto take required minimum distributions from a Roth IRAduring your lifetime.You cannot roll over a payment from the Plan to adesignated Roth account in an employer plan.For more information, see IRS Publication 590,“Individual Retirement Arrangements (IRAs).” You shouldconsult your tax advisor if you are interested in rolling overyour distribution to a Roth IRA.IF YOU ARE NOT A PLAN PARTICIPANTPayments made after the death of the participantIf you receive a distribution after the participant’s deaththat you do not roll over, the distribution will generally betaxed in the same manner described elsewhere in thisnotice. However, the 10% additional income tax on earlydistributions and the special rules for public safety officersdo not apply, and the special rule described under thesection, “If you were born on or before January 1, 1936”applies only if the participant was born on or before January1, 1936.If you are a surviving spouse. If you receive a paymentfrom the Plan as the surviving spouse of a deceasedparticipant, you have the same rollover options that theparticipant would have had, as described elsewhere inthis notice. In addition, if you choose to do a rolloverto an IRA, you may treat the IRA as your own or as aninherited IRA.An IRA you treat as your own is treated like any other IRAof yours, so that payments made to you before you areage 59-1/2 will be subject to the 10% additional incometax on early distributions (unless an exception applies)and required minimum distributions from your IRA do nothave to start until after you are age 70-1/2.If you treat the IRA as an inherited IRA, payments fromthe IRA will not be subject to the 10% additional incometax on early distributions. However, if the participant hadstarted taking required minimum distributions, you willhave to receive required minimum distributions from theinherited IRA. If the participant had not started takingrequired minimum distributions from the Plan, you willnot have to start receiving required minimum distributionsfrom the inherited IRA until the year the participant wouldhave been age 70-1/2.If you are a surviving beneficiary other than a spouse.If you receive a payment from the Plan because of theparticipant’s death and you are a designated beneficiaryother than a surviving spouse, the only rollover optionyou have is to do a direct rollover to an inherited IRA.Payments from the inherited IRA will not be subject to the10% additional income tax on early distributions. You willhave to receive required minimum distributions from theinherited IRA.Payments under a qualified domestic relations order.If you are the spouse or former spouse of the participantwho receives a payment from the Plan under a qualifieddomestic relations order (QDRO), you generally have thesame options the participant would have (for example, youmay roll over the payments to your own IRA or an eligibleemployer plan that will accept it). Payments under theQDRO will not be subject to the 10% additional income taxon early distributions.If you are a nonresident alienIf you are a nonresident alien and you do not do a directrollover to a U.S. IRA or U.S. employer plan, instead ofwithholding 20%, the Plan is generally required to withhold30% of the payment for federal income taxes. If the amountwithheld exceeds the amount of tax you owe (as mayhappen if you do a 60-day rollover), you may request anincome tax refund by filing Form 1040NR and attaching yourForm 1042-S. See Form W-8BEN for claiming that you areentitled to a reduced rate of withholding under an incometax treaty. For more information, see also IRS Publication519, “U.S. Tax Guide for Aliens,” and IRS Publication 515,“Withholding of Tax on Nonresident Aliens and ForeignEntities.”Other special rulesYou may have special rollover rights if you recentlyserved in the U.S. Armed Forces. For more information,see IRS Publication 3, “Armed Forces’ Tax Guide.”NOTICE PERIODGenerally, payment cannot be made from the Planuntil at least 30 days after you receive this notice. Thus,you have at least 30 days to consider whether or not tohave your payment rolled over. If you do not wish to waituntil this 30-day notice period ends before your electionis processed, you may waive the notice period by makingan affirmative election indicating whether or not youwish to make a direct rollover. Your payment will then beprocessed in accordance with your election as soon aspractical after it is received by the Plan administrator.FOR MORE INFORMATIONYou may wish to consult with the Plan administratoror payor, or a professional tax advisor, before taking apayment from the Plan. Also, you can find more detailedinformation on the federal tax treatment of paymentsfrom employer plans in: IRS Publication 575, “Pensionand Annuity Income”; IRS Publication 590, “IndividualRetirement Arrangements (IRAs)”; and IRS Publication571, “Tax-Sheltered Annuity Plans [403(b) Plans].” Thesepublications are available from a local IRS office, on theweb at www.irs.gov, or by calling 1-800-TAX-FORM.IMRF Form BW-60 (Rev. 09/2013) Page 5 of 5

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Exhibit 5M-a2211 South York Oak Brook IL 60523 1-800-ASK-IMRFMarch 18,2006JOHN DOE123 MAIN ST.ANYWHERE, IL 60000SSN: 001-01-1111By approval of the Board of Trustees of the Illinois Municipal Retirement Fund,you have been granted the following benefits:Retirement BenefitYour pension is $548.53 per month, effective April 1, 2006. On January 1, 2007,your monthly pension will be increased by $2.74. Each January 1 thereafter, itwill be increased by $16.46 a year, $1.37 per month.Your pension was based upon 16 years 8 months of IMRF service credit, a monthlyfinal rate of earnings of $1,935.59, and retirement age of 62 years 1 month.Survivor BenefitsAt your death, your eligible spouse will receive a one-time payment of$3,000.00 and a monthly pension of 50% of the pension you are receiving at thetime of your death. This pension will be payable for the life of your spouse.If your present spouse does not survive you, your beneficiary will be paid asingle payment of $3,000. If the total pension payments received do not equaltotal employee contributions of $9,779.11, plus interest of $6,900.28, totaling$16,679.39, the remainder will be paid to your beneficiary.Your IMRF PensionYour pension is payable for life, regardless of how much you contributed toIMRF. You will receive your pension check at the beginning of each month. Ifyou return to IMRF participation, your pension will be stopped.Your IMRF pension payment does not include Social Security benefits. You shouldapply for these benefits with the Social Security Administration.If you become unable to care for your own affairs, we can make payment to arepresentative payee. We will supply our representative payee form forcompletion by your spouse, daughter, son, or other relative.Income Tax InformationYour IMRF pension IS subject to federal income tax. $4,275.19 of thecontributions to IMRF were previously taxed. We will use the Simplified GeneralRule from the IRS to report your previously taxed contributions. Under thisrule, a fixed dollar amount of $16.78 per month will not be taxed until yourecover all of your previously taxed contributions.If you wish, IMRF can report the taxable amount using an alternate IRScalculation. In order to change reporting methods, you must file (or amend)your taxes for all years using the same method. For information on how tochange, please contact IMRF. Under the alternate calculation, a fixed percentof 12.66% of each monthly check will not be taxed until you recover all of yourpreviously taxed contributions.Your pension is NOT subject to Illinois income tax.EXECUTIVE DIRECTOR

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Exhibit 5M-b2211 South York Oak Brook IL 60523 1-800-ASK-IMRFMay 19, 2006JANE SMITH123 MAIN ST.ANYWHERE, IL 60000SSN: 001-01-1111By approval of the Board of Trustees of the Illinois Municipal RetirementFund, you have been granted the following benefits:Surviving Spouse Standard PensionYour pension is $338.05 per month, effective March 1, 2006. On January 1,2007, your monthly pension will be increased by $7.60. Each January 1thereafter, it will be increased by $10.14.Death BenefitsIf you die before you have received the total guaranteed amount of$4,335.11, the remainder will be paid to the secondary beneficiary(ies)designated by the deceased, or to his/her estate.Your IMRF PensionYour pension is payable for life, unless you remarry before you reach theage of 55. You will receive your pension check at the beginning of eachmonth. If you change your address or your name, fill in and return theform attached to your payment envelope.Your IMRF pension payment does not include Social Security benefits. Youshould apply for these benefits with the Social Security Administration.If you become unable to care for your own affairs, we can make payment toa representative payee. We will supply our representative payee form forcompletion by your spouse, daughter, son, or other relative.Income Tax InformationYour IMRF benefit is NOT subject to Illinois income tax. However, yourbenefit IS subject to federal income tax.EXECUTIVE DIRECTOR

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Election For Deductionsfor Health or Long-Term Care Insurance Premiums Paid Directly to InsurerIMRF Form 7.12D (Rev. 11/2013)PLEASE PRINT; USE BLACK INK.INSTRUCTIONS• The Pension Protection Act of 2006 allows retired or permanently disabled public safety employees (see back) todeduct up to $3,000 from their taxable income for health or long-term care insurance premiums paid from their IMRFpension directly to the insurance company or employer.• You may instruct IMRF to pay insurance premiums from your pension directly to the insurer.• Please submit this form no later than the 10th of the month prior to the month deductions are to begin, e.g., submitthe form no later than March 10th for deductions to begin with the April payment.SECTION 1 - MEMBER INFORMATIONMEMBER’S LAST NAME FIRST NAME MIDDLE INITIAL JR, SR. II. ETC. SOCIAL SECURITY NUMBERDoe Robert A.HOME STREET (MAILING) ADDRESS CITY STATE AND ZIP + 4POSITION TITLE ON LAST DATE OF IMRF PARTICIPATIONSECTION 2 - MEMBER CERTIFICATION AND AUTHORIZATIONExhibit 5N - Page 1 of 2_______ 0 0 0 - ____ 0 0 - _______ 0 0 0 012 Main Street Anywhere, IL 60000DAYTIME TELEPHONE NUMBER (w/Area Code)Police Officer ( 0 0 0 ) 0 0 0 - 0 0 0 0I certify I was an eligible Public Safety Officer when I terminated from IMRF participation at full retirement age orwhen I became disabled. I elect to have amounts deducted from my IMRF benefit payments to pay for qualifiedinsurance premiums, as provided under the Pension Protection Act of 2006.The maximum amount I can claim on my tax return is $3,000.I certify the deductions I am requesting are for qualified insurance premiums. Please provide the following:INSURANCE COMPANY/CARRIERMAILING ADDRESS CITY STATE ZIPACCOUNT NUMBERHealth Insurance Company 000-0MONTHLY PREMIUM123 Healthy Way, Healthy, IL 60000 $ 100.00I authorize IMRF to release information to the health care program to ensure proper handling of insurancepremiums. I further understand IMRF will not deduct more than one monthly premium from a benefit payment(IMRF will not make-up back premiums), and that IMRF will cease making any deduction if the monthly premiumamount exceeds my monthly IMRF benefit amount.I certify that I qualify for the benefit of payment of qualified insurance premiums and agree that IMRF is notresponsible for any additional tax liability, interest or penalties that may arise because I requested this benefit.I understand it is my responsibility to notify IMRF of any changes in premium amount or insurance carrier, and Iagree that IMRF is not responsible for lapsed insurance coverage or any other coverage or benefit issues that arisebecause of payment of premiums through this deduction program.In consideration of participation in this program, which I recognize is a valuable benefit, I waive anyclaims of any kind against IMRF arising from my participation and I hereby indemnify and release IMRF fromany liability arising from the administration of the payment of my qualified insurance premiums.This authorization is not an assignment of my right to receive payment. This authorization will remain in effect withIMRF until cancelled by written notice from me.X_______________________________________________SIGNATURE__________________________11/21/2013DATE (MM/DD/YYYY)FOR IMRF DATE ENTERED DATE EFFECTIVEUSE ONLYIllinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgIMRF Form 7.12D (Rev. 11/2013)

Distributions from Eligible Plansfor Public Safety Retiree Heath and Long-Term Care Insurance PremiumsEffective January 1, 2007, the Pension Protection Act of 2006 (PPA) allows retired or disabled public safetyemployees to take a tax reduction of up to $3,000 on their federal income tax return for health insurance orlong-term care insurance premiums. The health insurance or long-term care insurance coverage can include themember, spouse and dependents.You must be terminated from your IMRF employer because you were disabled or because you reached full(normal) retirement age (60 for Regular plan members or 55 with 35 years of service credit, 55 for ECO planmembers and 50 for SLEP and SLEP-ECO plan members). The insurance premiums must be paid directly fromyour pension.Taking the $3,000 deduction on your federal income tax returnsYour 1099-R tax statement will show your full pension payments before the deduction for insurance premiums.You take the deduction by reducing the taxable amount of your pension by the amount you paid for insurancepremiums when completing Form 1040 or Form 1040A, “U.S. Individual Income Tax Return.”What is the definition of a public safety employee?The PPA uses the definition in Section 1204(9)(A) of the Omnibus Crime Control and Safe Streets Act of 1968(42 U.S.C. 3796b(9)(A)). That definition includes the following individuals serving a public agency in an officialcapacity:• An individual involved in crime and juvenile delinquency control or reduction, or enforcement of thecriminal laws (including juvenile delinquency), including, but not limited to police, corrections, probation,parole, and judicial officers• Professional firefighters• Officially recognized or designated:- Public employee members of a rescue squad or ambulance crew- Members of a legally organized volunteer fire department- Chaplains of volunteer fire departments, fire departments, and police departmentsThe amount deducted will be paid directly to your insurerReimbursements are not covered. For you to take advantage of this deduction, IMRF must pay the premium tothe insurance provider directly.What if your insurance premium amounts change?You are required to inform IMRF of any change in the amount of your premiums. We must have notice of anychange by the 10th of the month prior to the month the amount is to change. You must pay your insuranceprovider directly for any premiums due in addition to the amount deducted from your pension.What if your insurance premiums exceed $3,000 annually?IMRF will deduct the premiums instructed from each pension payment. You may only reduce your taxable incomeby the amount actually paid in premiums, up to a maximum of $3,000.Is the deduction is available to an IMRF member’s spouse?No, the deduction is available only on the election of the member. No other individual is eligible to make theelection. This deduction not available to surviving spouses.Form 7.12D (Rev. 11/2013)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, Illinois 60523-2337Member Services Representatives 1-800-ASK-IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.orgExhibit 5N - Page 2 of 2

ELECTION FOR DEDUCTIONSHealth or Long-Term Care PremiumsPaid through Employer or Endorsed Plan AdministratorIMRF Form 7.12E (Rev. 11/2013)Exhibit 5O - Page 1 of 2INSTRUCTIONS• The Pension Protection Act of 2006 allows retired or permanently disabled public safety employees (see page two) todeduct up to $3,000 from their taxable income for health or long-term care insurance premiums paid from their IMRFpension directly to the insurance company or employer.• You may instruct IMRF to pay insurance premiums from your pension directly to your former employer.• Please submit this form with IMRF Form 7.10, “Health Insurance Continuation Through Employer — Premium DeductionAuthorization” or IMRF Form 7.10E, “Health Care Program Premium Deduction Authorization for IMRF-Endorsed Plans.”SECTION 1 - MEMBER INFORMATIONPLEASE PRINTMEMBER’S LAST NAME FIRST NAME MIDDLE INITIAL (JR.SR.II,ETC) SOCIAL SECURITY NUMBERDoe Robert J.HOME STREET (MAILING) ADDRESSSECTION 2 - MEMBER CERTIFICATION AND AUTHORIZATIONCITY, STATE, AND ZIP12 Main Street Anywhere, IL 60000POSITION TITLE ON LAST DAY OF IMRF PARTICIPATIONPolice Officer0 0 0 0 0 0 0 0 0_______________ - ________ - ________________DAYTIME TELEPHONE NUMBER (with Area Code)( 0 0 0 ) 0 0 0 - 0 0 0 0I certify I was an eligible Public Safety Officer when I terminated from IMRF participation at full retirement age or when Ibecame disabled. I elect to have amounts deducted from my IMRF benefit payments to pay for qualified insurance premiums,as provided under the Pension Protection Act of 2006.The maximum amount I can claim on my tax return is $3,000.I certify the deductions I am requesting are for qualified insurance premiums.I certify that I qualify for the benefit of a deduction of qualified insurance premiums and agree that IMRF is notresponsible for any additional tax liability, interest, or penalties that may arise because I requested this benefit.In consideration of participation in this program, which I recognize is a valuable benefit, I waive any claims ofany kind against IMRF arising from my participation.This authorization is not an assignment of my right to receive payment. This authorization will remain in effect withIMRF until cancelled by written notice from me or until IMRF is notified that a premium deduction is no longer required.X___________________________________________________SIGNATURE_____________________________11/21/2013DATE (MM/DD/YYYY)FOR IMRFUSE ONLYDATE ENTEREDDATE EFFECTIVEIMRF Form 7.12E (Rev. 11/2013)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.org

Distributions from Eligible Plansfor Public Safety Retiree Health and Long-Term Care Insurance PremiumsEffective January 1, 2007, the Pension Protection Act of 2006 (PPA) allows retired or disabledpublic safety employees to take a tax reduction of up to $3,000 on their federal income tax returnfor health insurance or long-term care insurance premiums. The health insurance or long-termcare insurance coverage can include a member, spouse and dependents.You must be terminated from your IMRF employer because you were disabled or because youreached full (normal) retirement age (60 for Regular plan members or 55 with 35 years of service,55 for ECO Plan members, and 50 for SLEP and SLEP-ECO Plan members). The insurancepremiums must be paid directly from your pension.Taking the $3,000 deduction on your federal income tax returnsYour 1099-R tax statement will show your full pension payments before the deduction forinsurance premiums. You take the deduction by reducing the taxable amount of your pension bythe amount you paid for insurance premiums when completing Form 1040 or Form 1040A, “U.S.Individual Income Tax Return.”What is the definition of a public safety employee?The PPA uses the definition in Section 1204(9)(A) of the Omnibus Crime Control and Safe StreetsAct of 1968 (42 U.S.C. 3796b(9)(A)). That definition includes the following individuals serving apublic agency in an official capacity:• An individual who is an officer of a public agency with the legal authority andresponsibility to arrest, apprehend, prosecute, adjudicate, correct or detain, or supervisesuch persons who are alleged or found to have violated the criminal laws (includingjuvenile delinquency laws).• Professional firefighters• Officially recognized or designated:° ° Public employee members of a rescue squad or ambulance crew.° ° Members of a legally organized volunteer fire department.° ° Chaplains of volunteer fire departments, fire departments, and police departments.The amount deducted will be paid directly to your insurerReimbursements are not covered. For you to take advantage of this deduction, IMRF must paythe premium to the insurance provider through:• Your former employer, if you are continuing insurance through your employer.• Doyle Rowe, LTD., if you are enrolled in an IMRF-endorsed plan.What if your insurance premiums exceed $3,000 annually?IMRF will deduct the premiums as instructed from each pension payment. You may only reduceyour taxable income by the amount actually paid in premiums, up to a maximum of $3,000.Exhibit 5O - Page 2 of 2Is the deduction available to an IMRF member’s spouse?No, the deduction is available only on the election of the member. No other individual is eligible tomake the election. This deduction is not available to surviving spouses.IMRF Form 7.12E (Rev. 11/2013)Illinois Municipal Retirement Fund2211 York Road Suite 500 Oak Brook, IL 60523-2337Member Services Representatives 1-800-ASK IMRF (1-800-275-4673) Fax: (630) 706-4289www.imrf.org

CHANGE ACCOUNT FOR ELECTRONIC PAYMENTS FROM IMRFIMRF Form 3.01 (08/06)Exhibit 5PPlease complete this form to change the account you would like IMRF to use when we send yourelectronic payment for health premiums deducted from your retired members’ benefit payments.EMPLOYER NAMEEMPLOYER NUMBER0City of Anywhere 0 0 0 0CONTACT NAMETELEPHONE NUMBERAnnie Agent ( 000 ) 000 - 0000ADDRESS (NUMBER, STREET)123 Elm StreetCITY STATE ZIP +4Anywhere IL 60000-0000BANKING INSTITUTION NAMETELEPHONE NUMBERFirst Bank of Anywhere ( 000 ) 000 - 0000ADDRESS (NUMBER, STREET)123 Main StreetCITY STATE ZIP +4Anywhere IL 60000-0000TYPE OF ACCOUNTChecking X❏ Savings ❏ACCOUNT NUMBER000-000-A1234ABA ROUTING NUMBER0 0 0 0 0 0 0 0 0xAnnie AgentAUTHORIZED AGENT (Print Name)SIGNATURE OF AUTHORIZED AGENTJuly 1, 2012DATEIMRF Form 3.01 (08/06)Illinois Municipal Retirement FundSuite 500 2211 York Road Oak Brook IL 60523-2337Service Representatives 1-800-ASK-IMRF (1-800-275-4673)www.imrf.org

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IMRF MEMBER INFORMATIONCOMPARING TIER 1 AND TIER 2 – REGULAR QRCComparing Tier 1 and Tier 2 – IMRF Regular PlanWhat makes youeligible?How much servicedo you need tovest?What is yournormal retirementage?What is yourearliest retirementage (pensionis reduced)?How is yourpension reduced?What is includedin your Final Rateof Earnings (FRE)?Final Rate ofEarnings CapRegular Tier 1 – RG01You are currently participating inRegular IMRFYou were enrolled in IMRF beforeJanuary 1, 2011.You previously participated in IMRFas an active member or in areciprocal system and return toparticipation.8 years 10 years60 6755 62 If you retire between age 55 and 60with less than 30 years of servicecredit: your pension is reduced 1/4%for each month under age 60. If you retire between age 55 and 60with at least 30 but less than 35 yearsof service credit, your pension isreduced by lesser of 1/4% for eachmonth Under age 60 or Of service credit less than 35years. If you retire with 35 or more years ofservice credit and are at least age 55,there is no reduction.Your FRE is the average of the highest 48months in your last 10 years of serviceThe 125% rule applies: Wages for each ofthe last three months cannot be morethan 25% greater than the highestearnings in any of the first 45 months.None for members first participatingbefore January 1, 1996.$260,000 annually (in 2014) for all others.Regular Tier 2 – RG03You are first enrolled in IMRF’s Regular Planon or after January 1, 2011.But there’s an EXCEPTION:You participate in Tier 1 if you havecurrent or previous IMRF or reciprocalretirement system participation (with theexception of the Judges’ RetirementSystem and the General AssemblyRetirement System) and are enrolled inIMRF after January 1, 2011.If you retire between age 62 and 67 withless than 30 years of service credit: yourpension is reduced 1/2% for each monthunder age 67.If you retire between age 62 and 67 withat least 30 but less than 35 years ofservice credit, your pension is reduced bythe lesser of 1/2% for each month Under age 67 or Of service credit less than 35 years.If you retire with 35 or more years ofservice credit and are at least age 62,there is no reduction.Your FRE is the average of the highest 96months in your last 10 years of serviceThe 125% rule applies: Wages for each of thelast three months cannot be more than 25%greater than the highest earnings in any ofthe first 93 months.The cap for 2014 is $110,631.26; this amountautomatically increases annually by the lesserof 3% or by one-half of the increase in theConsumer Price Index (urban) for thepreceding year.Updated December 2013 Page 1 of 2

IMRF MEMBER INFORMATIONCOMPARING TIER 1 AND TIER 2 – REGULAR QRCWhat is theamount of yourAnnual PensionIncrease?When are youeligible for anAnnual PensionIncrease?What is theamount of theSurviving SpousePension?What is theamount of theSurviving SpousePension AnnualIncrease?3% of the original amount The lower of 3% or one-half of the increase inthe Consumer Price Index (urban) for thepreceding year of the original amount.The first January following your retirementeffective date. For the first year theincrease is prorated for an effective dateother than January 1.50% of the pension you had earned at thedate of death.3% of the original amount, which ispayable each year on January 1.If the CPI decreases or is zero, no increase ispaid.Your first increase is not paid until the later ofage 67 or after one year of receiving yourpension.66-2/3% of the pension you had earned at thedate of death.The lower of 3% or one-half of the increase inthe Consumer Price Index (urban) for thepreceding year of the original amount.If the CPI decreases or is zero, no increase ispaid.The increase is payable each year onJanuary 1.How can youqualify for anEarly RetirementIncentive?Your employer’s governing body mustpass an ERI resolution.You must be at least age 50 and have20 years of service.You can purchase between onemonth and five years of service. Thisincreases your age and service forretirement calculation purposes. Your employer’s governing body mustpass an ERI resolution. You must be at least age 57 and have 20years of service. You can purchase between one monthand five years of service. This increasesyour age and service for retirementcalculation purposes.What About VoluntaryAdditionalContributions?What is the LumpSum Death Benefit(active member)?You may contribute up to an additional10% of your salary.One year’s salary plus any balance in themember’s account.You may contribute up to an additional 10%of your salary (up to the wage cap).One year’s salary (up to the wage cap) plusany balance in the member’s account.What stays thesame?Member contribution ratePension formula13th PaymentSurvivor benefits (except as noted above)Disability BenefitsMoney Purchase formulaUpdated December 2013 Page 2 of 2

IMRF MEMBER INFORMATIONCOMPARING TIER 1 AND TIER 2 – SLEP QRCComparing Tier 1 and Tier 2 – IMRF SLEP PlanNote: County Sheriffs who are newly enrolled in IMRF on or after January 1, 2011, and who elect to participatein ECO, will participate in ECO Tier 2.SLEP Tier 1 – SL01SLEP Tier 2 – SL03What makes youeligible?How much servicedo you need tovest?What is yournormal retirementage?What is yourearliest retirementage?Is your SLEPpension reduced?What is includedin your Final Rateof Earnings (FRE)?What is yourmaximum pensionpayable? You are participating in the IMRFSheriff’s Law Enforcement Personnel(SLEP) plan before January 1, 2011. You previously participated in SLEPbefore January 1, 2011 and returnedto SLEP participation at any time(either before or after January 1, 2011).20 years 10 years50 55N/A 50Your SLEP pension is not subject toreductionYour FRE is the average of the highest48 months in your last 10 years ofservice.125% rule applies: Wages for each ofthe last three months cannot be morethan 25% greater than the highestearnings in any of the first 45 months.You are first enrolled in the IMRF Sheriff’s LawEnforcement Personnel (SLEP) plan on or afterJanuary 1, 2011.Note this Exception! Prior participation inRegular IMRF or in a reciprocal retirementsystem before January 1, 2011, will NOT makeyou eligible for SLEP Tier 1.Your SLEP pension is reduced 1/2% for eachmonth under age 55.Your FRE is the average of the highest 96months in your last 10 years of service.125% rule applies: Wages for each of the lastthree months cannot be more than 25% greaterthan the highest earnings in any of the first 93months.80% of final rate of earnings. 75% of final rate of earnings.What is your Capon ReportableWages?What is the Limiton your ReportableWages ?None for members first participatingbefore January 1, 1996.$260,000 annually (in 2014) for allothers.None.The 2014 cap is $110,631.26; this amount automaticallyincreases annually by the lesser of 3%~OR~ by one-half of the annual increase in theConsumer Price Index (urban) for the 12months ending in September of the precedingyearIf the CPI decreases or is zero, the wage cap isnot increased.Compensation for overtime is not included inreportable wages.Updated December 2013 Page 1 of 2

IMRF MEMBER INFORMATIONWhat is theamount of yourAnnual PensionIncrease?When are youeligible for anAnnual PensionIncrease?What is theamount of theSurviving SpousePension?What is theamount of theSurviving SpousePension AnnualIncrease?How can youqualify for anEarly RetirementIncentive?What is the LumpSum Death Benefit(active member)?3% of the original amountThe first January following yourretirement effective date. For the firstyear the increase is prorated for aneffective date other than January 1.50% of the pension you had earned atthe date of death.3% of the original amount, which ispayable each year on January 1. Your employer’s governing body mustpass an ERI resolution. You must be at least age 50 and have20 years of service. You can purchase between onemonth and five years of service. Thisincreases your age and service forretirement calculation purposes.One year’s salary plus any balance in themember’s account.COMPARING TIER 1 AND TIER 2 – SLEP QRCThe original amount is increased by the lower of 3%~OR~ one-half of the annual increase in theConsumer Price Index (urban) for the 12months ending in September of the precedingyearIf the CPI decreases or is zero, no increase ispaid.Your increase is not paid until January 1 on orafter the later of : age 60~OR~ one year of receiving your pension66-2/3% of the pension you had earned at thedate of death.The original amount is increased by the lower of 3%~OR~ one-half of the annual increase in theConsumer Price Index (urban) for the 12months ending in September of the precedingyearIf the CPI decreases or is zero, no increase ispaid.The increase is payable each year on January 1on or after the spouse reaches age 60. Your employer’s governing body must passan ERI resolution. You must be at least age 50 and have 20years of service. You can purchase between one month andfive years of service. This increases yourage and service for retirement calculationpurposes.One year’s salary (up to the wage cap) plus anybalance in the member’s account.What stays thesame?Member contribution rate(not charged for wages in excess of thewage cap or for overtime wages)Pension formula13th PaymentDisability Benefits(salary used to calculate benefit subjectto wage cap)Survivor benefits (except as noted above)Money Purchase formulaUpdated December 2013 Page 2 of 2

TIER 2 MEMBER INFORMATION JANUARY 2014Return to Work and Effect onReciprocal Pension (through System “A”) ***Tier 1MembersTier 1 Member returning to an IMRF EmployerTIER 1 IMRF Annuitant Receiving an IMRFpension only (no reciprocity)IMRF annuitant returns to work for an IMRF employerParticipation depends on hourly standard position requirements and employer grandfathering of member!Participating positionIMRF Pension is suspended.Member participates in IMRF.Member is again Tier 1, if participatingin Regular or ECO plansSLEP Exception: If memberparticipates in SLEP and has notpreviously participated in SLEP, themember is Tier 2 SLEPNon-participating positionMember continues to receive IMRF pension.Member does not participate in IMRF.For a member returning to work for an IMRF employer,IMRF participation is determined by the employer’scurrent hourly standard.The only exception is Employer Grandfathering: If themember ever participated for an employer under a 600-Hour Standard, then the member must keep that 600-Hour Standard for that employer, even if that employernow has a 1,000-Hour Standard.TIER 1 IMRF Annuitant Receiving IMRF ~and~Participation depends on hourly standard position requirements and employer grandfathering of member!Participating positionEntire Pension is suspended.Member participates in IMRF.Member is again Tier 1, if participatingin Regular or ECO plansSLEP Exception: If memberparticipates in SLEP and has notpreviously participated in SLEP, themember is Tier 2 SLEPNon-participating positionMember continues to receive IMRF pension.Member does not participate in IMRF.For a member returning to work for an IMRF employer,IMRF participation is determined by the employer’scurrent hourly standard.The only exception is Employer Grandfathering: If themember ever participated for an employer under a 600-Hour Standard, then the member must keep that 600-Hour Standard for that employer, even if that employernow has a 1,000-Hour Standard.Members must check with reciprocal systems aboutparticipation requirements, return to work and anypension suspension.*** If member has reciprocal service, member should contact all systems about participation, pensionsuspension and other possible requirements, regardless of whether member retired reciprocally.Public Act 98-0389, effective August 16, 2013, changes the return-to-work enrollment rules forretirees. For further information, please see http://www.imrf.org/retirees/retiree-return-to-workchart.pdf. ALWAYS call IMRF before considering a return to work for an IMRF employer.RETURN TO WORK AND EFFECT ON MEMBER TIER QRC Page 1 of 4

TIER 2 MEMBER INFORMATION JANUARY 2014Return to Work and Effect onReciprocal Pension (through System “A”) ***Tier 1MembersTier 1 Member returning to a RECIPROCAL EmployerTIER 1 IMRF Annuitant Receiving anIMRF pension only (no recip)IMRF annuitant returns to work for a reciprocal systemMembers must check with reciprocal systems about participation requirements!Participating positionMember continues to receive IMRF pension.Member participates in reciprocal system.Member is again Tier 1Tier 2 Legislation Exception:If member initially participates in GARS orJRS after 01/01/2011, member is Tier 2 atthat system.Non-participating positionMember continues to receive IMRFpension.Member does not participate in reciprocalsystem.Members must check with reciprocalsystems about their participationrequirements, return to work and anypension suspension.Members must check with reciprocal systems about participation requirements!Participating position in System “A”Non-participating positionTIER 1 IMRF Annuitant Receiving IMRF ~and~Entire Pension is suspended.Member is again Tier 1Tier 2 Legislation Exception:If member initially participates in GARS orJRS after 01/01/2011, member is Tier 2 atthat system.Participating position in System “B”Member continues to receive IMRF pension.Member is again Tier 1.Members must check with reciprocal systemsabout their participation requirements, return towork and any pension suspension.Tier 2 Legislation Exception:If member initially participates in GARS orJRS after 01/01/2011, member is Tier 2 atthat system.Member continues to receive IMRFpension.Member does not participate in reciprocalsystem.Members must check with reciprocalsystems about their participationrequirements, return to work and anypension suspension.*** If member has reciprocal service, member should contact all systems about participation, pensionsuspension and other possible requirements, regardless of whether member retired reciprocally.RETURN TO WORK AND EFFECT ON MEMBER TIER QRC Page 2 of 4

TIER 2 MEMBER INFORMATION JANUARY 2014Return to Work and Effect onReciprocal Pension (through System “A” ) ***Tier 2MembersTier 2 Member returning to an IMRF EmployerIMRF annuitant returns to work for an IMRF employerTIER 2 IMRF Annuitant Receivingan IMRF pension only (no recip)Participation depends on hourly standard position requirements and employer grandfathering of member!Participating positionIMRF Pension is suspended.Member participates in IMRF.Member is Tier 2.Non-participating positionMember continues to receive IMRF pension.Member does not participate in IMRF.For a member returning to work for an IMRF employer,IMRF participation is determined by the employer’scurrent hourly standard.The only exception is Employer Grandfathering: If themember ever participated for an employer under a 600-Hour Standard, then the member must keep that 600-Hour Standard for that employer, even if that employernow has a 1,000-Hour Standard.TIER 2 IMRF Annuitant Receiving IMRF ~and~Participation depends on hourly standard position requirements and employer grandfathering of member!Participating positionEntire Pension is suspended.Member participates in IMRF.Member is Tier 2.IMPORTANT!Public Act 97-0609 suspendsthe pension of a Tier 2member – first participatingon or after 01/01/2012 – whoperforms services on acontractual basis with aformer IMRF employer.Non-participating positionMember continues to receive IMRF pension.Member does not participate in IMRF.For a member returning to work for an IMRF employer,IMRF participation is determined by the employer’scurrent hourly standard.The only exception is Employer Grandfathering: If themember ever participated for an employer under a 600-Hour Standard, then the member must keep that 600-Hour Standard for that employer, even if that employernow has a 1,000-Hour Standard.*** If member has reciprocal service, member should contact all systems about participation, pensionsuspension and other possible requirements, regardless of whether member retired reciprocally.Public Act 98-0389, effective August 16, 2013, changes the return-to-work enrollment rules forretirees. For further information, please see http://www.imrf.org/retirees/retiree-return-to-workchart.pdf. ALWAYS call IMRF before considering a return to work for an IMRF employer.RETURN TO WORK AND EFFECT ON MEMBER TIER QRC Page 3 of 4

TIER 2 MEMBER INFORMATION JANUARY 2014an IMRF pension only (no recip) ***Reciprocal Pension (through System “A” ) ***Return to Work and Effect onTier 2MembersTier 2 Member returning to a RECIPROCAL EmployerTIER 2 IMRF Annuitant ReceivingIMRF annuitant returns to workfor a reciprocal system – Excluding Judges RS and General Assembly RSMembers must check with reciprocal systems about participation requirements!Full-time positionIf “full-time” and formerly participated in Regular plan:Member’s pension is suspended.Note: SLEP exception – SLEP Tier 2 members do nothave the Return to Work limitations that Regularmembers have.Part-time positionMember continues to receive IMRFpension.Note: A member who first joinedIMRF on or after 01/01/2012 and whoreturns as a contractor to sameemployer from which they retired willhave their pension suspended.TIER 2 IMRF Annuitant Receiving IMRF ~and~Members must check with reciprocal systems about participation requirements!Participating position in System “A”Member’s entire pension is suspended.Member participates.Participating position in System “B” (a third reciprocal system)If “full time” and formerly participated in Regular plan- Member’s entire pension is suspended.- Member participates.- Member is Tier 2.If not “full time” and formerly participated in Regular plan- Member continues to receive IMRF pension.- Member participates in reciprocal system.- Member is Tier 2.Non-Participatingposition- If “full time” andmember formerlyparticipated in Regularplan:Member’s pension issuspended.- If part-time andmember formerlyparticipated in Regularplan:Member continues toreceive IMRF pension.Note: SLEP exception – SLEP Tier 2 members do not have theReturn to Work limitations that Regular members have.Note: Returning to Work “full-time” or “not full-time” is a determining factor for suspending a Tier 2 member’spension, but not necessarily for participation.*** If member has reciprocal service, member should contact all systems about participation, pensionsuspension and other possible requirements, regardless of whether member retired reciprocally.RETURN TO WORK AND EFFECT ON MEMBER TIER QRC Page 4 of 4

Illinois Municipal Retirement FundPublic Act 98-0389 Return-to-Work Rules: A guide for Retired MembersEffective August 16, 2013Please note: This chart outlines the new rules implemented by Public Act 98-­‐0389 only. Additional return-­‐to-­‐work rules may apply to your situation—ALWAYS call IMRF before considering a return to work for an IMRF employer.If you return to work for an IMRF employer: In a position that qualifies for IMRF participationYou are immediately enrolled in IMRF and your pension is suspended.In a position not expected to qualify for IMRF participationIn the 12 months following the date of employment:You work below 599/999 hoursYou reach 599/999 hoursYour pension payments continue.If you want your pension payments to continue, you would:• Stop working for that employer until the one yearanniversary of your employment date• On that date, your return to work period is reset for thenext 12 months.• You could return to work for that employer again afterthis date until you again reach 599/999 hours in thefollowing 12 months.You work 600/1,000 hours or more • You are re-enrolled in IMRF.• Your pension payments are suspended until you stopworking for the employer.• Once you stop working for that employer and your pensionpayments resume, the earliest date you could return to workfor that same employer without stopping your pension is oneyear from the last date of employment.For example, if you left your employer on October 2, 2014,the earliest you could return to work for that employerwithout an effect on your pension would be October 2, 2015.• If you return to work for that same employer sooner than oneyear• You must be re-enrolled in IMRF immediately regardlessof expected hours of your position and• Your pension payments are again suspended.You unexpectedly work 600/1,000hours or moreIf you want your pension payments to continue, you would:• Immediately terminate your employment relationship withthat employer. You must terminate employment in thesame month you exceed 599/999 hours.• If you continue working, you will be re-enrolled in IMRFand your pension payments stopped. (See above rulesunder, "You work 600/1,000 hours or more.")Revised December 19, 2013

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