This template is relevant only to health and welfare benefit plans and can be used to analyze the significant components of a plan's benefit obligations and current year changes in benefit obligations. (Benefit obligations covered by insurance should not be included.)
Entering Data
The first section of the Information worksheet requests:
Plan’s name
Preparer’s name
Financial statement date
The second section of the Information worksheet requests:
Amounts currently payable, including insurance premiums, claims, and claims incurred but not reported (IBNR)
Post-retirement benefit obligations
Post-employment benefit obligations, including accumulated eligibility credits and other post-employment benefits
Total participants at year end
Total employees at year end
The last section of the Information worksheet analyzes the significant components of a plan’s benefit obligations on a per participant basis. Cells that contain formulas have been shaded yellow to differentiate them from input cells. You do not need to enter figures into the yellow cells. These cells will populate after the underlying information is entered.
The Rollforward worksheet can be used to rollforward significant components of benefit obligations from the beginning of the year to the end of the year. Cells that contain formulas have been shaded yellow to differentiate them from input cells. You do not need to enter figures into the yellow cells. These cells will populate after the underlying information is entered.