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LYNDON SCHOOL DISTRICT NO. 504 SECTION 125 PREMIUM ONLY WAIVER/ELECTION FORMEMPLOYEE (Print): Soc Sec #: Based on Lyndon School Districts Section 125 Plan, you have a choice of electing pretax benefits
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How to fill out section 125 premium only

01
To fill out section 125 premium only, follow these steps:
02
Gather the necessary information: Ensure you have all the required information, such as employee details, plan options, and costs.
03
Complete the enrollment forms: Fill out the enrollment forms provided by your employer or insurance provider, accurately and thoroughly.
04
Choose the plan options: Select the plan options that suit your needs and preferences. Consider factors like coverage, costs, and network providers.
05
Provide supporting documentation: Attach any required supporting documentation, such as proof of dependent eligibility, if applicable.
06
Review and sign the forms: Carefully review all the filled-out forms, ensuring accuracy and completeness. Sign the forms where required.
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Submit the forms: Submit the completed forms to the designated person or department within your organization or insurance provider.
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Follow up: Keep track of the submission and follow up with the relevant parties to ensure the enrollment process is completed successfully.
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Confirm enrollment: Once your section 125 premium-only plan enrollment is processed, you will receive confirmation. Review the details provided and seek clarification if needed.

Who needs section 125 premium only?

01
Section 125 premium only plans can benefit both employees and employers.
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Employees who have access to these plans can take advantage of pre-tax deductions for eligible expenses, such as healthcare premiums, out-of-pocket medical costs, and dependent care expenses. This can lead to potential tax savings and increased take-home pay for employees.
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Employers can offer section 125 premium only plans to attract and retain employees. It can be particularly beneficial for small businesses, as it allows them to provide cost-effective benefits without incurring additional payroll taxes.
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While the eligibility and benefits of section 125 premium only plans may vary depending on the specific rules and regulations of your country or state, these plans are generally designed for both employees and employers to take advantage of pre-tax savings and reduce overall healthcare costs.

What is SECTION 125 PREMIUM ONLY WAIVER/ELECTION Form?

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SECTION 125 PREMIUM ONLY WAIVER/ELECTION template instructions

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Section 125 premium only, also known as a Premium Only Plan (POP), allows employees to pay their portion of health insurance premiums on a pre-tax basis.
Employers who offer health insurance benefits to their employees are required to offer a section 125 premium only plan.
To fill out a section 125 premium only plan, employers must set up a plan document outlining the rules of the plan, and employees must complete enrollment forms to indicate their election to participate.
The purpose of section 125 premium only is to allow employees to save money on health insurance premiums by paying them on a pre-tax basis, reducing their taxable income.
Information such as employee elections, premium amounts, and pre-tax deductions must be reported on section 125 premium only documentation.
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