Employee Benefits

Has The Employer Made A Qualified Transfer Of Excess Pension Assets To A 401(h) Retiree Health Account?

Yes

No

Combined State and Federal Tax Brackets for Illustration Assumption

If yes, please complete plan type:

Simple Plan

Profit Sharing Plan

401(k) Plan

Employer Match Yes

Catastrophic Medical Access: % Of Medical Fund

Employer Objectives - Benefits (Check All That Apply)

Provide Tax Favored Medical Accounts For Retired Employees

Reduce Income Tax Liability

Provide Life Insurance Protection For Estate Or Buy/Sell Plans

Provide Survivorship Life Insurance Protection

Provide Long Term Care Supplements For Employees and Dependents

Provide Dependent Coverage

State:

Phone *

Is Employer A Member Of An Affiliated Service Group

Yes

No

Email: *

Is This The First Illustration Request For This Employer?

Yes

No

Post Retirement Medical Savings

Survivorship Life: Multiple of Annual Comp

Is Employer A Member Of A Controlled Group

Yes

No

Please describe any and all health conditions you have (or have had) in the past

Does Employer Have An Active Qualified Retirement Plan:

Yes

No

Retirement Income as Percentage of Income

Zip:

Employer Goals (1)

contact person: *

Will the Business Participate in the Funding?

100%

Partial

Employee Only

Employer name: *

Plan Year End (Mo/Day):

Long Term Care Supplement: % Of Total LTC Costs

Employer Goals (2 a)

or Employer Goals (2 b)

Target Employee Benefits:

Employer Objectives - Funding/Tax Considerations (Check All That Apply)

Provide Tax Favored Medical Accounts For Retired Employees

Reduce Income Tax Liability

Provide Life Insurance Protection For Estate Or Avoid Excess Accumulation Problems

Favor The Key Employees When Permissible

Fund FASB 45/106 Requirements

Provide "Golden Handcuffs" For Employees

Favor Non-Key Employees

Address:

Additional Considerations /Requests

Main Line Of Business:

Employee Name / Key Man / Gender / Date Of Hire / DOB / Hours Wrk'd / Marital Status / Age Of Spouse / Annual W-2 Income

Individual Life: Multiple of Annual Comp

HIGHLAND CAPITAL FINANCIAL CONSULTING LLC9845 Erma Rd Ste 210A, San Diego CA 92131 US

HIGHLAND CAPITAL FINANCIAL CONSULTING LLC
9845 Erma Rd Ste 210A, San Diego CA 92131 US