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181 South Franklin Avenue, Suite 202 Valley Stream, NY 11581 pH: (212) 947-4800 ext 215 Fax: (516) 620-0789 FSA rpgny.com FSA MEDICAL AND DEPENDENT CARE REIMBURSEMENT COMPENSATION REDUCTION AGREEMENT

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What is section 125 election form?

Section 125 election form, also known as the Cafeteria Plan election form, is a document used by employers to allow employees to choose between taxable and non-taxable benefits, such as health insurance and flexible spending accounts.

Who is required to file section 125 election form?

Employees who wish to participate in their employer's Cafeteria Plan or flexible benefits program are required to file a section 125 election form to make their benefit elections.

How to fill out section 125 election form?

To fill out a section 125 election form, employees need to provide their personal information, select the benefits they want to enroll in, and indicate the amount to be deducted from their paycheck for each chosen benefit.

What is the purpose of section 125 election form?

The purpose of the section 125 election form is to allow employees to choose their desired benefits, including pre-tax deductions, and to notify their employer of their benefit elections and corresponding payroll deductions.

What information must be reported on section 125 election form?

The section 125 election form typically requires employees to report their name, address, social security number, employment status, desired benefits, benefit coverage levels, and chosen contribution amounts.

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