This is your Member Reference Number (MRN). You’ll need to provide this when you make an appointment with an EAP counselor or contact your EAP by phone.

Anthem provides automatic translation into multiple languages, courtesy of Google Translate. This tool is provided for your convenience only. The English language version is considered the most accurate, and in the event of a discrepancy between the translations, the English version will prevail. This translation tool is not controlled by Anthem, and the Anthem Privacy Statement will not apply. Please read Google's privacy statement. If you want Google to translate the Anthem website, select a language.

Benefits with Commonwealth of Virginia Members

Your EAP offers these great resources.

General Budget Worksheet

Track your income and expenses here.

Monthly Income
Income (Monthly)Current
Base Pay (Net)$ ________.____
Other Job Take-Home Pay$ ________.____
Other Income (Monthly)$ ________.____
Child Support/Alimony$ ________.____
Benefits$ ________.____
Rental Home Income$ ________.____
Retirement Pay$ ________.____
Social Security Benefits$ ________.____
Survivor Benefit Plan$ ________.____
Interest/Dividends$ ________.____
Other$ ________.____
Other$ ________.____
Total$ ________.____
Total of All Income$ _______.____


Monthly Expenses
ExpensesAmount
Housing (Rent/Mortgage)$ ________.____
Housing Maintenance $ ________.____
Electric$ ________.____
Gas/Oil$ ________.____
Water/Sewer$ ________.____
Telephone (Home)$ ________.____
Telephone (Cellular)$ ________.____
Trash Pickup$ ________.____
Cable/Satellite/Internet$ ________.____
Automobile Payment$ ________.____
Auto Insurance$ ________.____
Life Insurance$ ________.____
Child Support/Alimony$ ________.____
Medical Insurance$ ________.____
Entertainment/Hobbies$ ________.____
Alcohol/Cigarettes$ ________.____
Barber/Beauty$ ________.____
Pet Costs$ ________.____
Property Tax (Monthly Figure)$ ________.____
Savings$ ________.____
Food Costs (Work and School)$ ________.____
Food (Groceries)$ ________.____
Clothing$ ________.____
Transportation (Gas, Bus, or Subway Fare)$ ________.____
Car Maintenance$ ________.____
Personal Needs$ ________.____
Child Care$ ________.____
One Time/Annual Expenses$ ________.____
Other Health Costs$ ________.____
Other$ ________.____
Other$ ________.____
Other$ ________.____
Debt Payments (Credit Cards, Loans, etc.)$ ________.____
Total Expenses$ _______.____


Monthly Totals
Monthly Totals
Total
Total Income$ ________.____
Total Expenses$ ________.____
Surplus/Deficit (Difference + or –)$ _______.____

Workplace Options (WPO). (Revised 2023). General budget worksheet (B. Schuette, Ed.). Raleigh, NC: Author.

More about this Topics

  • Save for Emergencies and the Future

  • General Debt Management Techniques

  • Dealing with Debt

  • Create a Budget and Stick with it

  • Making a Budget: Worksheet

Other Topics

    • Make Your Money Work for You: A Debt Management Plan
    • 8/15/23 Digging Deep
    • Financial Fitness: Living Within a Realistic Budget
    • Your Financial Checkup
    • Effective Budgeting
    • Coping with Financial Stress
    • Making a Budget
    • Build an Emergency Fund (Part 1)
    • Build an Emergency Fund (Part 2)
    • How to Make and Use a Budget
    • Financial Basics Handbook