Total Compensation Statement
For: Jane Doe
Social Security # 440 Date of Hire: July 03, 1998 Date of Birth: June 08, 1964
Program Employer Cost Your Cost BENEFIT COMPENSATION
Medical $4,642 $1,989
Dental $0 $350
Life/AD&D $110 $0
Short Term Disability $71 $71 36.1%
EAP $15 $0 Empoyer Cost
Workers Comp. $180 $0
Unemployment $168 $0
Social Security/Medicare $3,042 $3,042
401(k) $272 $1,606
Programs Total $8,500 $7,059
Employer Cost: $12,494
Your Cost: $7,059
Total Cost of Your Benefits: $19,553
Paid Time Off Employer Cost Days Cash Compensation Amount
Vacation Days $2,400 113 Base Pay $41,665
Personal Days $476 24 Bonus & Other Compensation $1,918
Paid Holidays $1,118 57 Cash Compensation Total $43,583
Paid Time Off Total $3,994
401(k) Proft Share Plan
You are currently contributing 3% of your pay before taxes. 22.3%
You are always 100% vested in the value of your contributions.
You are 100% vested in the value of your employer's contributions. Compensation
Benefit Compensation: $12,494
Cash Compensation: $43,583
Total Compensation: $56,077
ABOUT YOUR REPORT:
Projections based on data as of: 1/1/06
Report Run On: 6/27/2006
Please review the information shown and report any discrepancies to your Human Resources Department. Every effort has been made to assure the information is accurate, however, this statement is subject to correction for any
errors in data or benefit calculations. This statement presents a brief overview of your benefits, based on current plans and contracts. Your actual benefits are governed by the provisions of the legal plan documents.
Your Total Compensation Statement is brought to you by Acadia Benefits.
Your Personalized 2007
HEALTH & WELFARE BENEFITS
Within every successful organization, you will
Medical benefits are provided through ________.
find hardworking and dedicated employees. At Dental
(Sample Company), we realize that employees Dental benefits are provided through ________
such as you, who efficiently utilize their time and Life Insurance.
talents to further the growth of our organization, Coverage is offered free of charge through _____
are our most valuable asset. That is why we at one times annual earnings up to $50,000.
provide competitive salaries and comprehensive Short Term Disability
employee benefits. Coverage is offered through _____.
Long Term Disability
This total compensation statement will briefly Coverage is offered free of charge through _____
outline the benefits that are provided by (Sample and it is available after 90 days of employment.
Company), as well as the cost of those benefits.
Please read this information carefully and if you
should have any questions, do not hesitate to 401(k)
contact __________ at ___________. Administrational costs for our company sponsored
401(k) plan are absorbed by (Sample Company)
It is our hope that your benefit package will and not transferred to our employees. All
provide added security for you and your family employees age 21 or older are eligible to
members. participate after 6 months of employment to the
nearest entry date. All employees are eligible for a
We appreciate your contributions and dedication company match on contributions. (Sample
to our team. Company) matches:
• Dollar for dollar on employees first 3% of
• 50 cents on the dollar for the next 2% of
Matched contributions after 2003 are 100% vested.
All full time employees are eligible for vacation
time according to an established schedule.
All full time employees are eligible for time off
with pay for the six observed holidays after date of
Statement Period: ________ to ____________ Sick Days/ Personal Days
All full-time employees are eligible for sick and
personal pay according to an established schedule.