Premium Only Plans - Medical & Dependent Care FSA's:


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Premium Only Plans - Medical & Dependent Care FSA's... 

Benefits of a Section 125 plan
Why does the government allow section 125 cafeteria plans? The pre-tax dollar incentive provided by section 125 helps both employers and employees control escalating health care costs. Regardless of which type of section 125 plan is incorporated in the business, whether a premium only plan, (POP Plan), medical flexible spending accounts, (FSA), or dependent care flexible spending accounts the tax advantages are the same.

Savings for Employers
Section 125 plans allow businesses to save Social Security (FICA), as well as federal unemployment taxes (FUTA) and generally, state unemployment taxes, on the money employees contribute to their premiums. Employer tax savings can average 7 to 10 percent of employees' contributions. (A tax advisor should be consulted for information on individual state regulations.)

EXAMPLE: An employer shows 20 employees, each contributing $1,200 in pre-tax medical contributions annually.

 

Pre-tax medical contributions:

$ 1,200

Number of employees:

x 20

Total employee contributions:

$24,000

FICA factor:

x .0765

Estimated annual FICA savings:

$ 1,836

 

Savings for Employees
Premium contributions are automatically deducted from employee salaries before taxes are taken out. Because their taxable income is reduced by the amount they contribute, employees pay less taxes on the money they earn. Employees see a savings in their FICA, federal, and, in most cases state, income taxes. When employees become more aware of how they spend money on benefit items, they also tend to practice more cost-containment, resulting in savings for everyone.

EXAMPLE:

 

With Section 125

Without Section 125

Monthly gross pay:

$1,000

$1,000

Pre-tax child care contribution:

200

0

Pre-tax unreimbursed medical deduction:

20

0

Taxable gross pay:

780

1000

Applicable taxes:

127

189

After-tax child care cost:

0

200

After-tax unreimbursed medical cost:

0

20

Net spendable income:

653

591

Increase in monthly spendable income:

62

--

Increase in annual spendable income:

744

--

 

Glossary of Terms:

Cafeteria Compensation Plan: IRS Code Section 125.

A group benefit plan established by an employer for the employees. Cafeteria Compensation Plans are authorized under the U.S. Internal Revenue Code, Section 125. Also referred to as a Section 125 Plan and a Flexible Benefits Plan.

Reimbursement Accounts:

A non-insurance plan established for employees that allows them to set aside certain funds, tax free, to be used to reimburse the employee for expenses authorized under the plan. Medical Reimbursement accounts can be established to reimburse employees for out-of-pocket expenses not covered under the group health and medical plan such as annual deductibles, employee's co-insurance share, prescriptions, and the like. Dependent Care accounts can be established to reimburse employees for out-of-pocket expenses relating to dependent care.

These accounts may be funded by employee elections through salary reduction or they may be employer funded. They are also called unreimbursed medical accounts and flexible spending accounts. Employees may participate in reimbursements, without regard to participation in other medical plans.

Medical/Dental Reimbursement Account: IRS Code Section 105.

Expenses not covered by the employer plan may qualify as eligible expenses reimbursable under Accident and Health coverage. If the plan is not totally funded or paid by the employer's medical plan, employees may make annual elections and have these deductions placed in his/her Medical/Dental Reimbursement Account.

Annual elections are most generally payroll deducted from the employee's paycheck on a per pay period basis, and deposited in the employee's Reimbursement Account. These payroll deduction amounts are made on a Pre-Tax basis.

When an eligible expense is incurred, the employee submits these expenses (much like filing an insurance claim form) and completes an expense voucher from which they are reimbursed on a Pre-Tax basis.

Dependent Care Assistance: IRS Code Section 129.

Dependent Care Assistance for employees is covered under Code Section 129, and may be provided through use of reimbursement accounts, flexible spending accounts or actual on site facilities.

Elections and benefits are limited to $2,500 or $5,000 annually depending on whether the employee's tax filing status is joint or separate.

Elections are payroll deducted on a Pre-Tax basis and placed in the employee's Dependent Care Assistance Account. As dependent care expenses are incurred, the employee submits the expense with a completed claim voucher and is reimbursed from his/her account on a Pre-Tax basis.

It is important to note that Dependent Care Reimbursement expenses do not have to be just for child(ren). These expenses may also cover expenses for elder care.

Accident & Health Plans: Excluded for gross income via Code Sections 105 and 106.

Premium costs for these programs are eligible under Section 125. These programs would include employer sponsored Personal Accident plans, Accidental Death & Dismemberment plans, Disability plans and Cancer/Intensive Care plans, etc.

Only plans that have no cash accumulations or return of premium features (even as optional riders) are eligible for inclusion.

Term Life Insurance: IRS Code Section 79.

The expense of the first $50,000 is excluded from gross income under Code Section 79. Amounts above $50,000 may be included on the employee's menu of benefits, but are not payable on a Pre-Tax basis.

In addition, amounts other than "de minimus" amounts are not deductible for the employee spouse and or children.