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  • Section 125 Cafeteria Plan Change In Election Form - Ibn

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SECTION 125 CAFETERIA PLAN CHANGE IN ELECTION FORM Company Name: Group Policy Number G Employee Name: Social Security No. Employee Address: Street City State Zip Code Check Applicable Box REPLACEMENT.

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Section 125(a). A cafeteria plan is defined in § 125(d)(1) as a written plan maintained by an employer under which all participants are employees, and the participants may choose among two or more benefits consisting of cash and qualified benefits.

Section 125 permits employees to choose between taxable cash and “qualified benefits” through a cafeteria plan. Only qualified benefits can be part of a cafeteria plan. Tuition Assistance (employer tax-free reimbursement permitted under §127 or §132) • 403(b) Plan (different from 401(k)!)

These events are defined by the IRS and include: Change in your legal marital status (i.e., marriage, legal separation, divorce, or death of your spouse) Change in employment status (for you, your spouse, or dependent) that affects eligibility for health insurance benefits. Change in your number of tax dependents.

A cafeteria plan may permit a participant to make election changes due to a change in coverage under another employer plan. This would be triggered by one of two situations: The other employer plan allows a permissible election change. The other employer plan has a different period of coverage.

A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.

What is the new permitted election change? Put simply, the new permitted election change allows an employee to drop group health plan coverage for a dependent so the dependent can enroll in an individual health insurance plan through the Marketplace.

The written plan must specifically describe all benefits and establish rules for eligibility and elections. A section 125 plan is the only means by which an employer can offer employees a choice between taxable and nontaxable benefits without the choice causing the benefits to become taxable.

Qualified Status Change (QSC) means a change in family or work status that allows limited mid- year changes to benefit plans consistent with the individual event. Outside of open enrollment, a QSC is the only time a change in enrollments can occur.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232