Get Section 125 Flexible Benefit Plan Change/election Form

Filling out the Section 125 Flexible Benefit Plan Change/Election Form is a crucial step for individuals seeking to modify their benefits due to a qualifying event. This guide provides clear, straightforward instructions to help users accurately complete the form online, ensuring they make informed elections that reflect their current circumstances.

Follow the steps to complete the Section 125 Flexible Benefit Plan Change/Election Form online.

1. Click the ‘Get Form’ button to access the Section 125 Flexible Benefit Plan Change/Election Form and open it in your chosen document editor.
2. Begin by entering your basic details: provide your employer's name, employee ID number, your name, social security number, and email address.
3. Indicate that you have experienced a change in status or other qualifying event by selecting the appropriate box. Review the list of qualifying events carefully and ensure that your reason aligns with the changes you wish to make.
4. In the explanation section, describe why your election change is consistent with the change in status. Make sure to provide a clear rationale that connects your change to the event selected.
5. For benefits changes, review the sections for adding, dropping, or changing specific benefit options. Mark the appropriate boxes next to each benefit you wish to adjust.
6. Input the company/plan information for all the benefits selected under the 'Company/Plan' header, including medical, dental, and any other related insurances.
7. Specify the amounts for after-tax deductions and employer-paid contributions for each selected benefit under the respective categories.
8. Review all provided information to ensure accuracy, then date and sign the form to certify that the information is true.
9. Finally, save changes, download, print, or share the completed form as needed for submission.

Take control of your benefits today by completing the Section 125 Flexible Benefit Plan Change/Election Form online.