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2012 WAGE & BENEFIT SURVEY

— ANONYMOUS —

Please complete this survey and remember that this survey is completely anonymous.

A summary of the compiled data will be available in early 2012.

This info will be invaluable to assist your efforts to provide competitive wages and benefits.

COMPANY SIZE
Previous Years Annual Volume:
Number of Employees:
Company Type:
Do you outsource your payroll?Yes    No
WAGE DATA
EMPLOYMENT CLASSIFICATION
(Be specific)		BASIC HOURLY RATE
(Do not include fringe benefits)
BENEFIT INFORMATION
Do you provide health insurance for employees:Hourly
Yes    No

Salary
Yes    No

Do you provide dental insurance for employees:Hourly
Yes    No

Salary
Yes    No

What percentage of the employees’ health ins. premium do you pay:Hourly:

Salary:

What percentage of spouse/family health ins. premium do you pay:Hourly:

Salary:

What percentage of the employees dental ins. premium do you pay:Hourly:

Salary:

What percentage of the spouse/family dental ins. premium do you pay:Hourly:

Salary:

What is the total cost for: A SINGLE health premium:

A FAMILY health premium:

A SINGLE dental premium:

A FAMILY dental premium:

What is your health plan deductable: SINGLE:

FAMILY:

Is your health plan an HSA or HRA:HSA
Yes    No

HRA
Yes    No

Does your company “self insure” any of the health plan deductable:Yes    No
Do you offer Section 125 Plans (premium conversion, medical or dependent care reimbursement)?Yes    No
Do you provide short term disability?Hourly
Yes    No

Salary
Yes    No

Do you provide long term disability?Hourly
Yes    No

Salary
Yes    No

Do you provide bonus/incentive plans? Explain:Yes    No

Explain

Do you offer a 401K / Simple IRA PlanYes    No

If any, employer match; please define:

What other lifestyle benefits do you provide for your employees?
Please enter the verification code   

Please review your answers and when complete simply click
the submit button ---->