Get Cafeteria Plan/section 125 Enrollment/change Form - Dexter ... - Dexterschools

Filling out the Cafeteria Plan/Section 125 Enrollment/Change Form is essential for employees to manage their benefits effectively. This guide provides clear, step-by-step instructions to help you complete the form accurately, ensuring compliance with Section 125 of the Internal Revenue Code.

Follow the steps to successfully complete the Cafeteria Plan/Section 125 Enrollment/Change Form.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin with Section 1: Provide basic information including your name, social security number, birth date, street address, city/state, and zip code. Ensure all information is accurate to avoid delays.
3. In Section 2, indicate your benefit election by checking the box to participate in the Cafeteria Plan/Section 125 Plan. Complete the corresponding elected sections as necessary.
4. If you choose to decline participation, complete Section 3 by signing the certification confirming your decision.
5. For Sections 4, 5, and 6, fill in your salary reduction amounts for health flexible spending arrangements and dependent care flexible spending arrangements. Be mindful of the annual contribution limits specified.
6. In Section 7, authorize direct deposit by providing your bank details and attach a voided check to facilitate smooth processing of reimbursements.
7. Complete Section 8 by signing and dating the certification, acknowledging your elections and understanding of the plan's terms and conditions.
8. Finally, review all entries for accuracy, then save, download, print, or share the completed form as needed. Ensure to return the form to the Payroll & Benefits Office within 30 days after hire or qualifying event.

Start completing your Cafeteria Plan/Section 125 Enrollment/Change Form online today!