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Maryland Board of Nursing 
Patricia A. Noble, MSN, RN, Executive Director
Nancy D. Adams, MBA, RN, President
PERSONAL & CONFIDENTIAL

TO: John Doe
FROM: Personnel Department
DATE: February 14, 2003
RE: 2002 Total Compensation Paid

Listed below are the payments made by your employer on your behalf for calendar year 2002:

Wages 50,000
Bonus  2,000
        Total Wage Compensation  52,000
Benefits: 
Health Insurance Premiums  7,500 
Pension Contributions  5,200
Social Security: employer’s contribution (6.2% of salary, max of $84,900)  3,224
Medicare: employer’s contribution (1.45% of salary)  754
Life Insurance, Accidental Death & Dismemberment, L-term disability  420
Worker’s compensation, Employee Assistance Plan 250
Flexible Spending Administrative Fee  195
Health club subsidy  50
Federal & State Unemployment 
        Total Fringe Benefits  17,593
Total Compensation Paid for Calendar Year 2002  69,593

In addition to the above, your employer provided you with the following paid time off in 2002:

Annual Leave  10 days 
Holiday/Personal  10 days
Sick  12 days 



Last update: May 31, 2005
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Copyright © 1999-2005 Maryland Board of Nursing

Robert L. Ehrlich, Jr., Governor
Michael S. Steele, Lt. Governor
S. Anthony McCann, Secretary

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