MsFiscallyFit's Benefits Checklist Company Name: ________________________________________________
Hire Date: ________________________________________________ Personnel Manager: ___________________________ No./Ext.:_________
Description |
Available |
Date Eligible |
Medical Coverage |
|
|
Dental Program |
|
|
Eye Care Program |
|
|
Flexible Spending Account (FSA) – Healthcare |
|
|
Flexible Spending Account (FSA) – Daycare |
|
|
Life Insurance |
|
|
Disability Insurance |
|
|
Qualified Pension Plans |
|
|
Retirement Savings Plans (401(K) & 403 (B) Plans, Section 457 Plans) |
|
|
Profit Sharing Plans |
|
|
Employee Stock Ownership Plans (ESOPS) |
|
|
Supplemental Executive Retirement Plans (SERP) for executive level |
|
|
Nonqualified Excess 401(K) and 403(B) Plan for executive level |
|
|
Vacation Days |
|
|
Flextime |
|
|
Childcare Assistance |
|
|
Counseling Services |
|
|
Educational Programs (i.e., MBA, Continuing Education) |
|
|
Other (i.e., Final Planning, Legal) |
|
|
Place a check under the "Available" column for each benefit that is offered along with the date you are eligible to receive the benefit (for example medical coverage
may not kick in until 90 days after you've started; take your hire date, add 90 days and drop in that date). |
