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FLEXIBLE SPENDING ACCOUNT (FSA) ELECTION FORM (Please clearly print all information)Employer Name: ADM Community School DistrictPlan Year: 7/1/2020 6/30/2021Participant Name: ___ Social Security Number:

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How to fill out base 125 cafeteria plan

01

Determine if your employer offers a base 125 cafeteria plan

02

Enroll in the cafeteria plan during your employer's open enrollment period

03

Choose the pre-tax benefits you want to participate in, such as healthcare, dependent care, or commuter benefits

04

Estimate the amount of expenses you will have for the year that are eligible to be paid with pre-tax dollars

05

Elect a specific amount to contribute to the cafeteria plan from each paycheck

06

Submit any required documentation, such as proof of dependent care expenses, to the plan administrator

07

Monitor your cafeteria plan balance and expenses throughout the year

Who needs base 125 cafeteria plan?

01

Employees who want to save money on taxes by using pre-tax dollars to pay for certain expenses

02

Employers who want to offer their employees a tax-advantaged way to pay for benefits

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What is base 125 cafeteria plan?

A base 125 cafeteria plan is a type of employer-sponsored benefit plan that allows employees to contribute a portion of their pre-tax salary to pay for qualified expenses such as medical, dental, and vision insurance premiums.

Who is required to file base 125 cafeteria plan?

Employers who offer a base 125 cafeteria plan to their employees are required to file the plan with the IRS.

How to fill out base 125 cafeteria plan?

To fill out a base 125 cafeteria plan, employers need to provide information about the plan, including the types of benefits offered, contribution limits, and eligibility requirements.

What is the purpose of base 125 cafeteria plan?

The purpose of a base 125 cafeteria plan is to provide employees with a tax-efficient way to pay for qualified benefits and save money on their healthcare expenses.

What information must be reported on base 125 cafeteria plan?

Information that must be reported on a base 125 cafeteria plan includes employee contributions, benefits offered, plan documents, and compliance with IRS regulations.

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