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Online
Order Form for Section 125 Plan Documents
with HSA Module: |
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First,
choose the Plan or combination of Plans that
meet your needs from the following 4 options: |
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Section 125 Premium Only
Plans with the HSA Modules allow Employers to
pretax insurance premium including primary health
insurance such as PPO, HMO and HSA Plans. This
document package also allows the pretax treatment
of ancillary benefits such as dental, vision,
accident, cancer, hospital indemnity, and term
life insurance up to $50,000. The HSA module
allows employers to also pretax the HSA savings
component that goes to the bank. HSA contributions
can be changed if the employee wants to increase
or decrease the amount going to the health savings
account. |
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The Premium Only Plan (POP)
and Health FSA for medical expense reimbursements
combination includes the new HSA module. This
combination allows employees to pretax primary
and ancillary insurance premium and the HSA
savings component, plus the Health Flexible
Spending Account that allows employees to use
pre-tax dollars to pay medical bills not covered
by their insurance. The Health FSA has special
language to limit Health FSA reimbursements
to only dental, vision and preventative care
for employees also participating in an HSA Plan. |
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The Section 125 Premium Only
Plan (POP) and Dependent Care Assistance Plan
FSA combination allows employees to pretax insurance
premium, HSA savings, and establish a Flexible
Spending Account to reimburse dependent care expenses
incurred as a result of employment. |
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The full Section 125 Cafeteria
Plan includes all three, Premium Only
Plan (POP) with HSA Module, Health FSA,
and the Dependent Care Assistance FSA
Plans outlined above. This option allows
you to save $98 by combining all 3 Plans
together in one document. |
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