Salary Deferral Plans Fact Finder
Salary Deferral Plans (Total Income Plans)Producer InformationName: Company: Address: City: State: Phone: Email: Zip Code: Fax:ContributionsExecutive Contributions (Deferrals) Deferral Type: □% of Total Compensation Number of Years □Schedule: □Specified Amount: $ Number of Years Corporate Insurance Funding:Corporation InformationName of Company: State of Incorporation: Corporate Tax Bracket: Plan Year:□Before -Tax □After-Tax Corporate Contributions: □% of Executive Deferral: Number of
Content
Salary Deferral Plans (Total Income Plans)
Producer Information
Name: Company: Address: City: State: Phone: Email: Zip Code: Fax:
Contributions
Executive Contributions (Deferrals) Deferral Type: □% of Total Compensation Number of Years □Schedule: □Specified Amount: $ Number of Years Corporate Insurance Funding:
Corporation Information
Name of Company: State of Incorporation: Corporate Tax Bracket: Plan Year:
□Before -Tax □After-Tax Corporate Contributions: □% of Executive Deferral: Number of Years: □Schedule: □Specified Amount: $ Number of Years %
Benefits
Pre-Retirement Survivorship Benefits: □No Additional Benefit □As % of Total Compensation □Specified Benefit: □Solve □Specified Benefit Benefit Years: Retirement Benefits: □Executive Rate of Return Specified: Solve: Benefit Years: %
Cost Recovery
Age at Death: □Life Expectancy: □Specified Age: Quality Option: □Out of Pocket □Borrow □Withdraw □Withdraw to Basis and then Borrow □Borrow
Cost Recovery (continued)
Loan Interest Option: □Pay Loan □Borrow Gross Interest □Borrow After-tax Interest Recovery Option □Full Cost □Partial Cost □Net Insurance Outlay □Net After-Tax Insurance Outlay □Premiums □Retirement Benefits □After-Tax Retirement Benefits □Loss Tax deduction on Deferrals □Split Dollar Bonuses □Including Cost of Money □None Recovery Age: □Specified Age: □Life Expectancy Investment Rate □Cost of Money: Accounting Method: □APB 12After-Tax Mortality Table: □80 CSO Blended □GAM 71 □Up 84 □Tax Facts
Details of Program
Individual Life Insurance: □Universal Life □Accumulation UL □Protection UL-G □Performance UL Core □Performance UL □Variable □Performance VUL □Accumulation VUL □Protection VUL □Whole Life □Level Premium □Modified Premium(NJ only)
Survivorship Life Insurance
□Universal Life □Survivorship UL-G □whole Life (Traditional) □Level Premium Estate Protection □Variable □Survivorship VUL Death Benefit Options □Level □Increasing □Schedule □Performance SVUL
Comments
Participant Information
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.
Name Age/DOB Sex Smoking Status Salary Incentive Compensation Bonus Amount Spouse Age Spouse U/W
35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50.
Producer Information
Name: Company: Address: City: State: Phone: Email: Zip Code: Fax:
Contributions
Executive Contributions (Deferrals) Deferral Type: □% of Total Compensation Number of Years □Schedule: □Specified Amount: $ Number of Years Corporate Insurance Funding:
Corporation Information
Name of Company: State of Incorporation: Corporate Tax Bracket: Plan Year:
□Before -Tax □After-Tax Corporate Contributions: □% of Executive Deferral: Number of Years: □Schedule: □Specified Amount: $ Number of Years %
Benefits
Pre-Retirement Survivorship Benefits: □No Additional Benefit □As % of Total Compensation □Specified Benefit: □Solve □Specified Benefit Benefit Years: Retirement Benefits: □Executive Rate of Return Specified: Solve: Benefit Years: %
Cost Recovery
Age at Death: □Life Expectancy: □Specified Age: Quality Option: □Out of Pocket □Borrow □Withdraw □Withdraw to Basis and then Borrow □Borrow
Cost Recovery (continued)
Loan Interest Option: □Pay Loan □Borrow Gross Interest □Borrow After-tax Interest Recovery Option □Full Cost □Partial Cost □Net Insurance Outlay □Net After-Tax Insurance Outlay □Premiums □Retirement Benefits □After-Tax Retirement Benefits □Loss Tax deduction on Deferrals □Split Dollar Bonuses □Including Cost of Money □None Recovery Age: □Specified Age: □Life Expectancy Investment Rate □Cost of Money: Accounting Method: □APB 12After-Tax Mortality Table: □80 CSO Blended □GAM 71 □Up 84 □Tax Facts
Details of Program
Individual Life Insurance: □Universal Life □Accumulation UL □Protection UL-G □Performance UL Core □Performance UL □Variable □Performance VUL □Accumulation VUL □Protection VUL □Whole Life □Level Premium □Modified Premium(NJ only)
Survivorship Life Insurance
□Universal Life □Survivorship UL-G □whole Life (Traditional) □Level Premium Estate Protection □Variable □Survivorship VUL Death Benefit Options □Level □Increasing □Schedule □Performance SVUL
Comments
Participant Information
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.
Name Age/DOB Sex Smoking Status Salary Incentive Compensation Bonus Amount Spouse Age Spouse U/W
35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50.
