QPSA Waiver
(Spousal Consent) (Defined Benefit Plan)

This is a template used to consent to the waiver of a qualified preretirement survivor annuity (QPSA) benefit in a defined benefit plan by the spouse of a plan participant who is electing not to have the mandatory default spousal survival benefit apply in accordance with the requirements under I.R.C. § 417(a). This template contains practical guidance, drafting notes, and alternate and optional clauses. Use this template with the QPSA Notice (Defined Benefit Plan), which explains the QPSA benefit to plan participants and their election rights regarding the benefit as required under I.R.C. § 417(a)(3)(B). The QPSA rules (and rules regarding qualified joint and survivor annuities (QJSAs)).apply to all defined benefit plans (including cash balance plans), money purchase pension plans, and certain defined contribution plans. I.R.C. § 401(a)(11)(A); Treas. Reg. § 1.401(a)-20, Q&A-3; ERISA § 205(b) (29 U.S.C. § 1055(b)). These plans must provide as a default for a QPSA form of benefit payable to a married participant's surviving spouse upon the death of the participant before his or her retirement date. The QPSA benefit for married participants must be in the form of a life annuity having an actuarially equivalent value that is at least equal to 50% of the participant's accrued plan benefit, commencing as of the earliest retirement age the participant could have begun receiving retirement benefits under the plan. I.R.C. § 417(c); ERISA § 205(e) (29 U.S.C. § 1055(e)). The survivor annuity rules permit a participant to waive a QJSA to elect another form of retirement benefit and to waive the right to a QPSA, but only if the participant's spouse signs a consent form. This consent form must acknowledge the effect of the waiver and be witnessed by a plan representative or notary public. I.R.C. § 417(a)(2)(A).)). This form is designed to satisfy the spousal consent requirement and is based upon a model consent provided in I.R.S. Notice 97-10. Historically, the spouse needed to sign a QPSA consent waiver in the physical presence of the plan representative or notary, but proposed regulations, which may be relied upon pending finalization, provide for alternative procedures for remote witnessing via an electronic system using audio-video communications. See Prop. Treas. Reg. § 1.401(a)-21(d)(6) (87 Fed. Reg. 80,501 (Dec. 30, 2022)). Temporary relief from the physical presence requirement that was available during the period from January 1, 2020, through December 31, 2022, due to the novel coronavirus (COVID-19) pandemic has expired. See I.R.S. Notice 2020-42, most recently extended by I.R.S. Notice 2022-27. However, the proposed regulations noted above largely adopt the same procedures employed in the Notice guidance with an additional recordkeeping requirement. For a discussion of the QJSA/QOSA/QPSA rules, see Beneficiary Designations in Qualified Retirement Plans — Survivor Annuity Rules. For a discussion about the spousal consent requirements, see Beneficiary Designations in Qualified Retirement Plans — Spousal Consent under the Survivor Annuity Rules. For a template providing for the explanation of the QPSA, see QPSA Notice (Defined Benefit Plan). For similar templates related to a QJSA, see QJSA Notice (Defined Benefit Plan) and QJSA Waiver (Spousal Consent) (Defined Benefit Plan).