Intermountain Paycheck Planner Plus

<strong>Paycheck Planner PLUS</strong> is designed to help you determine how to defer additional one-time large amounts into your 401(k), 403(b) or other retirement savings plan. Ideally, this tool will help you maximize your retirement account contribution without negatively impacting your take-home pay or the matching contributions you receive from Intermountain Healthcare.

Use the TAB key to move from one box to the next and input information from your statement of earnings from Intermountain Healthcare. Enter your 'current' information in the first column and your 'pay period 20' scenario with your proposed increased 401(k), 403(b) or other savings in the second column. When finished, click 'submit' at the bottom of the page.

Compare your 'pay period 20' take-home pay to your 'current' take-home pay, then scroll back to the top of the page and make changes to your deferral amounts. Click 'submit' again, review the comparison, and continue this same process until you reach your desired combination of take-home pay and retirement savings contributions.

If you want to make adjustments to your 'pay period 20' deferral amount, refer to the PTO Cashout communication materials you received at your home or contact the Intermountain Retirement Program for the appropriate timing to make that change.

Paycheck Information

State of employment

Age as of 12/31/10

Scheduled hours per week

Hourly rate

PTO cashout hours

Savings Plus/401(k):
year-to-date contributions

Tax-Deferred Savings Plan/403(b):
year-to-date contributions

Earnings Information

	Current	Pay Period 20
Both your 'current' earnings and your 'pay period 20' earnings will be calculated automatically using the information you have entered above. Leave this area as $0 unless you want to override this calculation. If you receive a significant amount of premium pay, such as overtime or shift differential, you may want to enter your own per pay period earnings here.

Withholding Information

	Current	Pay Period 20
Filing status: (W-4 form)
Number of allowances claimed: (W-4 form)
Extra federal/state taxes withheld

Pre-Tax Deductions

Medical

Dental

Basic Life

ADD

FSA Heath Care / HSA

Other Pre-Tax Deductions

After-Tax Deductions

LTD Employee

Employee Optional Life

Spouse Optional Life

Child Dependant Life

Loan Payments: 401(k)/403b

Other miscellaneous after-tax deductions

Dependant/Health Care Reimbursements

Savings Information

	Current	Pay Period 20
Savings Plus/401(k): (do not include matching)
Tax-Deferred Savings Plan/403(b): (enter % or leave at 0% and enter dollar amount)	OR	OR
Other Savings: (enter % or leave at 0% and enter dollar amount)	OR	OR
Roth 401(k): (do not include matching)

Intermountain Healthcare has provided this program to assist you in planning for your future. We caution you that this is only a tool. While we have made every effort to make this program accurate, the results you receive should be considered an estimate, not a guarantee, of what may actually happen in you own circumstances. For example, if your income changes, or if you file jointly with someone else and the other filer's income changes, these differences might affect the accuracy of the estimates generated by this program. The same is true for changes in the number of dependents, changes in filing status, different methods of computing deductions, different amounts of deductions, etc. Also, changes in the tax laws and regulations can affect such things as tax rates, withholding rates, amounts of deductions, etc. This program is provided to you for your assistance in estimating, generally, the effect certain decisions you make may have on your take-home pay. Your choice to use this program or to rely on its estimates is completely your own, voluntary decision. In making your decision, please note that if there is a difference between the estimates generated by this program and your actual results, Intermountain Healthcare will not be responsible for the results of any such differences.