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					Sample Budget Allocation Worksheet                                 Benefits Interface, Inc.
Health Spending Account Cost Summary                                          P.O. Box 30
Ontario Staff                                                    Newmarket, ON L3Y 4W3
November 8, 2011                                                      admin@benefits.org



Description of Class                                  Monthly    Number       Total Monthly
or Specific Employee                                  Deposit    of Staff     Contribution
 Employees during 1st year of employment              $ 100.00              2 $      200.00
 Employees during 2nd year of employment              $ 150.00              2 $      300.00
 Employees with more than 2 years of employment       $ 200.00              4 $      800.00
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
                                                                              $          -
Monthly Cost Summary
         Total Monthly Contributions Deposited to Member Benefit Accounts     $    1,300.00
                                                     Admin (10% of Deposit)   $      130.00
                          Provincial Retail Sales Tax (RST) = 8% of Deposit   $      104.00
                    Provincial Premium Tax (PPT) = 2% of Deposit & Admin      $       28.60
                                                        HST (13% of Admin)    $       16.90
                                                         Total Monthly Cost   $    1,579.50
Sample Budget Allocation Worksheet                         Benefits Interface, Inc.
Health Spending Account Cost Summary                                  P.O. Box 30
Ontario Staff                                            Newmarket, ON L3Y 4W3
November 8, 2011                                              admin@benefits.org



Description of Class                          Monthly    Number       Total Monthly
or Specific Employee                          Deposit    of Staff     Contribution
 Executives                                   $ 300.00              2 $      600.00
 Key Staff                                    $ 200.00              2 $      400.00
 Salaried Staff                               $ 100.00              2 $      200.00
 Hourly Staff                                 $    -                  $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
                                                                      $          -
Monthly Cost Summary
 Total Monthly Contributions Deposited to Member Benefit Accounts     $    1,200.00
                                             Admin (10% of Deposit)   $      120.00
                  Provincial Retail Sales Tax (RST) = 8% of Deposit   $       96.00
            Provincial Premium Tax (PPT) = 2% of Deposit & Admin      $       26.40
                                                HST (13% of Admin)    $       15.60
                                                 Total Monthly Cost   $    1,458.00
Sample Budget Allocation Worksheet                               Benefits Interface, Inc.
Health Spending Account Cost Summary                                        P.O. Box 30
Ontario Staff                                                  Newmarket, ON L3Y 4W3
November 8, 2011                                                    admin@benefits.org

                                                                                Formula
                          Percentage of earnings for every year of service           2%
                                              Maximum Years of Service               10
                                                       Mimimum Amount $             100
                                                       Maximum Amount $             300

Description of Class                          Monthly          Years of         Monthly
or Specific Employee                          Income           Service          Deposit
1                                             $    2,000.00            2    $    100.00
2                                             $    2,200.00            2    $    100.00
3                                             $    2,400.00            3    $    144.00
4                                             $    2,600.00            3    $    156.00
5                                             $    2,800.00            4    $    224.00
6                                             $    3,000.00            4    $    240.00




Monthly Cost Summary
       Total Monthly Contributions Deposited to Member Benefit Accounts     $     964.00
                                                   Admin (10% of Deposit)   $      96.40
                        Provincial Retail Sales Tax (RST) = 8% of Deposit   $      77.12
                  Provincial Premium Tax (PPT) = 2% of Deposit & Admin      $      21.21
                                                      HST (13% of Admin)    $      12.53
                                                       Total Monthly Cost   $   1,171.26

				
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