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Life Insurance:

When do your company employees become eligible for life insurancecoverage?

What percentage of the premium for life insurance is paid by the company?

What coverages are included in the life insurance program?

Medical Insurance:

When do your company employees become eligible for medical insurancecoverage?

What percentage of the medical insurance premium is paid by the employer?

What type of pension/retirement plan do your company provide?

On what basis are employees reimbursed when traveling?

Does your company offer reimbursement for training or professional

development? Please indicate which of the following benefits are provided to employees:

Paid jury duty time Paid bereavement leave Employee assistance program Employee savings plan

What type of incentive systems do your company currently have in place?Individual incentives Small group/team incentives Organization specified goal bonus Discretionary bonus Profit sharing Spot awards Key contributor plan None

Do your company link pay to performance appraisal? Yes No

What type of performance appraisal plan do your company use? Management by Objectives (MBO) Forced Choice Questionnaire Narrative Analysis Behaviorally Anchored Rating Scales (BARS) No formal plan

What is your company benchmark date for conducting performanceappraisals/salary reviews? Fiscal year end Other fixed date

Do your company have a formal severance pay policy? Yes, same for exempt and nonexempt employees

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Yes, different policy for exempt and nonexempt employeesWhat is the average percent of salary that is allocated to benefits? (Benefits abovebasesalary include all voluntary and mandated benefits)_____________%

Total company payroll expense (wages and benefits) as a percent of total revenue(most recent fiscal year)_____________%

SICK/PERSONAL LEAVE

How many paid sick/personal days per year do you provide to employees?________days

Under what conditions do you permit employees to use accrued sick/personalday pay?

Only used for employee illness/injury Death in family Doctor's appointment Personal business Additional vacation time Dental appointment Ill child Ill spouse Ill parent or in-law Ill domestic partner

Unused sick/personal leave time is: Canceled at the end of the year Paid for at the end of the year Carried over to the following year

MATERNITY/FAMILY LEAVE

Number of weeks provided forpaid maternity/disability leave:______ weeks

Number of weeks provided forunpaid maternity/disability leave: _______weeks

HOLIDAYS What is the total number of paid holidays your organization provides?

(excludes

personal days and vacation days)_______days

How many floating holidays do you provide? ______days

VACATIONPlease indicate the days of vacation earned for the years of service listed below.Number of DaysTop Other Exempt Non-ExemptYears of Service Management Personnel Staff

After 1 year _______ _______ _______After 5 years _______ _______ _______

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After 10 years _______ _______ _______After 15 years _______ _______ _______

Unused vacation is: Canceled

Paid for at the end of the year Carried over to the following year