Section 1: Identifying Information
Section 2: Service Month Allocation
The allocation must relate to the actual period
of absence from service due to the injury.
A. Date of Injury: |
B. Reported Service
Months To Date:
(Exclude Deemed Service Months in or after the year of injury) |
C. Service Months Need To
Attain: |
120 240 360 |
D. Service Month
Allocation: |
Year |
Allocated Months |
Total |
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J F M A M J J A S O N D |
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|
J F M A M J J A S O N D |
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|
J F M A M J J A S O N D |
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|
J F M A M J J A S O N D |
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|
J F M A M J J A S O N D |
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|
J F M A M J J A S O N D |
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E. Total Allocated Service
Months: |
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|
F. Service Months to Date:
|
+ |
2B |
G. Projected Total Service
Months: |
= |
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Section 3: Minimum Creditable Compensation
Calculation
The monthly compensation
allocation must be at least ten times the employee's daily pay rate in effect on
the firsl day to which Pay for Time Lost Payments relate.
A. Employee's Daily Pay Rate: |
B. Minimum Monthly
Compensation: |
Employee Daily Pay Rate (3A) X 10 = |
C. Total Allocated
Compensation:: |
Minimum Monthly Compensation (3B) X
Total Allocated Service
Months (2E) = |
Section 4: Railroad Retirement Tax Act
Calculation
Employer Tax Calculation |
Tier I Taxable Compensation X 6.2% |
= Tier I Tax |
Medicare Taxable Compensation X 1.45% |
= Medicare Tax |
Tier II Taxable Compensation X (Note: Each Year the Percentage
is different) |
= Tier II Tax |
Total Employer Tax |
|
Employee Tax Calculation |
Tier I Taxable Compensation X 6.2% |
= Tier I Tax |
Medicare Taxable Compensation X 1.45% |
= Medicare Tax |
Tier II Taxable Compensation X 4.9% |
= Tier II Tax |
Total Employee Tax |
|
Section 5: Railroad Unemployment Insurance
Act Employer Contributions
RUIA
contributions are calculated using the rates and monthly limits in effect during
the months the Pay for Time Lost payments relate. RUIA creditable compensation
is calculated by multiplying the service months allocated to the year by the
lesser of the applicable RUIA monthly maximum or the employee’s allocated
monthly compensation.
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X |
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= |
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X |
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= |
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X |
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= |
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X |
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= |
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X |
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= |
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X |
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= |
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Total Employer RUIA
Contribution |
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|