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Authorization for Pretax Payroll Reduction CAFETERIA PLAN ADVISORS, INC. Enrollment Deadline is 11/30/2021.420 Washington St., Ste. 100 Braintree, MA 02184 Tel.: 7818489848* Late Enrollments not Accepted.
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How to fill out premium only plan authorization

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How to fill out premium only plan authorization

01
Obtain the premium only plan authorization form from your employer or insurance provider.
02
Fill out your personal information such as name, address, date of birth, and social security number.
03
Specify the type of plan you are authorizing and provide any additional information required.
04
Sign and date the form to indicate your consent to participate in the premium only plan.
05
Return the completed form to your employer or insurance provider for processing.

Who needs premium only plan authorization?

01
Employees who wish to participate in a premium only plan offered by their employer.
02
Individuals who want to take advantage of pre-tax savings on eligible expenses such as health insurance premiums.
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Premium only plan authorization is a document that allows employees to contribute a portion of their salary towards payment of their health insurance premiums on a pre-tax basis.
Employers offering a premium only plan to their employees are required to file the authorization document.
To fill out a premium only plan authorization, employers must provide the necessary information about the plan and employee contributions.
The purpose of premium only plan authorization is to allow employees to save on taxes by contributing to health insurance premiums on a pre-tax basis.
The authorization document must include details about the premium only plan, employee contributions, and other relevant information.
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