How to Fill Out and Submit the Empower QDRO Form

Dividing an Empower-administered retirement account in a divorce runs through a Qualified Domestic Relations Order, and the cleanest way to produce one is to use the Empower QDRO form built for your specific plan. Empower offers a model template for most of the plans it recordkeeps, written in language the administrator has already approved, which cuts down sharply on the back-and-forth that derails generic orders.¹ The work breaks into four stages: get the model, fill it out, send the unsigned draft to Empower for pre-approval, then have the judge sign and return a certified copy.

How to Get Empower’s Model QDRO

Call an Empower Service Center representative and ask for the model QDRO that matches your plan. Some employers also post the template in the “Plan Documents” or “Forms” area of the participant’s online dashboard, but availability varies, so the service center is the reliable route.¹

Using the plan’s own model matters more than most people realize. The Department of Labor has noted that many domestic relations orders fail on first submission because they reference benefit formulas, loan rules, or payment options that don’t match the actual plan.² A template pulled from a legal forms site can’t know what your particular Empower plan allows. The model does.

Before you start filling anything in, pull together:

The full legal name of the retirement plan — not just the employer’s name. Empower recordkeeps plans with very specific titles, and “the ABC Company 401(k)” may actually be “the ABC Company Savings and Investment Plan.” Check the Summary Plan Description or an account statement.
Current mailing addresses for both the participant and the alternate payee.
The divorce decree or settlement agreement that sets out how the retirement assets are being divided.

What the Order Must Contain

Federal law sets a short list of items every QDRO has to include, and the Empower form is built around them. Under 26 U.S.C. §414(p)(2) and 29 U.S.C. §1056(d)(3)(C), the order must specify:³

The participant’s name and last known mailing address, and the name and mailing address of each alternate payee.
The dollar amount or percentage of the participant’s benefits going to each alternate payee, or the method for calculating it.
The number of payments or the time period the order covers.
Each retirement plan the order applies to, by name.

Social Security numbers are not on the statutory list. Empower may ask for them on administrative forms to match records, but attorneys sometimes keep them out of the court order itself for privacy reasons.

Filling Out the Key Sections

The model walks you through each required element, but three sections are where drafting problems concentrate.

Defining the Account

You’ll have to say which portion of the participant’s account the order reaches. Some Empower models, such as the one for South Carolina state employees, define the account broadly to include “all amounts maintained under all of the various accounts and/or sub-accounts established on behalf of the Participant, including rollover and transfer contributions.”⁴ Others let you pick specific sources — employer matching contributions, elective deferrals, rollover money. If the settlement divides only certain sub-accounts, the form has to say so exactly.

Setting the Award

You can designate a fixed dollar amount or a percentage. Percentage is more common because account balances move with investment returns between the agreement date and the date the funds actually transfer. If you use a percentage, address whether gains and losses after the valuation date belong to the alternate payee’s share. Silence here is the easiest way to spark a fight months later.

Loans and Survivor Benefits

If the participant has an outstanding plan loan, the parties need to decide whether the loan balance reduces the alternate payee’s award. Not every Empower model addresses loans — the South Carolina model doesn’t — so if the template is silent and a loan exists, language may need to be added. Survivor benefits also vary: some models explicitly exclude joint-and-survivor annuity options for the alternate payee, so confirm the form matches what the settlement intended.

Send the Draft to Empower Before the Judge Signs

This is the step most people miss, and skipping it is the single most expensive procedural mistake. Before any judge signs anything, send the unsigned draft to Empower for a preliminary review. Empower’s team checks the language against both federal requirements and the plan’s own terms, then either issues a pre-approval letter or sends back a notice explaining what needs to change.⁴

Submit the draft by mail or fax to the address on your plan’s model. Commonly referenced contact points include:

Mail: Empower, P.O. Box 173764, Denver, CO 80217-3764.
Fax: The number varies by plan. The South Carolina plan uses (866) 345-3050; the Kansas plan uses (866) 745-5766. Confirm the correct number on your plan’s template.

Published Empower materials don’t commit to a specific review turnaround. In practice it depends on volume and how clean the draft is. If the pre-approval comes back with requested changes, revise and resend. There is no cap on resubmissions, but each round adds time.

Sending a signed court order straight to Empower without pre-approval is the error that costs the most. If the language fails review, the court has to sign a corrected version, which means another hearing, another filing fee, and weeks of delay. Getting the pre-approval letter in hand before the court hearing avoids all of it.

Getting the Order Signed and Returned to Empower

After Empower pre-approves the draft, take it to the state court handling the divorce. The judge signs the order and the clerk issues a certified copy bearing the court’s official stamp or raised seal. Mail or fax that certified copy back to Empower at the same address used for the draft.

Once Empower receives a domestic relations order — or is notified by the plan sponsor that a divorce is pending — it places a distribution restriction on the participant’s account, preventing withdrawals or loans against the disputed portion while the transfer is processed.¹

There is a clock worth knowing about. Under ERISA, the plan administrator must separately account for any amounts that would have been payable to the alternate payee while the order’s qualified status is being determined. If the order is approved within 18 months of when the first payment would have been due, the segregated amounts plus interest go to the alternate payee. If the question isn’t resolved inside that 18-month window, the segregated funds revert to the participant, and any later determination applies only going forward.⁵ That’s a reason to turn around Empower’s requested corrections quickly rather than let a draft sit.

Once the order is formally qualified, Empower creates a “QDRO takeover account” for the alternate payee, moves the awarded assets into it, and processes the distribution per the alternate payee’s instructions.¹ One limitation: Empower cannot establish a takeover account for a minor. In that case the distribution may be made directly from the participant’s account without a separate segregated account.

Why Empower Rejects QDROs

Most first-round rejections come down to a short list of avoidable errors:

Wrong plan name — the order lists the employer or an outdated plan title instead of the exact legal name Empower uses.
Missing or incorrect mailing addresses for the participant or alternate payee. The statute requires them, so leaving them out is an automatic deficiency.²
Ambiguous benefit calculation — no dollar amount, no percentage, no clear formula, or a reference to a benefit structure the plan doesn’t offer.
Conflict with plan terms — the order directs payment in a form the plan doesn’t allow, or on a timeline the plan’s rules don’t permit.

When Empower rejects an order, the notice should identify the specific problems, point to the relevant plan provisions, flag any applicable time limits, and describe what modifications would make the order qualify.² Treat that letter as the revision checklist. Attorneys who work from it instead of arguing with it get orders approved much faster.

What Happens to the Money After Approval

Once the funds are in the alternate payee’s takeover account, a spouse or former spouse generally has several options:

A direct rollover into an IRA or another employer-sponsored plan that accepts rollovers (a 401(k), 403(b), or governmental 457(b)), with no immediate tax.⁶
A lump-sum cash distribution, which is taxable as income.
Leaving the money in the plan, if the vested balance exceeds the plan’s minimum threshold.
Installment payments on a schedule the plan allows.

The direct rollover option is only available to a spouse or former spouse; a child or other dependent alternate payee cannot roll the distribution over.⁶ One other point worth knowing while you’re deciding: under IRC §72(t)(2)(C), a distribution paid directly to an alternate payee under a QDRO is exempt from the 10% early withdrawal penalty that normally applies before age 59½.⁷ That exemption applies only to the plan distribution itself. If the alternate payee rolls the money into an IRA and later pulls it out before 59½, the usual IRA early withdrawal penalty applies to the later withdrawal.

1
Empower. QDRO Processing
2
U.S. Department of Labor. QDROs – Determining Qualified Status and Paying Benefits FAQs
3
Office of the Law Revision Counsel. 26 USC 414 – Definitions and Special Rules
4
South Carolina Fiscal Accountability Authority. Empower QDRO Model
5
Legal Information Institute. 29 U.S. Code 1056 – Form and Payment of Benefits – Definition: Alternate Payee
6
Internal Revenue Service. Retirement Topics – QDRO: Qualified Domestic Relations Order
7
Office of the Law Revision Counsel. 26 U.S. Code 72 – Annuities; Certain Proceeds of Endowment and Life Insurance Contracts