HTML Preview Insurance Company Budget page number 1.
TRUSTMARK INSURANCE COMPANY
ENROLLMENT EXPENSE BUDGET WORKSHEET
NAME:
PREPARED BY: DATE:
CASE NAME:
NUMBER OF ELIGIBLE EMPLOYEES:
ESTIMATED NUMBER OF APPLICATIONS:
ESTIMATED ANNUAL PREMIUM: $
PRODUCT:
ENROLLMENT DATES FROM: TO:
EXPENSES
SALARY
Manager: Rate x Days = $
Enroller: Rate x Days = $
TOTAL SALARY $
TRANSPORTATION
Air Fare: Rate x # of tickets = $
Car Rental: Rate x Days = $
Other
TOTAL TRANSPORTATION $
LODGING & MEALS
Hotel: Rate x Days x People = $
Meals: Days x People = $
TOTAL LODGING & MEALS $
MISCELLANEOUS
Equipment Rental: = $
TOTAL MISCELLANEOUS $
Total Advance Request: $ Grand Total: $
Home Office Use Only:
Comments:
Approval: Date:
P485-048