Section 125 - Flexible
Spending Account Information
OVERVIEW
Under Section 125 of the Internal Revenue Code (often referred to as Cafeteria
Plans),
employers can use pre-tax dollars to provide employee benefits when the
employee is
participating in the costs. The method used is salary reduction. Instead of
offering payroll
deduction to employees, the employer can offer a payroll reduction in the
amount of the
employee's share of the benefits cost. The employee receives a lower gross
pay amount
thereby paying fewer state and federal tax dollars, possibly fewer FICA
dollars and increasing
his take home pay. All participants in a Section 125 Cafeteria plan must be
employees of the
employer offering the plan.
MEDICAL REIMBURSEMENT ACCOUNT (MRA)
Section 125 of the Internal Revenue Code allows for employees to set aside
some of their
wages into Medical Reimbursement Accounts (MRA). The money set aside in the
MRA can be
used to pay for medical expenses not covered by the company's health plan.
Examples of
things not covered by a health plan might be the deductible (the amount the
employee spends
before the health plan will pay), non-perscription drugs, eyeglasses, etc.
The employee decides how much to put into the MRA on an annual basis. He does
this based
on his own personal situation. He must plan ahead to estimate what he thinks
an appropriate
amount may be. Once he has selected the amount for the full year, that amount
is divided by
the number of pay periods in a year. The result of that is the amount that
will be withheld from
the employee's paycheck each pay period.
The rules laid down by the IRS require a "Use it or Lose it" of those amounts.
In other words,
once the money has been selected by the employee to be withheld from his
paycheck, that
money is only available to reimburse the employee for medical expenses he
actually paid but
was not reimbursed by his medical plan. If there is any balance in the MRA at
the end of the
year, the money in the MRA cannot be given back to the employee. Employees
are advised to
be cautious when selecting the amount they want in the MRA.
DEPENDENT CARE ACCOUNT
Dependent Care, whether it is for a child or a parent, can be a significant
expense for
employees. Under a Section 125 Plan, employees can use pre-tax dollars to pay
this expense.
Up to $5,000 a year can be contributed to a Dependent Care Account (DCA) on an
annual basis.
* Like an MRA, the money is deducted from the employee's wages evenly each pay
period. This
account must be distinct and separate from the MRA. Funds in an MRA cannot be
used to pay
dependent care and vice versa. Unlike MRA's, only the amount of money deducted
at any given
time can be reimbursed to the employee. There is minimal risk to the employer
that the
employee might withdraw more than was contributed to the DCA. Like an MRA,
Federal and
State Income Taxes and FICA on the amount spent on dependent care are avoided
and
become savings to the employee. Amounts reimbursed to the employee for
dependent care are
reported on the employee's W-2 wage report for Income Taxes.
*$2,500 maximum if not filing jointly.
HOW THE PLAN WORKS
When employees enroll in a Section 125 plan, their contributions to the plan
will be reduced
from their pay on each regular payday throughout the plan year. The company
will use these
amounts to pay premiums for their selected medical insurance coverage,
reimburse expenses
eligible under the plan and reimburse for dependent care, if applicable.
RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE SERVICE
Once employees have selected to enroll or not to enroll in the Section 125
plan, they cannot
change their mind until the beginning of the next plan year. Employees may
not change the
amount of their contribution either. If employees start out with family
medical coverage and
changed to single medical coverage after the employee had already enrolled in
the Section 125
plan, the law requires that you continue to contribute into the Section 125
plan at the family
medical coverage amount. THIS MONEY CANNOT BE GIVEN BACK TO YOU.
THERE ARE SOME EXCEPTIONS.
The Internal Revenue Service will allow changes to the amount employees
contribute to the
Section 125 plan for the following "Life Event" changes during the plan year:
* if the employee marries, divorce or legally separate
* if the employee, spouse, or a dependent has a change in residence
* if the employee has a baby or adopt a child
* if the employee gains or loses a dependent
* if there is a change in eligibility of the employee’s dependent, such as
graduation from
college
* if the employee spouse starts or stops working
* if the employee has a change in employment status such as changing from
hourly to salary
* if the employee working status changes from full to part time or the other
way around
* if the employee goes on an unpaid leave of absence
* if there is a significant change in health coverage due to the employee
spouse's employment
* if the employee leaves or are released from the company
* if the employee covered dependents become entitled to COBRA continuation
coverage
* if the employee, spouse or dependents gain or lose Medicare or Medicaid
entitlement
* if the employee is in receipt of a qualified medical child support order (QMED)
If one of the above occurs during the plan year employees may choose to:
renroll in the Section 125 plan (assuming they hadn't before)
elect out of the plan altogether and have no future monies go into the plan.
Once employees
decide to do this, however, they cannot get back into the plan until the next
enrollment date.
Change the amount of the contribution to match the change in their medical
insurance
coverage caused by one of the above "Life Events".
IT IS IMPORTANT THAT YOU UNDERSTAND that if while employed you decide to drop
your
medical insurance coverage, or want to change your medical reimbursement
contributions
during the plan year for any reason other than a "Life Event" as explained
above, the law
requires that your contribution to the Section 125 plan must continue for the
remainder of the
plan year. This means your pay will continue to be reduced by the amount of
money that you
were paying for your medical insurance coverage and medical reimbursement
account at the
time you enrolled in the Section 125 plan. The Internal Revenue Service
forbids any refunding of
unused contributions.
SECTION 125 EFFECTS ON COMPENSATION
Participation in the Section 125 Plan will not affect an employee's
compensation for
determining benefits under any other plan sponsored by the company.
Eligibility and benefits
received will be based on pre-Section 125 wages.
SOCIAL SECURITY
One of the advantages of the Section 125 Plan is that it reduces the amount of
Social Security
taxes withheld. In 2001, Social Security tax is computed on wages up to
$80,400 at 7.65% rate.
Participation in a Section 125 Plan over an extended period of time could have
an effect on the
amount of benefits received under Social Security. The reduction in Social
Security benefits is
usually minimal, if any. Earnings over the maximum taxable base generally are
not affected.
*1.45% to an unlimited maximum for Medicare Tax
TAXES
A Section 125 Plan can have favorable tax effects in that the amounts
contributed to the plan are
not subject to Federal Income Tax and in most states are not subject to State
Income Tax as
well. However, each individual's situation is unique and any specific tax
consequence from
participating in the Section 125 Plan should be determined by the employee
with his personal
tax advisor.
SUMMARY
Both the employer and the employee can realize significant savings by
implementing a Section
125 Cafeteria Plan. Careful planning is required to design a plan that meets
the needs of the
specific makeup of the employees.
This document is not intended to cover all the details of the Section 125
Cafeteria Plans. This
is a summary and overview only. For a detailed explanation, please ask your
Financial Advisor
to schedule an appointment to discuss Section 125 Cafeteria Plans in detail.
EXAMPLES OF MEDICAL EXPENSES
ELIGIBLE FOR REIMBURSEMENT
· Acupuncture
· Adoption fees
· Alcoholism
· Ambulance hire
· Artificial limbs
· Artificial teeth
· Birth control pills
· Braces
· Braille - books and magazines
· Chiropractors
· Christian Science practitioners' fees
· Coinsurance for health insurance
· Cosmetic surgery (even though not recommended by physician)
· Cost of operations and related treatments
· Crutches
· Deductible for health insurance
· Dental fees (including orthodontia)
· Dentures
· Diagnostic fees
· Drug and medical supplies
· Employee contributions to Group Dental, Vision, Life & AD&D
· Legal and Disability Income contributions
· Eyeglasses, including examination fee
· Fee of practical nurse
· Fees for healing services
· Fees of chiropractors
· Fees of licensed osteopaths
· Handicap people’ special schools
· Hair transplants
· Health insurance premiums including Medicare Part B payments, but
Part A coverage
is not deductible
unless person is 65 or over and is not entitled to Social Security benefits
· Hearing devices and batteries
· Home improvements motivated by medical considerations
· Hospital bills
· Hospitalization insurance
· Insulin
· Laboratory fees
· Laetrile by prescription
· Lead base paint removal--for children with leach poisoning
· Life fee to retirement home for medical care
· Membership fees in association furnishing medical services,
hospitalization, and clinical
care
· Nurses' fees (including nurses' board and Social Security tax where
paid by taxpayer)
· Obstetrical expenses
· Operations
· Orthopedic shoes
· Oxygen
· Physician fees
· Psychiatric care
· Psychologist fees
· Retarded persons cost for special home
· "Seeing-eye" dog and its upkeep
· Special diets
· Sterilization fees
· Surgical fees
· Therapy treatments
· Transportation expenses primarily for rendition of medical service,
i.e., railroad fare to
hospital or to
recuperation home, cab fare to obstetrical cases
· Tuition at special school for handicapped
· Tuition fee (part), if college or private school furnishes
breakdown of medical charges
· Vitamins by prescription
· Wheelchair
· Wigs
· X-rays
This is not an inclusive list. If you have specific questions on items not on
this list, contact your
local IRS office.