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Saving for Retirement
What is a Tax Deferred Plan?
403(b) and 457(b) plans are retirement plans that allow participants to contribute pre-taxed dollars to annuity contracts or custodial accounts (mutual funds). The employee elects to
make contributions by use of a Salary Reduction Agreement. Earnings on these contributions are also tax deferred; however the contributions are subject to FICA at the time they are contributed. Dearborn Public Schools sponsors both type of plans. Contributions to these plans are invested only in certain funding vehicles. These are limited to annuity contracts and custodial accounts. Insurance companies offer annuities. Custodial accounts are only allowed to invest in mutual funds. Following is an example of tax savings that can be achieved using a Tax Deferred Plan.
Example: Without 403(b) With 403(b)
$40,000 $40,000 $0 $5,000 $40,000 $35,000 $6,000 $5,250 $2,800 $2,450 $8,800 $7,700 $1,100
Income 403(b)/457(b) Deduction Taxable Income Federal Tax (15%) State Tax (7%) Total Taxes Tax Savings
Who is Eligible to Participate
Dearborn Public Schools sponsors both a 403(b) and a 457(b) plan. Every employee
who performs services for Dearborn Public Schools is eligible to participate in either or both plans.
Contribution Limits
In the calendar year of 2016, all eligible employees have a base limit of $18,000. Any employee age 50 or over qualifies for a catch up of an additional $6,000 per year (2016 amount) to each plan. Depending upon your personal circumstances, you may be eligible for catch-up contributions. The contact person listed or your financial advisor can assist you in determining your personal limit.
How to Participate
The employee, after choosing a vendor from the attached lists, is responsible for contacting the vendor to open an account. Once the account has been established the employee must complete and submit the applicable OMNI SALARY REDUCTION
AGREEMENT FORM (SRA) (403(b) or 457) to the OMNI Group, Third Party Administrator for Dearborn Public Schools.
X:\Tax Shelters\Word Documents\OMNI Contact Information(January 2016).doc 1/22/16
403b & 457 Information Contact Information
THE
OMNI GROUP Water Tower Park 1099 Jay Street, Building F, 2nd Floor Rochester, NY 14611
Third-Party Administrator for Dearborn Public Schools 403b and 457 Plans
Website: www.omni403b.com Phone: 877.544.OMNI (6664) Fax Numbers: For Salary Reduction Agreements 585.436.3633 For All Other Forms 585.756.5557 Starting a New 403b or 457 Deduction
It is your responsibility to establish an account with a participating provider.Instructions to start a payroll deduction must then be sumitted to the OMNI Group using either a 403b or 457 Salary Reduction Agreement form. OMNI will
confirm that an appropriate account has been established and give the Payrolloffice instructions as to when to start the deduction. Please allow up to 2 payperiods for this to occur. Changing, Stopping or Restarting an Existing Deduction Instructions to change, stop or resume an existing deduction must be submitted to OMNI by entering the information on the Dearborn Public Schools Client Home Page on the OMNI website, http://omni403b.com/ or by submitting a Salary Reduction Agreement form (available online or from the Payroll office) by fax or U.S. Mail. OMNI will communicate the information to Payroll. Please allow up to 2 pay periods for this to occur. Distribution of Funds from an Existing Account As third party administrator, OMNI is to receive all requests for rollovers and distributions of any kind at the fax number listed above. Participants should allow processing time of 24 hours before contacting OMNI with questions on any forms submitted.
January 2016
Account Maintenance (PIN Reset, address changes, statements, etc.) and General Information 800.343.0860 or through the Fidelity website at www.fidelity.com/atwork
New Accounts, Transfers/Rollovers, Account Consolidation or Reviews of Account Portfolios Paul Schmidt 734.478.5982 [email protected]
Joe Banach Cell 248.250.8314 Office 877.891.769.4032 [email protected]
Bill Dolunt 800.892.5558 ext 87358 Cell 734.891-7325
Craig Nikischer 800.892.5558 ext 87996 Cell 734.476.9633
Gary Niemczak Direct 1.734.464.0907 Office 1.800.232.2383 [email protected]
OFFICE OF BUSINESS SERVICES/PAYROLL DEPARTMENT DEARBORN PUBLIC SCHOOLS 403(B) PLAN
403b TAX SHELTER RULES
Contacts with the companies listed below are the personal responsibility of the employee. No deductions will be made without authorization from The OMNI Group, our third party administrator. The general limit for 2016 is $18,000.
403b PLANS CONTACT
Jim Thorpe 313.216.0132 [email protected]
Joanne Hardin 313.213.0125 [email protected]
Brian Mosallam 313.712.5300 [email protected] Tom Tafelski 313.718.1066
[email protected] Gehad Alawan 313.506.0456
[email protected] Badri Jawad 313.418.4664 [email protected] Rich Gilbertson 734.560.3148 [email protected]
Keith Kaminski 248.227.6650
January 2016
Joe Banach Cell 248.250.8314 Office 877.769.4032
John Fleming Office 1.734.525.4560
Bill Dolunt 800.892.5558 ext 87358 Cell (734) 891-7325 [email protected]
Craig Nikischer 800.892.5558 ext 87996 Office (734) 975-1756 [email protected]
1.800.842.2776 www.tiaa-cref.org
Gary Niemczak Direct 1.734.464.0907 Office 1.800.232.2383
OFFICE OF BUSINESS SERVICES/PAYROLL DEPARTMENT DEARBORN PUBLIC SCHOOLS 457(b) PLAN
Contacts with the companies listed below are the personal responsibility of the employee. No deductions will be made without
authorization from The OMNI Group, our third party administrator. The general limit for 2016 is $18,000.
457 Plans CONTACT PERSON
Jim Thorpe 313.216.0132 [email protected]
Joanne Hardin 313.216.0125
Brian Mosallam 313.712.5300 [email protected]
Tom Tafelski 313.718.1066 [email protected] Gehad Alawan 313.506.0456 [email protected] Badri Jawad 313.418.4664
[email protected] Rich Gilbertson 734.560.3148
[email protected] Keith Kaminski
403(b) SALARY REDUCTION AGREEMENT FORM (SRA) For Tax Sheltered Annuities and Custodial Accounts
403(b)Please supply the information requested below.■
■ Read all agreements on this form before submitting.■ Fields having an asterisk notation are required.IMPORTANT NOTICE: Before You Sign, Read All Information on this form:A Tax Sheltered Annuity (“TSA”) is an investment account that is set aside for your retirement (only), and is paid for with “pre-tax” dollars. A Custodial Account (“CA”) is the group or individual custodial account or accounts, established for each Employee, by the Employer, or by each Employee individually, to hold assets of the Plan. Unless utilizing the catch-up provisions, your Maximum Allowable Contribution (“MAC”) cannot exceed $18,000 ($24,000 if age 50 or over). Both TSA & CA receive tax deferred treatment.
Part 1: Employee InformationPlease check here if you have contributed to another 403(b) or 401(k) plan with another employer this calendar year. If so, please provide the
$ and the name of theamount of the year-to-date contributions you have made to the other employer's plan:
other employer:* Social Security Number: * First Name: * Last Name: MI:
*Address:
City: Zip:State: * **
Email address:* Date of Birth: * Phone: *
Part 2: Employer Information* Full Organization Name, City and State: * Date of Hire: (mm/dd/yyyy)
Part 3: Contribution InformationOPTION 1: Recurring Contributions
WARNING!!! Any new recurring contributions will supercede all current recurring contributions to your employer's 403(b) plan administered by OMNI. If you are currently contributing to multiple service providers under your employer's 403(b) plan, please be sure to list all contributions you wish to continue. Any active 403(b) contributions found in our records, but not listed below WILL BE DISCONTINUED.Also, a contribution may be discontinued by listing it below with an amount of zero.Please withhold funds from my pay for the following 403(b) contributions until further notice: Percent Per
Pay Period OREffective Date Plan Type Service Provider Amount Per Pay Account # 403(b) ROTH 403(b)
403(b) ROTH 403(b)
403(b) ROTH 403(b)
403(b) ROTH 403(b)
403(b) ROTH 403(b)
If you have requested a percentage amount for any of the contributions above, please supply:Your Annual Salary: Number of Pay Periods Per Year:
Please check here if you are NOT a full-time employee After this contribution, any 403(b) recurring contributions to this service provider should be:
OPTION 2: One-Time Contributions (Elective Contributions Only)Service Provider Effective Date Account # Amount
403(b) ROTH 403(b) DISCONTINUED RESUMED
403(b) ROTH 403(b) DISCONTINUED RESUMED
403(b) ROTH 403(b) DISCONTINUED RESUMED
403(b) ROTH 403(b) DISCONTINUED RESUMED
403(b) ROTH 403(b) DISCONTINUED RESUMED
Please check here if you are NOT a full-time employee
OPTION 3: Participation Opt OutI do not wish to participate at this time. I understand that I may participate in the future simply by filling out a new Salary Reduction Agreement form.
© 2015 The OMNI Group | 403(b) Salary Reduction Agreement, Effective 01/01/15, Page One of Two Continued on next page...
Plan Type
Part 4: Agreements and AcknowledgementsThe above named Employee where applicable, agrees as follows:
1. To modify his/her salary reduction as indicated above.2. That his/her Employer transfers the above stated funds on Employee’s behalf to OMNI for remittance to the selected Service Provider(s).3. This SRA is legally binding and irrevocable with respect to amounts paid.4. This SRA may be changed with respect to amounts not yet paid.5. This SRA may be terminated at any time for amounts not yet paid or available, and that a termination request is permanent and remains in
effect until a new SRA is submitted.6. (a) That OMNI does not choose the annuity contract or custodial account in which your contributions are invested.
(b) OMNI does not endorse any authorized Service Provider, nor is it responsible for any investments.(c) OMNI makes no representation regarding the advisability, appropriateness, or tax consequences of the purchase of the TSA
and/or CA described herein. (d) (i) OMNI shall not have any liability whatsoever for any and all losses suffered by Employee with regard to his/her selection of the
TSA and/or CA, its terms, the selection of any service provider, the financial condition, operation of or benefits provided by said service provider, or his/her selection and purchase of shares by any service provider. Nothing herein shall affect the terms of employment between Employer and Employee. (ii) Employee acknowledges that Employer has made no representation to Employee regarding the advisability, appropriateness, or tax consequences of the purchase of the annuity and/or custodial account described herein. (iii) The Employer shall not have any liability for any and all losses suffered by an Employee with regard to the selection(s) of any TSA and/or CA, any related terms and conditions, the selection of any service provider, the financial condition, operation of or benefits provided by any service provider or the selection and purchase of shares by any service provider. 7. To be responsible for setting up and signing the legal documents necessary to establish a TSA or CA.8. To be responsible for naming a death beneficiary under their TSA or CA. This is normally done at the time the contract or account is
established. Beneficiary designations should be reviewed periodically.9. When provided all required information in a timely manner, OMNI is responsible for determining that salary reductions do not exceed the
allowable contribution limits under applicable law, and will complete MAC calculations as required by law.10. To contact OMNI and complete the appropriate OMNI forms for any requests for distributions, loans, hardship withdrawals, account exchanges
plan-to-plan transfers or rollover contributions. Processing fees for the foregoing transactions may apply.11. This SRA is subject to the terms of the Services Agreement between OMNI and Employer, and to the Information Sharing Agreement
between OMNI and the Service Providers. 12. This agreement supercedes all prior salary reduction agreements and shall automatically terminate if Employee’s employment is terminated.
Part 5: Employee Signature (Mandatory)I certify that I have read this complete agreement and that my requested salary reduction(s), if in excess of my base limit, represent(s) my wish to utilize any catch-up provisions for which I may be eligible. I further certify that my salary reductions do not exceed contribution limits as determined by applicable law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the TSA or CA established by me under the Plan are enforceable solely by my beneficiary, my authorized representative or me.
Part 6: Acknowledgement and Representation of Sales Agent/Representative (If Applicable)I agree to comply with all pertinent written directives regarding the solicitation of Employee. A calculation of maximum allowance will be provided annually for Employee contributing more than $18,000 ($24,000 if over 50) or utilizing the “catch-up provisions”. Furthermore, my employer (name)__________________________________________________ agrees to indemnify and hold harmless the Employer, any individual member of the governing board and the Employee participating in the 403(b) Program against any claims based on an error in the MAC I provided, except where the error is based upon erroneous information provided by Employer or Employee. Additionally, I will notify OMNI regarding any distributions or loans to participants.
Part 7: Employer Acknowledgement (If Applicable)
Please return this agreement to The OMNI Group, unless otherwise advised by your employer: The OMNI Group
Water Tower Park • 1099 Jay Street, Building F • Rochester, NY 14611 Toll Free: (877) 544-OMNI ® • Fax: (585) 672-6194 Please visit our website at www.omni403b.com
© 2015 All rights reserved. No part of this SRA may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from The OMNI Group. Requests for permission to reproduce content should be directed to [email protected].
© 2015 The OMNI Group | 403(b) Salary Reduction Agreement, Effective 01/01/15, Page Two of Two
OMNI ® is a registered service mark of OMNI Financial Group, Inc. d/b/a The OMNI Group
Employee Signature: Date:
Sales Agent/Representative Name: Phone:
Address:
Signature: Date:
Employer Name & Title:
Employer Signature: Date:
Salary: Effective Payroll Date:# of TSA/CA Pay Periods:
457 SALARY REDUCTION AGREEMENT FORM (SRA) For Tax Sheltered Annuities and Custodial Accounts
457Please supply the information requested below.■■ Read all agreements on this form before submitting.■ Fields having an asterisk notation are required.IMPORTANT NOTICE: Before You Sign, Read All Information on this form:A Tax Sheltered Annuity (“TSA”) is an investment account that is set aside for your retirement (only), and is paid for with “pre-tax” dollars. A Custodial Account (“CA”) is the group or individual custodial account or accounts, established for each Employee, by the Employer, or by each Employee individually, to hold assets of the Plan. Unless utilizing the catch-up provisions, your Maximum Allowable Contribution (“MAC”) cannot exceed $18,000 ($24,000 if age 50 or over). Both TSA & CA receive tax deferred treatment.
Part 1: Employee InformationPlease check here if you have contributed to a 457 plan with another employer this calendar year. If so, please provide the
$ and the name of theamount of the year-to-date contributions you have made to the other employer's plan:
other employer:* Social Security Number: * First Name: * Last Name: MI:
*Address:
City: Zip:State: * **
* * *Date of Birth: Phone: Email address:
Part 2: Employer Information* Full Organization Name, City and State: * Date of Hire: (mm/dd/yyyy)
Part 3: Contribution InformationOPTION 1: Recurring ContributionsWARNING!!! Any new recurring contributions will supersede all current recurring contributions to your employer's 457 plan administered by OMNI. If you are currently contributing to multiple service providers under your employer's 457 plan, please be sure to list all contributions you wish to continue. Any active 457 contributions found in our records, but not listed below WILL BE DISCONTINUED.If you simply wish to discontinue a contribution, fill in an amount of zero.Please withhold funds from my pay for the following 457 contributions until further notice: Percent Per
Pay Period OREffective Date Plan Type Service Provider Amount Per Pay Account # 457 ROTH 457
ROTH 457457
ROTH 457457
ROTH 457457
If you have requested a percentage amount for any of the contributions above, please supply:Your Annual Salary: Number of Pay Periods Per Year:
Please check here if you are NOT a full-time employee After this contribution, any 457 recurring contributions to this service provider should be:
OPTION 2: One-Time Contributions (Elective Contributions Only)Effective Date Service Provider Account # Amount Plan Type
457 ROTH 457 DISCONTINUED RESUMED
DISCONTINUED RESUMED457 ROTH 457
ROTH 457 DISCONTINUED RESUMED457
457 ROTH 457DISCONTINUED RESUMED
Please check here if you are NOT a full-time employee OPTION 3: Participation Opt Out
I do not wish to participate at this time. I understand that I may participate in the future by filling out a new Salary Reduction Agreement form.
© 2015 The OMNI Group | 457 Salary Reduction Agreement, Effective 01/01/15, Page One of Two Continued on next page...
Part 4: Agreements and AcknowledgementsThe above named Employee where applicable, agrees as follows:
1. To modify his/her salary reduction as indicated above.2. That his/her Employer transfers the above stated funds on Employee’s behalf to OMNI for remittance to the selected Service Provider(s).3. This SRA is legally binding and irrevocable with respect to amounts paid.4. This SRA may be changed with respect to amounts not yet paid.5. This SRA may be terminated at any time for amounts not yet paid or available, and that a termination request is permanent and remains in
effect until a new SRA is submitted.6. (a) That Omni does not choose the annuity contract or custodial account in which your contributions are invested.
(b) Omni does not endorse any authorized Service Provider, nor is it responsible for any investments.(c) Omni makes no representation regarding the advisability, appropriateness, or tax consequences of the purchase of the TSA
and/or CA described herein. (d) (i) Omni shall not have any liability whatsoever for any and all losses suffered by Employee with regard to his/her selection of the
TSA and/or CA, its terms, the selection of any service provider, the financial condition, operation of or benefits provided by said service provider, or his/her selection and purchase of shares by any service provider. Nothing herein shall affect the terms of employment between Employer and Employee. (ii) Employee acknowledges that Employer has made no representation to Employee regarding the advisability, appropriateness, or tax consequences of the purchase of the annuity and/or custodial account described herein. (iii) The Employer shall not have any liability for any and all losses suffered by an Employee with regard to the selection(s) of any TSA and/or CA, any related terms and conditions, the selection of any service provider, the financial condition, operation of or benefits provided by any service provider or the selection and purchase of shares by any service provider.. 7. To be responsible for setting up and signing the legal documents necessary to establish a TSA or CA.8. To be responsible for naming a death beneficiary under their TSA or CA. This is normally done at the time the contract or account is
established. Beneficiary designations should be reviewed periodically.9. When provided all required information in a timely manner, Omni is responsible for determining that salary reductions do not exceed the
allowable contribution limits under applicable law, and will complete MAC calculations as required by law.10. To contact Omni to start the process on any requests for loans, hardship withdrawals, account exchanges or plan-to-plan transfers.11. This SRA is subject to the terms of the Services Agreement between Omni and Employer, and to the Information Sharing Agreement
between Omni and the Service Providers.12. This agreement supersedes all prior salary reduction agreements and shall automatically terminate if Employee’s employment is terminated.
Part 5: Employee Signature (Mandatory)I certify that I have read this complete agreement and that my requested salary reduction(s), if in excess of my base limit, represent(s) my wish to utilize any catch-up provisions for which I may be eligible. I further certify that my salary reductions do not exceed contribution limits as determined by applicable law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the TSA or CA established by me under the Plan are enforceable solely by my beneficiary, my authorized representative or me.
Part 6: Acknowledgement and Representation of Sales Agent/Representative (If Applicable)
Part 7: Employer Acknowledgement (If Applicable)
Please return this agreement to The Omni Group, unless otherwise advised by your Employer: The OMNI Group
Water Tower Park • 1099 Jay Street, Building F • Rochester, NY 14611 Toll Free: (877) 544-OMNI ® • Fax: (585) 672-6194 Please visit our website at www.omni403b.com
© 2015 All rights reserved. No part of this SRA may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the Omni Group. Requests for permission to reproduce content should be directed to [email protected] ® is a registered service mark of Omni Financial Group, Inc. d/b/aThe Omni Group
© 2015 The OMNI Group | 457 Salary Reduction Agreement, Effective 01/01/15, Page Two of Two
Employee Signature: Date:
I agree to comply with all pertinent written directives regarding the solicitation of Employee. A calculation of maximum allowance will be provided annually for Employee contributing more than $18,000 ($24,000 if over 50) or utilizing the “catch-up provisions”. Furthermore, my employer (name)__________________________________________________ agrees to indemnify and hold harmless the Employer, any individual member of the governing board and the Employee participating in the 457 Program against any claims based on an error in the MAC I provided, except where the error is based upon erroneous information provided by Employer or Employee. Additionally, I will notify OMNI regarding any distributions or loans to participants.
Sales Agent/Representative Name: Phone:
Address:
Signature: Date:
Employer Name & Title:
Employer Signature: Date:
Salary: Effective Payroll Date:# of TSA/CA Pay Periods:
