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ResetPrintSaveOptionALLA MESSAsponsored Section 125 PlanPremium Contribution or Cash in Lieu Election and Authorization Employees name AddressFirstMiddleLastStreetApt/Lot #CityStateZIP code Job titleEmployees
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Premium contribution or cash is a mandatory payment made by individuals or organizations towards a premium insurance plan or service.
Individuals or organizations who have opted for a premium insurance plan are required to file premium contribution or cash.
Premium contribution or cash can be filled out by providing accurate information regarding the payment method, amount, and purpose.
The purpose of premium contribution or cash is to ensure that individuals or organizations are covered by an insurance plan in case of unforeseen events.
Information such as payment amount, payment method, purpose of payment, and recipient details must be reported on premium contribution or cash.
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