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 The Local Choice

Your EAP offers these great resources.

Making a Budget: Worksheet

Use this worksheet to see how much money you spend this month. Then, use this month's information to help you plan next month's budget.

Some bills are monthly, and some come less often. If you have an expense that does not occur every month, put it in the "Other expenses this month" category.

MONTH__________________________ YEAR__________________

My Income This Month

Monthly Income Worksheet
IncomeMonthly Total
Paychecks (salary after taxes, benefits, and check-cashing fees)$
Other income (after taxes); for example, child support$
Total Monthly Income$

My Expenses This Month

Housing

Housing Expenses Worksheet
ExpensesMonthly Total
Rent or mortgage$
Renter's insurance or homeowner's insurance$
Utilities (like electricity and gas)$
Internet, cable, and phones$
Other housing expenses (like property taxes)$

Food

Food Expenses Worksheet
ExpensesMonthly Total
Groceries and household supplies$
Meals out$
Other food expenses$

Transportation

Transportation Expenses Worksheet
ExpensesMonthly Total
Public transportation and taxis$
Gas for car$
Parking and tolls$
Car maintenance (like oil changes)$
Car insurance$
Car loan$
Other transportation expenses$

Health

Health Expenses Worksheet
ExpensesMonthly Total
Medicine$
Health insurance$
Other health expenses (like doctors' appointments and eyeglasses)$

Personal and Family

Personal and Family Expenses Worksheet
ExpensesMonthly Total
Child care$
Child support$
Money given or sent to family$
Clothing and shoes$
Laundry$
Donations$
Entertainment (like movies and amusement parks)$
Other personal or family expenses (like beauty care)$

Finance

Finance Expenses Worksheet
ExpensesMonthly Total
Fees for cashier's checks and money transfers$
Prepaid cards and phone cards$
Bank or credit card fees$
Other fees$

Other

Other Expenses Worksheet
ExpensesMonthly Total
School costs (like supplies, tuition, and student loans)$
Other payments (like credit cards and savings)$
Other expenses this month$
Total Expenses
Total Monthly Expenses$

Income – Expenses = $_____________


If your income is more than your expenses, you have money left to save or spend. If your expenses are more than your income, look at your budget to find expenses to cut.

U.S. Federal Trade Commission (FTC), Consumer.gov. (2012, September). Make a budget – Worksheet. Retrieved June 21, 2024, from https://www.consumer.gov

More about this Topics

  • Protections for Consumers Sending Money Abroad

  • Investing: Consumer Tips

  • Managing Finances This Holiday Season

  • Four Elements Define Personal Financial Wellbeing

  • Ways to Save Extra Money

Other Topics

    • Family Financial Statement
    • Financial Basics Handbook
    • Your Routine Financial Checkup
    • Your Financial Checkup
    • Effective Budgeting
    • Maintaining Personal and Fiscal Resiliency During Tough Economic Times (2017)
    • Digging Deep
    • Financial Calculators
    • Financial Resources for Older Americans
    • Choose to Save
    • Mint
    • GasBuddy Find Gasoline Bargains
    • Federal Deposit Insurance Corporation
    • For Seniors: Quick Tips for Protecting Your Finances-Part 4
    • Creditors and Debt Settlement Companies
    • Banking: Consumer Tips
    • Managing Your Checking Account
    • Money Management: A Planner