RCUH Policies and Procedures
of the University of Hawai‘i
Human Resources Department
Supplemental Retirement Annuity – Agreement for Salary Reduction Form
IMPORTANT NOTICE: Prior to submitting this form to RCUH, you will need to first enroll in an Supplemental Retirement Annuity (SRA) account online with TIAA-CREF. Please go to http://www1.tiaa-cref.org/tcm/rcuh to create an account.
Employee Name: RCUH Employee ID #:
Salary Reduction Election
☐ _______% Fixed percentage per pay period
☐ $______ Fixed amount per pay period
☐ Maximum allowable (Based on IRS Regulations for Calendar Year)
(Mo) (1st or 16th) (Yr)
*RCUH may change start date as necessary due to PAF deadline.
Agreement of Terms and Conditions
By this AGREEMENT made between the Employee named above, and the RESEARCH CORPORATION OF THE UNIVERSITY OF HAWAII, hereinafter referred to as the RCUH, the parties hereto agree as follows:
1. The RCUH agrees to make the initial premium payment and all successive premium payments so long as this Agreement is in force. The Employee shall be responsible for compliance with the provisions of Section 403(b), the limitations of Section 415, or the limitations of Section 402(g) of the United States Internal Revenue Code, as amended, to include, but not limited to, compliance with the maximum exclusion allowance provisions.
2. This Agreement supersedes any other previously executed Agreement for Salary Reduction.
3. The Employee releases all rights, present and future, to receive any or all of the amounts to be used by the RCUH
as premium payments in any other form except as such right might accrue under the Tax-Sheltered Annuity
4. This Agreement shall be legally binding and irrevocable as to each of the parties hereto while employment
continues; provided, however, that from the effective date hereof either party may terminate this Agreement as of the end of the pay period so that it will not apply to salary subsequently earned, by giving written notice of such termination in accordance with RCUH policies and procedures governing reduction of income for SRAs.
5. It is the Employee’s responsibility to coordinate maximum allowable benefits with any multiple tax sheltered annuities under another Employer to ensure they do not exceed the IRS limit.
6. Employees who are at least 50 years of age during the current calendar year will be eligible to elect in the catch-up option that is based on their age (IRC Section 414(v)).
Employee Signature: Date:
Submit via email: RCUH_Benefits@RCUH.com or Fax: 808-956-5022
RCUH Form B-6
Created 05/25/2004, (Revised 03/2011, 06/2012, 07/31/2012, 02/11/2014, 03/11/2014, 09/26/2014, 03/30/16)
For RCUH Use Only
☐ Enrolled in TIAA-CREF SRA account Data Entry Initial/Date ____________
Data Entry Special Instructions: ________________________ Edited By Initial/Date ____________