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Employee Flexible Benefits Profile Employee Name: _______________________________________________________________ Employee Address: _____________________________________________________________ This report has been prepared to give you a better idea of our flexible benefits program as it applies to you and your family as of [date]. The information in this statement is based on the following: Your date of birth: ______________________ Your Social Security number: ______________________ Your most recent date of hire: ______________________ Your base regular earnings: ______________________ Your employee number: ______________________ Health Benefits Your flexible benefits medical plan provides valuable protection for you and your family. The plan covers a broad range of health services and supplies. Depending on the option selected, expenses are covered at either: 80 percent, 90 percent, or 100 percent of “reasonable and customary” (R&C) charges after an annual deductible has been met. Regardless of the option you have selected, catastrophic protection is provided at 100 percent of R&C charges if covered expenses exceed $________. Benefits are payable up to a lifetime maximum of $___________ per covered individual. During the period January 1, [2006] to December 31, [2006], the Company paid health expenses of $ [1000.00] on behalf of your family. Our records show that as of January 1, [2006] you are enrolled in the following plans: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Life Insurance and Survivor Benefits Your survivor benefits provide valuable protection for your family during your career, and, if you retire from the Company with at least [20] years of service, after you retire. 1 Our records show that as of January 1, [2006] you are enrolled in the following plans: ______________________________________________________________________________ ______________________________________________________________________________ The following summarizes your current coverage levels based on your salary as indicated below: Amount of coverage Current annual employee contribution Core life insurance $___________ $___________ Core travel accident insurance ____________ ____________ *Core ten-year survivor coverage ____________ ____________ *Core twenty-five-year survivor coverage ____________ ____________ Option ________________ life insurance ____________ ____________ Accidental death and dismemberment ____________ ____________ Dependent coverage: Spouse ____________ ____________ Child ____________ ____________ *Assumes beneficiary is same age as you. Vacation Based on your accredited service with the Company, during [2006], you were entitled to [3] weeks of regular paid vacation. During [2006] you are eligible for [2007] weeks of regular paid vacation. In addition, during each enrollment period, you are eligible to purchase up to [5] extra vacation days with flexible credits. The flex cost of each day depends on your base annual salary. In [2005] you purchased ____ extra days at a cost of $______ flexible credits. In [2006] you purchased ____ extra days at a cost of $ ______ flexible credits. 2 Disability Benefits If you are unable to work because of illness or injury, your core disability plans provide a continuous source of income. In addition, you can supplement this income by choosing among the optional coverage available. Our records indicate that as of January 1, [2006] you are enrolled in the following plans: ______________________________________________________________________________ ______________________________________________________________________________ If you were to become temporarily disabled your income from the plan would be: $_____ per month for up to [6] months and $_____ per month for an additional [6] months (including any Social Security payments) If you were to become totally disabled your income from the plan would be: $______ per month for up to [12] months and $______ per month until the earlier of the date you recover, die, reach age 65, or retire (including any Social Security payments). During total disability, your retirement plan benefits would continue to provide a continuous source of income after you retire. Depending on the form of payment you choose, you can also provide a monthly income to your eligible designated beneficiary after your death. Retirement Plan Your retirement plan, in combination with Social Security, is intended to provide a continuous source of income after you retire. Depending on the form of payment you choose, you can also provide a monthly income to your eligible designated beneficiary after your death. Shown in the accompanying tables is the estimated monthly income payable to you when you retire. These illustrations assume that your current annual earnings will remain unchanged between now and when you retire. In addition, these illustrations do not take into account any other additional forms of includable compensation such as overtime pay and/or incentive bonuses that you may have received in the past or may receive in the future. Depending on your circumstances, additional Social Security may be payable to your spouse as early as age 62. If you retire prior to age 62 your benefits will not be reduced to reflect the Social Security offset until you reach age 62. The following examples assume that your spouse is the same age as you. 3 50 percent Joint and Survivor Benefits: If you retire at age 62 55 65 Monthly income from retirement plan $_____ $_____ $_____ Monthly income from Social Security $_____ $_____ $_____ Total monthly retirement income $_____ $_____ $_____ Total monthly retirement as a percentage of final average earnings ______ % ______ % ______ % Straight Life Annuity: If you retire at age 62 55 65 Monthly income from retirement plan $_____ $_____ $_____ Monthly income from Social Security $_____ $_____ $_____ Total monthly retirement income $_____ $_____ $_____ Total monthly retirement as a percentage of final average earnings ______ % ______ % ______ % The 50 percent joint and survivor form of pension provides you with a lower level of benefits during your lifetime, but after your death your spouse will receive a lifetime monthly benefit equal to one-half the amount you were receiving before your death. Unless you elect otherwise, this is the normal form of payment you will receive if you are married. The life annuity form of pension provides you with a lifetime monthly income with no payments made after your death, unless you elect otherwise. This is the normal form of payment you will receive if you are not married at the time you retire. Other forms of retirement benefits are available. Note: The benefit levels indicated above are only illustrations. They do not take into account possible changes in the Social Security law or any increases in salary that you may receive between now and the time you retire. The closer you are to retirement, the more accurate these estimated benefits are. In any event, the retirement plan, along with Social Security, should provide you with an ongoing monthly retirement income approximately equal to the percentage of final average earnings indicated above, regardless of changes in your salary. Capital Accumulation Plan In [2006] you and the Company contributed to your account as follows: 4 Amount of annual contributions from: Payroll deductions Company match of payroll deductions Flexible credits Allocated to: $ ____________ $ ____________ $ ____________ Company stock $ ____________ $ ____________ $ ____________ Guaranteed interest fund $ ____________ $ ____________ $ ____________ Diversified investment fund The total amount contributed to your account during [2006] was $______. The total value of your accounts as of December 31, [2006] was $______. When you reach age 65 your capital accumulation plan account will have a total value of $______ and will be capable of providing an estimated average monthly income of $______ for the rest of your life assuming that (1) annual contributions are made into your account at the same level as during [2006]; (2) no withdrawals are made; (3) the average annual investment yield is ____ percent between now and when you reach age 65; and (4) your monthly payment is in the form of a single life annuity. Employee's Stock Purchase Plan. In [2006] you and the Company contributed to your account as follows: $ ______ in payroll deductions $ ______ in Company match of payroll deductions $ ______ total Value of Your Benefits and Compensation As an employee of [Company], you and your family are protected by a wide variety of benefits, as described above. Your benefits have the following value: Value of your benefits during [2006] Health $ ____________ Disability $ ____________ Vacation/holiday $ ____________ Life and survivor $ ____________ Retirement $ ____________ 5 Capital accumulation $ ____________ Stock purchase $ ____________ Total value of summarized benefits $ ____________ Employee payroll deductions $ ____________ Total value of Company-provided benefits $ ____________ Regular base earnings as of December 31, [2006] $ ____________ Social Security paid on your behalf during [2006] $ ____________ Total value of compensation and summarized benefits $ ____________ Additional Benefits [Company] also provides the following additional benefits: Paid holidays Excused absences Full pay while on jury duty Military reserve salary differential Service awards Matching gifts to colleges and universities Tuition refund to help improve your education Student loans to help your children continue their education These benefits, along with those summarized in this profile, significantly increase the value of your total compensation. How Your Flexible Benefits Profile Was Prepared This benefit report has been prepared by the human resources department, on the basis of the information available in our records. Every effort has been made to provide you with data that is accurate and up to date; nevertheless errors can occur. If you have any questions about anything shown on your statement, please contact your employee relations officer. Eligibility for benefits and the actual amount payable under the various benefit plans described will be determined in accordance with the formal documents creating and governing such plans. If there is any discrepancy between a benefit described in this report and the benefits provided under the plan documents, the documents will determine the actual benefit. Social security benefits shown in this report and used in the calculation of retirement benefits are estimates based on the law in effect on December 31, [2006], and assume that you have had, and will continue to have, covered wages until you retire. You actual benefits from Social Security at the time you retire will depend on the law in effect at that time and your actual earnings history. If you want additional information about your Social Security earnings and benefits, you can ask 6 for a “Request for Earnings and Benefit Estimate Statement” (Form SSA-7004) from the Social Security Administration. Courtesy of American Can Company, Greenwich, Conn. 7