5 Years 15 Years Age 67

315,456

940,195

1,620,889

279,866

668,981

1,013,565

247,863

479,035

643,691

Employee Savings & Protection Plan - Salary Deferral SourceXYZ's Tax Deferred ES&P Plan allows you to save for your retirement through convenient payrolldeductions on a pretax basis. You can choose to invest in any or all of 17 investments funds.

You can choose to defer, in whole percentages, from 1% to 50% of your compensation up to anannual maximum of $16,500 in 20xx. Once you reach age 50, you may be eligible for "catch-up"contributions which allows an increase in your maximum dollar amount. Your savings and theirinvestment earnings are free from Federal Income Taxes until they are withdrawn.

Employee Savings & Protection Plan - Employer Contribution SourceEach year that you are eligible to share in contributions, XYZ will contribute to the Plan on yourbehalf an amount equal to 6% of your compensation up to $245,000 in 20xx. Your account will becredited annually with a share of the investment earnings or losses of the trust fund.

For further information regarding this plan, please call Fidelity Investments at 1-800-294-4015 orvisit their website at http://www.NetBenefits.com.

Employee Savings & Protection Plan Projections

Annual Investment Growth Rates 3% 6% 9%

The following projections illustrate what your account (including employee and employercontributions) might be worth in 5 years, 15 years, and at age 67 (your normal retirement age)based on your current total retirement account balance of $155,512 and annual investmentgrowth rate assumptions of 3%, 6%, and 9%. The projections assume that your pay, your currentcontribution rate of 9%, ES&PP 6% Employer Contribution, and the Plan provisions will remain thesame in the future.

Note: The information presented has been rounded to the nearest whole number. Every effort has been taken to ensurethat the information in this statement is accurate; however, no warranty of guarantee is implied or intended. If adiscrepancy is found to exist between your benefit statement and the benefit summary plan descriptions, the provisions ofthose documents will govern.

FV401k 3% 5yrs$247,863

FV401k 3% 15yrs$479,035

FV401k Age67 3%$643,691

Age Now

46.3

FV401k 6% 5yrs$279,866

FV401k 6% 15yrs$668,981

FV401k Age67 6%$1,013,565FV401k Age67 9%$1,620,889

FV401k 9% 5yrs$315,456

FV401k 9% 15yrs$940,195

'401k ESPP EE annl Cont

$3,121

'401k ESPP EE %9.00

'401k ESPP ER %

Base Annl Salary$100,000Commissions Paid in 2008

$9,500

'401k ESPP EE Proj Match At 3%

'401k ESPP ER Proj Match At 6%

'401k ESPP Total balance$155,512

'401k ESPP EE Acct Balance$155,512

'401k ESPP ER Cont Balance

If EE cont = 0%, FV is based2% cont for EE and ER. ERCont Source para = need tofind out ER's matching %

JOHN T. SAMPLE

ANY TOWN, NY XXXXX123 MAIN STREET

Prepared For:

I am very pleased to present your Total Compensation Statement. Each year XYZCompany makes significant contributions toward your personal benefits which are animportant component of your total compensation. This statement outlines the totalincome opportunity and benefits provided to you by XYZ as well as the cost of thosebenefits.

This statement is a convenient way to keep track of your benefit elections and is a usefulfinancial planning tool. Please review this statement and retain it with your otherimportant documents.

Sincerely,

David SmithPresident

Dear John,

How This Statement Was PreparedYour Total Compensation Statement reflects your benefit elections and your totalcompensation as of December 31, 20xx.

Your Personal InformationThe information in this statement is based on XYZ's records. Should you have any questionsconcerning the information represented in this Total Compensation Statement, please contactyour HR Department.

Hire Date:

Base Salary: $100,000

4/1/1996

$9,609

RETIREMEMT BENEFITSCompany's

Contribution

Once you have completed five years of service, and met all eligibility requirements, you may be100% vested and have a permanent right to your account balance under the Plan, even if you leavethe Company before retirement.

Last Name SampleFirst Name Processed John

Address1 123 MainAddress2

City Any TownState NY

Zip Code

X YZ

COMPANY

YOUR TOTAL COMPENSATION STATEMENT

As of December 31, 20xx, your balance was $155,512 and your 20xx Plan contribution was$3,121.

For 20xx, XYZ made a contribution to your plan in the amount of $9,609.

POMCO Group315-432-9171 Toll free 1-800-934-2459

INCOME PROTECTION BENEFITSNO CommissionWith Commission

Your 20xx benefits, including paid timeoff, represent approximately 34% of your

total compensation.

Paid Time OffTotal Benefit Costs

Pay for Time Worked

Total Compensation

$36,584

$153,529

$15,384

$9,500

CompanyContribution

Health Care Benefits $14,932

Retirement Benefits$10,620Social Security and Medicare Benefits$9,609

Commissions Paid in 20xx$92,061

$563Survivor Benefits$860Income Protection Benefits (24%)

(10%)

(60%)

(6%)

John T. Sample

ADD ER Cont 50

LifeER Cont $511

- Medicaland/or Dental

- SocialSecurity

$9,609

$14,878$667- Disability

& Life

- Workers' Compensation &Unemployment Insurance

$585

- ES&PP (Employer Contribution of 6% BaseSalary estimated for 2008)

(41%)(2%)

(29%)(2%)

(0%)

The following pie chart graphically illustrates how your payand benefits combine to form your total compensation.The benefits slice is further broken down into severalbenefit categories, as shown below. Note that health carecosts represent a significant portion of your benefits.

YOUR TOTAL COMPENSATION -

XYZ Company contributes an amount equal to your own Social Security and Medicare contribution.Monthly Social Security benefits may go to you and/or your dependents when you retire, becomeseverely disabled, or die. The amount of any benefits will depend on prior earnings, adjusted toaccount for changes in wages since 1951. The Social Security Administration will mail you an annual"Earnings and Benefit Estimate Statement" verifying the earnings credited to your account. Forcomplete information on your actual Social Security benefits, consult the local Social SecurityAdministration office.

Other benefits of significant value that you may be utilizing, but are not included in the Companybenefits cost, include the following:

•••

Referral BonusDirect Deposit for PaycheckEmployee Assistance Program

Salary ContinuationEducational Assistance ProgramJury DutyBereavement LeaveMilitary LeaveAdjusted Work Week March - Nov.

Attendance Incentive •• •

•••

•

SUMMARY OF 20XX TOTAL COMPENSATION

$15,384

$2

XYZ Company provides you with health care coverage to minimize the potential financial impact ofmedical costs for you and your eligible family members. The plan provides coverage for preventivecare, physician services, hospital services, and prescription drugs.You are currently enrolled in the medical plan with family coverage.

Dental Benefits

Medical Benefits

In addition to medical coverage, XYZ Company offers a dental plan to help reduce your out-of-pocket dental care costs. The plan is designed to encourage preventive care which will diminishyour need for costly corrective treatment in the future.You are currently enrolled in the dental plan with family coverage.

HEALTH CARE BENEFITS

Flexible Spending Accounts (FSA)

$13,241

$1,637$10,620

ADDITIONAL BENEFITS

Vacation Days Holidays 1320.0

Personal Days 2 Sick Days 5.0

PAID TIME OFF

Company'sContribution

Company'sContribution

SOCIAL SECURITY AND MEDICARE BENEFITS Company'sContribution

Prepared for John T. Sample

SURVIVOR BENEFITS Company'sContribution

XYZ Company offers you the option to purchase Supplemental Life Insurance coverage for yourself,your spouse and/or dependent child(ren), at favorable group rates, through payroll deduction.

XYZ Company provides you with Life and Accidental Death and Dismemberment Insurance benefitequal to 1.5 times your base annual salary up to a maximum of $400,000. Your beneficiary may beentitled to receive $115,000 in the event of your death. If you injured in an accident, you or yourbeneficiary may receive an additional $115,000 for loss of life or dismemberment.

Basic Life And Accidental Death & Dismemberment Insurance

Supplemental Life And Accidental Death & Dismemberment Insurance

You have elected to purchase $50,000 of additional coverage on yourself.

$54

XYZ Company provides employees with Short Term Disability Insurance. This insurance is designedto stabilize your income in the event that you are disabled due to a non-work related injury orillness. Benefits are calculated at 66.67% of your average weekly salary, up to a maximum of $542.Should you become disabled, you may be eligible for payments of $542 per week for maximum of26 weeks.

Under the Company's Long Term Disability plan, if you are disabled for more than 90 days, you mayreceive 60% of your average monthly earnings up to $10,000 until the age of 65, or until yourdisability ends, as defined in the contract. If you were to become disabled, you may be eligible toreceive up to $5,000 per month. Please be aware that this benefit is integrated with statutorydisability benefits such as Workers' Compensation and Social Security.

Long Term Disability

Short Term Disability

$66

In the event of a disability due to a work related injury or illness, you may be eligible to receive aweekly benefit up to the state maximum, depending on the nature of the disability or accident.These benefits are generally paid for as long as the disability exists.

Workers' Compensation

XYZ Company makes contributions to the state unemployment insurance fund. Should you becomeunemployed through no fault of your own, you may be eligible for weekly unemployment benefits.Check with your local unemployment office for more details as benefits vary from state to state.

Unemployment Insurance

$14

$585

Company'sContribution

$561

Business Travel & Accident InsuranceXYZ Company offers a Business Travel & Accident Policy in the amount of $200,000 of insurance inthe event of death or disability while traveling on company business. This benefit is provided toyou at no cost and is in addition to the Group Term Life Insurance you have.

XYZ's Flexible Spending Accounts allow you to pay for unreimbursed medical and dependent careexpenses with pre-tax dollars. Taxable earnings are reduced so you pay less taxes on earnings andyour take home pay is increased. You may elect to have up to $2,500 ($5,000 if married, filingseparately) deducted pre-tax per year for eligible dependent care expenses and up to $2,500deducted pre-tax per year for eligible health care expenses.You are currently contributing $2,000 annually to your medical care account and $1,000 toyour dependent care account.

$195

YOUR PERSONAL STATEMENT OF BENEFITS

Jane M. Sample15 Main StreetNew York, NY 13203

Your benefits,including paid time

off and bonus,represent

approximately 28% ofyour total

compensation.

Note: Your Total Compensation Statement reflects your benefit elections and your total target compensation as of 12/31/20XX. Annual totals are projections based on Company records as of this date andassumes perfect eligibility. Every effort has been taken to ensure that the information in this statement is accurate; however, no warranty or guarantee is implied or intended. If a discrepancy is found toexist between your benefit statement and the benefit booklets or summary plan descriptions, the provisions of those documents will govern.

COMPANYCONTRIBUTION

We are pleased to present to you this personalized statement of benefits. Thebenefits you enjoy represent a significant portion of your total compensationpackage. This annual statement was prepared so that you may have a betterunderstanding of the benefits provided by XYZ Corporation.

Dear Jane,

I encourage you to review your benefit statement carefully and keep it in a safeplace for future reference. If you have any questions about this statement orrequire additional information on any of the benefits offered, please contactHuman Resources.

Sincerely,Susan SmithPresident

Flexible Spending AccountsShort Term DisabilityLong Term DisabilityWorkers’ Compensation

ANNUAL BENEFITS CONTRIBUTIONS

401(k) Retirement Plan

XYZ Corporation provides eligible employees with Short Term Disability Insurance. This insurance is designed to stabilizeyour income in the event that you are disabled due to an off the job injury or illness. You may be eligible for payments of$444 (66% of your average weekly earnings) per week, for a maximum of 26 weeks.

HEALTH CARE BENEFITS

$1,344XYZ’s Annual Contribution:$480Your Annual Contribution:

Your Medical Plan: Good MedicineYour Medical Coverage Level: Family

$252XYZ’s Annual Contribution:$156Your Annual Contribution:

Your Dental Plan: Happy TeethYour Dental Coverage Level: Family

Medical Insurance

Dental Insurance

Flexible Spending Accounts

$2,500Your Annual Contribution:$103XYZ’s Annual Contribution:

INCOME PROTECTION

Short Term Disability$444Weekly Benefit:$175XYZ’s Annual Contribution:

Long Term Disability$1,750Monthly Benefit:

$193XYZ’s Annual Contribution:

Workers’ Compensation$346XYZ’s Annual Contribution:

SURVIVOR BENEFITS

Benefit Amount: $70,000

Your Benefit Amount: $200,000Your Spouses Benefit Amount: $100,000

Group Life Insurance

Supplemental Life & AD&D Insurance

$2,100Your 401(k) Contribution:

$1,050XYZ’s 401(k) Match:

$294XYZ’s Annual Contribution:Benefit Amount: $70,000

Group AD&D Insurance

Your Child(ren)s Benefit Amount: $10,000

RETIREMENT BENEFITS

$681,151Future Value Amount:(estimated value at retirement)

$2,430Your Annual Contribution:

$2,430XYZ’s Annual Contribution:

SOCIAL SECURITY AND MEDICARE

PAID TIME OFF

$1,215Holiday Pay :$1,890Vacation Pay:

$3,105XYZ’s Annual Contribution:

YOUR TOTAL COMPENSATION

Pay For Time Worked $31,895

Total Compensation $44,187

Total Other Benefits $6,187

Pay For Time Off $3,105Bonus $3,000

YOUR PERSONAL STATEMENT OF BENEFITS

Jane M. Sample15 Main StreetNew York, NY 13203

YOUR TOTAL COMPENSATION

Your benefits,including paid time

off and bonus,represent

approximately 28% ofyour total

compensation.

Pay For Time Worked $31,904Pay For Time Off $3,096

XYZ Corporation provides eligible employees with the opportunity to participate in Flexible SpendingAccounts that allow you to pay your share of unreimbursed medical expenses and dependent careexpenses with pre-tax dollars. You may elect to have up to $5,000 deducted pre-tax per year foreligible dependent care expenses and up to $3,000 deducted pre-tax per year for eligible medical anddental care expenses.

Flexible Spending Accounts

You are currently contributing $1,000 to your dependent care and $1,500 to your medical careaccounts annually.

$103

Short Term Disability

$175

Bonus $3,000

We are pleased to present to you this personalized statement of benefits. Thebenefits you enjoy represent a significant portion of your total compensationpackage. This annual statement was prepared so that you may have a betterunderstanding of the benefits provided by XYZ Corporation.

I encourage you to review your benefit statement carefully and keep it in a safeplace for future reference. If you have any questions about this statement orrequire additional information on any of the benefits offered, please contactHuman Resources.

Sincerely,Susan SmithPresident

Total Compensation $44,435

Total Other Benefits $6,435

In addition to medical insurance, XYZ Corporation offers a dental program to help reduce your “out ofpocket” dental care costs. This plan is offered to encourage preventative care which will diminish theneed for costly corrective procedures in the future.

$252

You are currently enrolled in the Smile Saver dental plan with Family coverage.

Dental Insurance

XYZ Corporation provides eligible employees with health care coverage to minimize the potentialfinancial impact of medical costs for you and your eligible family members. The Company offers you aPPO or HMO for your medical plan options.

$1,344

You are currently enrolled in the PPO plan with Family coverage.

Medical Insurance

Long Term DisabilityUnder the Company's Long Term Disability Plan, if you are disabled for more than 90 days, you mayreceive 60% of your base salary up to $6,000 per month until the age of 65, or until your disability ends,as defined in the contract. Please be aware that this benefit is integrated with statutory disabilitybenefits such as Workers' Compensation and Social Security. If you were to become disabled or injured,you may be eligible to receive benefits of $1,750 per month.

$193

Workers’ CompensationIn the event of a disability due to a work related injury or illness, you may be eligible for a weeklybenefit up to the state maximum depending on the nature of the disability or accident. These benefitsare generally paid for as long as the disability exists.

$346

INCOME PROTECTION BENEFITS

HEALTH CARE BENEFITSCOMPANY

CONTRIBUTION

XYZ Corporation provides eligible employees with Short Term Disability Insurance. This insurance isdesigned to stabilize your income in the event that you are disabled due to an off-the-job injury orillness. Beginning on the 8th day of illness or injury, you may be eligible for payments of $444 (66% ofyour average weekly earnings) per week, for a maximum of 26 weeks.

COMPANYCONTRIBUTION

Dear Jane,

XYZ Corporation provides eligible employees with Life and Accidental Death and DismembermentInsurance. Your beneficiary may be entitled to receive a benefit in the amount of $70,000 in the eventof your death. If you die or are injured by an accident, you or your beneficiary may be entitled toreceive an additional benefit.

$294

Note: The information presented has been rounded to the nearest whole number. Your Total Compensation Statement reflects your benefit elections and yourtotal target compensation as of 12/31/2012. Annual totals are projections based on Company records as of this date and assumes perfect eligibility. Everyeffort has been taken to ensure that the information in this statement is accurate; however, no warranty or guarantee is implied or intended. If a discrepancy isfound to exist between your benefit statement and the benefit booklets or summary plan descriptions, the provisions of those documents will govern.

Employee Stock Purchase Plan (ESPP)

Direct Deposit

Federal Credit Union

Tuition Reimbursement

XYZ Corporation contributes an amount equal to your own Social Security and Medicare contributions.Monthly Social Security benefits may go to you and/or your dependents when you retire, becomeseverely disabled, or die. The amount of any benefits will depend on prior earnings, adjusted toaccount for changes in wages since 1951. The Social Security Administration will annually mail you an"Earnings and Benefit Estimate Statement" verifying the earnings credited to your account. Forcomplete information on your actual Social Security benefits, consult the local Social SecurityAdministration Office.

$2,678

$3,096Vacation Days:9Holidays: 14

XYZ Corporation encourages you to save for your future retirement by offering a 401(k) RetirementSavings Plan. All employees are eligible to participate in this plan after attaining age 21 and after oneyear of service in which 1,000 hours have been worked. You may contribute a percentage of yourcompensation up to the IRS limitation each year. You are always 100% vested in your contributions.

$1,050As of December 31, 2012, you were contributing 6% of your salary to your 401(k) Retirement SavingsPlan. The Company’s match is anticipated to be $1,050. Your total account balance as of December 31,2012 was $34,125. If you and the Company continue to contribute at the current rate, and your accountgrows at a modest rate of 6%, your account balance is estimated to be $681,151 at retirement age 65.

RETIREMENT BENEFITS

SURVIVOR BENEFITS

PAID TIME OFF

SPECIAL PROGRAMS

SOCIAL SECURITY & MEDICARE

Your 401(k) can be extremely helpful to you by increasing your retirement assets. You may wish toincrease your contribution.

The Company will match 50% of your contributions up to 6% of your pay for a total of 3% of your grosscompensation. You become 100% vested in the Company’s contributions to your account after six (6)years of service. You are currently 100% vested in XYZ Corporation’s contributions to your account.

COMPANYCONTRIBUTION

COMPANYCONTRIBUTION

COMPANYCONTRIBUTION

COMPANYCONTRIBUTION

•

•

•

•

401(k) Retirement Savings Plan

Life Insurance and Accidental Death & Dismemberment Insurance

"In addition, the Company offers you the opportunity to purchase Supplemental Life and AccidentalDeath & Dismemberment Insurance for yourself, your spouse and your dependent child(ren) through theFarmington Company."

Voluntary Life and Accidental Death & Dismemberment Insurance

POMCO Group315-432-9171 Toll free 1-800-934-2459

Workers’ CompensationIn the event of disability due to a work relatedinjury or illness, you may be eligible for aweekly benefit up to the State maximumdepending on the nature of the disability oraccident. These benefits are generally paid foras long as the disability exists.

XYZ’s Contribution $671

Income Protection Benefits

We are pleased to present to you thispersonalized statement of benefits. The benefitsyou enjoy represent a significant portion of yourtotal compensation package. This annualstatement was prepared so that you may have abetter understanding of the benefits provided byXYZ Company.

I encourage you to review your benefitstatement carefully and keep it in a safe placefor future reference. If you have any questionsabout the statement or require additionalinformation on any of the benefits offered,please contact Human Resources.

Jane Doe

YOUR TOTAL COMPENSATION

Pay for Time Worked: $31,635Paid Time Off:Other Benefits:

Total Compensation:

$3,365$12,108

$47,108

Health Benefits

Medical InsuranceXYZ Company provides you with acomprehensive health care plan that includesprescription drug coverage to minimize thepotential financial impact of medical costs foryou and your eligible family members. TheCompany offers a choice between two plans,Plan A and Plan B.

You are currently enrolled in medical Plan Awith Employee and Family coverage.

XYZ’s Contribution $6,000

Dental InsuranceIn addition to medical coverage, XYZ Companyoffers a dental plan to help reduce your out-of-pocket dental care costs.

You are currently enrolled in the dental planwith Employee and Family coverage.

XYZ’s Contribution $420

Flexible Spending PlanXYZ's Flexible Spending Accounts allow you topay for unreimbursed medical and dependentcare expenses with pre-tax dollars. Alladministrative expenses are paid by XYZ.

You are currently participating in the medicalcare and dependent care flexible spendingaccounts.

XYZ’s Contribution $98

You

r Pe

rson

al B

enef

it S

tate

men

t

Annual Salary

35000

Long Term DisabilityUnder the Company's long term disability plan,if you are disabled for more than 180 days, youmay be eligible to receive up to $1,750 (60% ofyour monthly earnings up to $6,000) per monthuntil the age of 65, or until your disabilityends, as defined in the contract. Please beaware that this benefit is integrated withstatutory disability benefits such as Workers'Compensation and Social Security.

XYZ’s Contribution $193

Doe

Jane

Dear Jane,

Your benefits,including paid time

off, representapproximately 33% of

your totalcompensation.

Sincerely,

Short Term DisabilityXYZ Company provides eligible employees withshort term disability insurance, which isdesigned to stabilize your income in the eventthat you are disabled due to an off-the-jobinjury or illness. In the event of an off-the-jobdisability, you could be eligible for paymentsup to $500 per week for a maximum of 26weeks.

XYZ’s Contribution $88

Med Cov Level Employee and

Employee and

XY

Z

XY

ZCO

MPA

NY

Alex SmithPresident and CEO

Paid Time Off

Vacation Days15

Holidays10

XYZ’s Contribution $3,365

Social Security & MedicareXYZ Company contributes an amount equal toyour own total Social Security and Medicarecontributions. A monthly Social Securitybenefit may go to you and/or your dependentswhen you retire, become severely disabled, ordie. The amount of any benefits will dependon prior earnings, adjusted to account forchanges in wages since 1951.

XYZ’s Contribution $2,678

123

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Jane

Doe

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enef

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XYZ’s Contribution $210

Survivor BenefitsXYZ Company provides eligible employees withLife & Accidental Death and DismembermentInsurance. Your beneficiary may be entitled toreceive $50,000 in the event of your death. Ifyou are injured in an accident, your beneficiarymay receive an additional $50,000 for loss oflife or dismemberment.In addition, the Company offers you the optionto purchase Voluntary Life Insurance coveragefor yourself, spouse and dependent child(ren)through payroll deduction.

You elected to purchase $50,000 ofadditional coverage on yourself, $25,000 onyour spouse, and $10,000 of coverage onyour child(ren).

Special ProgramsDirect Deposit

Tuition Reimbursement

Employee Assistance Program (EAP)

Retirement BenefitsXYZ Company maintains a 401(k) Savings Planfor eligible employees to assist you during yourretirement years. In order to participate in theplan, you must be at least twenty-one years ofage, have completed one full year of service,and have worked at least 1,000 hours during theplan year. The plan consists of two parts:

XYZ’s Contribution $1,750

You can set aside a percentage of your totalwages up to the IRS limitation each year.Your contributions are made with pre-taxdollars and grow tax-deferred in youraccount.

XYZ Company will match 50% of yourcontributions not to exceed 6% of your totalcompensation. You will be fully vested inthe company’s contributions after five yearsof service.

You are currently contributing 10% of yoursalary to your 401(k) Plan.

XYZ Company's annual match is anticipatedto be $1,750.

XY

Z

XY

ZCO

MPA

NY

Address 1 123 MAIN STREET

City ANY TOWN

State NY

Zip ?NOTE: Every effort has been taken to ensure that the information in thisstatement is accurate; however, no warranty or guarantee is implied orintended. Calculations are based on benefit plan provisions and yourcompensation as of 12/31/20XX. If a discrepancy is found to exist betweenyour benefit statement and the benefit booklets or summary plandescriptions, the provisions of those documents will govern.

You are eligible for the following paid time off: