Get California State University Northridge Section 125 Cafeteria Plan Election Form 2016-2026

Filling out the California State University Northridge Section 125 Cafeteria Plan Election Form is an essential step for employees wishing to make pre-tax benefit elections. This guide will provide you with a clear, step-by-step approach to complete this form online, ensuring you understand each component of the document.

Follow the steps to fill out the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information including your name, social security number, address, phone number, and birth date. Ensure all information is accurate and complete.
3. Indicate your pay cycle by selecting the appropriate option: Weekly, Bi-Weekly, Semi-Monthly, or Monthly. This determines how often your contributions are deducted.
4. If you are a new employee, please provide your benefit eligibility date to ensure accurate processing.
5. For your pre-tax elections, indicate your selections for Group Medical Insurance by marking 'YES' or providing the respective premium amounts for health, dental, and vision plans.
6. Complete the Flexible Spending Account sections by entering your desired contributions for Dependent Care Expenses and Medical Out-Of-Pocket Expenses. Note the maximum limits for each.
7. If you wish to select commuter benefits, fill in the amounts allocated for Parking and Mass Transit Expenses, again adhering to the maximum limits.
8. Calculate your total pre-tax contribution amount and ensure it reflects all selections made throughout the form.
9. Review the Flex-Advantage Plan Election Agreement section carefully. By signing below, you confirm your election decisions and acknowledge the conditions outlined regarding contributions and status changes.
10. Finally, sign and date the form in the designated areas to validate your elections. After completing all steps, you can save changes, download, print, or share the form as needed.

Complete your documents online today to manage your benefits effectively.