ATTACHMENT_3_Summary_of_Benefits.docx

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DS/IP/OPO SUPPORT CONTRACT
Solicitation number
SAQMMA16R0232
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Attachment 3 - Summary of 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______ 10th Yr ______

15th Yr______ 20th Yr_______

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 YESNO
TUITION REIMBURSEMENT
Up To $

ATTACHMENT 1

BENEFITS
EXPLANATION OF BENEFITS
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
(Examples – tuition reimbursement, award recognition programs, life programs/assistance day care, legal assistance etc.)

*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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