Work Years And Personnel Costs Report-Cost Of Employees Benefits Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Work Years And Personnel Costs Report-Cost Of Employees Benefits Form. This is a Official Federal Forms form and can be use in OPM US Office Of Personnel Management.
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WORK YEARS AND PERSONNEL COSTS REPORT
COST OF EMPLOYEES BENEFITS
FISCAL YEAR
2. Agency Code
1. Agency Name
CODE
ITEM
OMB
OBJECT
CLASS
300
Total Cost of Benefits
12.1
301
Health Insurance
COST (Thousands)
For Agency Edit Check:
COST AS PERCENT OF
BASIC PAYROLL
12.1
- Federal Employees Health Benefits Act
- Other
302
Life Insurance – Federal Employees Group Life Insurance (FEGLI)
12.1
303
Retirement
12.1
304
- Civil Service Retirement System (CSRS)
12.1
305
- Federal Employees Retirement System (FERS) Basic Benefit
12.1
306
- Federal Employees Thrift Plan (FERS)
12.1
307
- Other Retirement Systems (specify)
12.1
308
Federal Insurance Contributions Act Taxes (OASDHI)
12.1
309
Federal Employees Compensation Act (FECA)
Payments to Department of Labor
12.1
310
Uniform Allowances
12.1
311
Overseas Allowances (including overseas cost of living allowance (COLA))
12.1
312
Non-Foreign COLA
12.1
313
Retention Allowance
12.1
314
Recruitment Bonus
12.1
315
Relocation Bonus
12.1
316
Other Benefits included in Object Class 12.1
12.1
400
Total Separation Pay (includes severance pay and separation incentive)
13.0
- Severance Pay
- Separation Incentive (i.e., "Buyout Bonus")
Total Benefits Plus Separation Pay (Sum of Codes 300 and 400)
12.1 & 13.0
OPM Form 1351-B (Re v. 11/97)
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