Section J_Attachment_B_Summary of Professional Employee Benefits.docx
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- SAQMMA12R0020
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Section J Attachment B Summary of Professional Employee Benefits
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SECTION J, ATTACHMENT B
SUMMARY OF PROFESSIONAL EMPLOYEE BENEFITS
| BENEFITS |
| EXPLANATION OF BENEFITS |
| HOLIDAYS |
| Days _____ |
| PERSONAL TIME OFF (PTO) |
| Days -- 1St Yr 1_____ 5th Yr_____ 1 0th Yr _____ 15th Yr____ _ 20thYr_____ |
| SICK LEAVE (if not included under PTO) |
| Days _____ |
| BEREAVEMENT/EMERGENCY |
| Days _____ |
| JURY DUTY |
| Days _____ |
| *HEALTH INSURANCE |
| Name of Insurance Provider: |
Plan Type:
Include summary of benefits:
Employer share of premiums:
Employee share of premiums:
Insurance Waiting Periods:
YES ____ NO ____ If Yes, please explain.
| *VISION |
| Name of Insurance Provider: |
Plan Type:
Include summary of benefits:
Employer share of premiums:
Employee share of premiums:
Insurance Waiting Periods:
YES ____ NO ____ If Yes, please explain.
| *DENTAL |
| Name of Insurance Provider: |
Plan Type:
Include summary of benefits:
Employer share of premiums:
Employee share of premiums:
Insurance Waiting Periods:
YES ____ NO ____ If Yes, please explain.
| *LIFE |
| Name of Insurance Provider: |
Plan Type:
Employer share of premiums:
Employee share of premiums:
Basic Plan:
Optional Plan:
| *SHORT TERM DISABILITY |
| Name of Insurance Provider: |
Employer share of premiums:
Employee share of premiums:
| *LONG TERM DISABILITY |
| Name of Insurance Provider: |
Employer share of premiums:
Employee share of premiums:
FLEXIBLE SPENDING ACCOUNT
Medical YES ____ NO ____ Dependent Care YES ____ NO ____
| TUITION REIMBURSEMENT |
| Up To $ |
| COMMUTER REIMBURSEMENT SAVING ACCOUNT |
| Up To $ |
| SPOT BONUS |
| Up To $ |
PARKING REIMBURSEMENT
PROFIT SHARING
| 401K |
| YES ____ NO ____ |
Date Established __________ Type of Plan:
Traditional_______ Safe Harbor______
SIMPLE__________
Co. Match Yes ___ No____ Co. Match % of Salary_____ Up to $ ________ % Match on the Dollar _____ Currently Available to All Employees Yes ___ No ___ Vesting Schedule (Provide details):
OTHER
*DEPENDENT CARE
A traditional 401(k) plan – Employers have discretion to make contributions on behalf of all participants, to match employees’ deferrals, or do both. These contributions can be subject to a vesting schedule (which provides that an employee’s right to employer contributions becomes nonforfeitable only after a period of time). In addition, a traditional 401 (k) allows participants to make pre-tax contributions through payroll deductions. Annual testing ensures that benefits for rank and file employees are proportional to benefits for owners/managers.
A safe harbor 401(k) plan is similar to a traditional 401 (k) plan, but, among other things, must provide for employer contributions that are fully vested when made. However, the safe harbor 401 (k) is not subject to many of the complex tax rules associated with a traditional 401 (k) plan, including annual nondiscrimination testing.
A SIMPLE 401(k) plan is not subject to the annual nondiscrimination tests that apply to the traditional plans. Similar to a safe harbor 401(k) plan, the employer is required to make employer contributions that are fully vested. This type of 401(k) plan is available to employers with 100 or fewer employees who received at least $5000 in compensation from the employer for the preceding calendar year. In addition, employees that are covered by a SIMPLE 401(k) plan may not receive any contributions or benefit accruals under any other plans of the employer.
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