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Section 125 / Premium Only Plan Document Application Pre-Tax Payment of Insurance Premiums and HSA Contributions Employers may permit their employees to pay their group insurance premium contributions

How to fill out section 125 application

How to Fill Out Section 125 Application:

1. Gather necessary information: Before starting the application, gather all the required information such as your personal details, employment information, and any eligible dependents you wish to include.
2. Provide employee information: Fill out the section where you provide your employee details, including your full name, address, social security number, and employment start date.
3. Choose the benefits you want: Indicate the specific benefits you wish to enroll in, such as health insurance, dental coverage, vision plans, or flexible spending accounts. Make sure to read the descriptions and requirements of each plan before selecting.
4. Determine the contribution amount: Decide how much money you want to contribute towards each benefit plan. Note that some plans may have maximum or minimum contribution limits, so review the rules before entering the amounts.
5. Include eligible dependents: If you have eligible dependents, provide their details, including their full names, dates of birth, and relationship to you. This step is necessary if you wish to cover them under your benefit plans.
6. Review and sign the application: Once you have filled out all the necessary sections, review the application carefully to ensure accuracy. Check for any errors or missing information. Finally, sign and date the application to acknowledge the accuracy of the provided details.

Who needs Section 125 application?

1. Employers: Employers who wish to offer a cafeteria plan or flexible benefit arrangements to their employees would need to complete a Section 125 application. This application allows the employer to establish the plan and outline the benefits available for employees to choose from.
2. Employees: Employees who are interested in enrolling in their employer's cafeteria plan or flexible benefit arrangements would also need to fill out the Section 125 application. This application allows employees to select the benefits they want and determine their contribution amounts.
3. Eligible dependents: If an employee wishes to cover their eligible dependents under the benefit plans offered through the Section 125 plan, they would also need to provide the necessary information and complete the application for their dependents. This ensures that the dependents are included in the coverage and receive the desired benefits.

For pdfFiller’s FAQs

What is section 125 application?

Section 125 application refers to a document that allows employees to choose between taxable benefits like cash and nontaxable benefits such as health insurance.

Who is required to file section 125 application?

Employers are required to provide section 125 application to eligible employees.

How to fill out section 125 application?

Employees can fill out section 125 application by providing their personal information, choosing their benefits, and signing the document.

What is the purpose of section 125 application?

The purpose of section 125 application is to give employees the option to pay for certain benefits with pre-tax dollars, reducing their taxable income.

What information must be reported on section 125 application?

Information such as employee name, employee ID, benefits selection, and signature must be reported on section 125 application.

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