Benefits & Payroll Reconciliation

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The Benefits & Payroll Reconciliation Worksheet is used whenever an employee separates from Sanctuary Social and has participated in the company's employer-sponsored insurance benefits. This form provides a clear record of all insurance premiums paid by the company, the employee's required contribution, payroll deductions already collected, and any remaining balance owed at the time of separation.

The worksheet documents:

• Medical, Dental, Vision, and Life Insurance coverage 
• Coverage effective and termination dates 
• Total premiums paid by the employer 
• Employee's required premium responsibility 
• Payroll deductions collected during employment 
• Remaining balance due, if any 
• Final payroll deduction amount 

This document serves as the official reconciliation record for the employee's personnel file and supports final payroll processing, benefit administration, and compliance with company policy. It provides a transparent calculation of insurance-related deductions and helps ensure accurate documentation should questions arise regarding the employee's final paycheck or benefits after separation.

When to Use:

• Voluntary resignation 
• Involuntary termination 
• Job abandonment 
• Retirement 
• Any separation where the employee was enrolled in company-sponsored insurance benefits 

Completed By: General Manager, Owner, or Payroll Administrator before the employee's final payroll is processed.