Employee Benefit Service...

...Employee Benefit Solutions

 
Section 125 Flexible Benefit Plans  
PREMIUM ONLY PLANS
Put the tax code to work for you —
so you and your employees get the savings you deserve.
If your employees pay a portion of their health insurance costs, you may be able to reduce your payroll taxes, and give workers a little extra in their checks each and every week. How? By letting us handle payroll deductions for insurance premiums with a Premium Only Plan.

A Premium Only Plan, or POP, allows employees to make contributions to their health, dental, life and disability insurance costs before taxes are calculated. Under Section 125 of the Internal Revenue code, employees save FICA, federal income tax, and in many cases, state income tax on their health insurance deductions with every paycheck.

You can save too, because eligible businesses do not pay FICA matches or FUTA tax on employee medical deductions. For many small to medium-size companies, the savings can be impressive.

But POP paperwork is time-consuming. IRS eligibility standards are stringent and, of course, very complicated. Until recently, few smaller companies could afford to enjoy all the benefits of a POP.

Fortunately, no one is more qualified to cut through the red tape for you than Advantage. We make it easy for you and your employees to get everything that’s coming to you. Our complete and affordable POP services include:

 

Sample Plan Document
   

Employee enrollment forms
   

Enrollment and annual re-enrollment administration
   

Non-discrimination and other federal eligibility testing
   

All required IRS (Form 5500) and Department of Labor filings (For employers with 100+ employees)
How much could you save?
Here’s how much an employee grossing $450 each week could save with a POP.


 
After Tax Deductions
Gross Wages  
$450.00
Taxable Wages  
$450.00
FICA  
$34.43
Fed. Tax (15%)  
$67.50
State Tax (2%)  
$5.00
Med. Insurance  
$50.00
Net Pay  
$285.07
     
     
Pre-Tax Deductions
Gross Wages  
$450.00
Taxable Wages  
$400.00
FICA  
$30.60
Fed. Tax (15%)  
$60.00
State Tax (2%)  
$8.00
Med. Insurance  
$50.00
Net Pay  
$301.40
Difference  
+$12.33
Annual x 52  
$641.16


Here’s how much you could save on this employee if your business had a POP.

 

After Tax Deductions
FICA Match  
34.42
     
Pre-Tax Deductions
FICA Match  
30.60
Difference  
+$3.83
Annual x 52  
$199.16
     


A small business with 10 employees participating in the above scenario would realize savings of at least $1,991.60 (10 x $199.16) in FICA match alone.

Contributions to a POP plan are also exempt from FUTA, and in many states, SUTA.

WHAT IS A FLEXIBLE SPENDING ACCOUNT?

 

Section 125 of the Internal Revenue Code allows you to defer a portion of your gross income into a tax free spending account (Flexible Spending Account or FSA) which may be used to pay for medical, dental, and vision related expenses for you and your eligible dependents.  Throughout the year, when an eligible expense is incurred, you may submit these claims for these expenses and they are reimbursed with the pre-tax money in the FSA.  The expenses you claim must not be eligible for reimbursement elsewhere and you will not be able to claim the reimbursed expenses as a medical deduction on your tax return. 

You may also establish a separate dependent care expense account, which may be used to reimburse eligible daycare expenses.  You will not pay federal, state, Medicare, or social security taxes on the portion of your gross income you elect to deposit to you medical and/or dependent care spending account(s).  If you determine that participating in an FSA plan is beneficial for you, you may enroll in one or both of these accounts.

 

HOW DO I SAVE TAXES USING A FLEXIBLE SPENDING ACCOUNT?

 

                Premium contributions are automatically deducted from employee salaries before taxes are taken out.  Because their taxable income is reduced by the amount they contribute, employees pay less tax on the money they earn.  Here is an example of how you will increase your spendable income by deferring gross income to one or both of the spending accounts:

 

John Doe’s Salary Example

With Flexible Spending Accounts

Without Flexible Spending Accounts

Monthly Gross Pay

$2000

$2000

Pre-tax Dependent Care Contributions

$195

$0

Pre-tax Medical Contributions

$78

$0

Taxable Gross Pay

$1727

$2000

Applicable Taxes (20% Estimate)

$345.40

$400

After-tax Dependent Care Cost

$0

$195

After-tax Medical Cost

$0

$78

Net Spendable Income

$1381.60

$1327

Estimated Monthly Tax Savings

$54.60

 

Estimated Annual Tax Savings

$655.20

 

 

HOW DO I KNOW HOW MUCH TO CONTRIBUTE TO THE PLAN?

 

                You choose the annual amount of pre-tax contribution from your income up to the allowable maximums based on your estimated PREDICTABLE expenses.  Be careful not to overestimate your anticipated expenses since funds not used by plan the end of the plan year will be forfeited.  When estimating expenses, remember to include expenses for both you and your dependents.  If you know you will have specific qualified dependent care and/or medical expenses during the next calendar year, you will probably benefit from enrolling in one or both of these plans.  Please use the attached worksheet to estimate your medical expenses.  If you do not have any anticipated expenses, this plan is not for you.

Following is a sample medical expense estimate worksheet for John Doe:

 

Predictable Expense

Amount

Prescription Glasses for himself

$100

Recurring prescriptions for his wife

$211

Orthodontic payments for his daughter

$625

Total Annual Expense

$936

Based on the chart, John’s annual out-of-pocket medical expenses are estimated at $936.  John also has a toddler in childcare that costs him $2340 annually.  In addition to his medical FSA, he may also want to participate in a flexible spending account for dependent care and take advantage of yet more tax savings.  John can reasonably set up $2340 as an annual election for his dependent care FSA. 

 

HOW MUCH MONEY IS TAKEN OUT OF EACH PAYCHECK?

 

                The amount withheld from your paycheck is determined by dividing your annual election amount for each account by the number of payroll periods during the plan year.  For example, John Doe’s annual elections for his medical and dependent care FSAs are $936 and $2340 respectively.  He has 26 pay periods per year.  A medical annual election of $936 divided by 26 pay periods is $36 per pay period.  Likewise, his dependent care annual election of $2340 divided by 26 pay periods is $90 per pay period.  He will be making a total contribution of $126 into his FSAs per pay period.  This contributed amount is subtracted from John’s gross pay before taxes are calculated.

               

HOW DOES THE MEDICAL SPENDING ACCOUNT WORK?

 

                Medical reimbursement accounts are established to reimburse employees for out-of-pocket expenses not covered under the group medical plan such as annual deductibles, co-payments, eye exams, eye glasses, orthodontic services, prescriptions, etc.  Elections are payroll deducted on a pre-tax basis and placed in your Medical Flexible Spending Account.  As out-of-pocket medical expenses are incurred, you may submit the expense and be reimbursed from the pre-tax money in your account.

                Claims for medical expenses incurred during the plan year are eligible for reimbursement up to the annual election amount regardless of what has been contributed.  For example, if your annual election amount is $1,200 and you incur an expense of $600 during the first month of the plan year, you will be reimbursed the $600 regardless of your plan contributions to date (the plan advances payment and future pay withholdings pay back the plan).

 

HOW DOES THE DEPENDENT CARE SPENDING ACCOUNT WORK?

 

                Dependent Care accounts are established to reimburse employees for out-of-pocket expenses relating to dependent care.  THE DEPENDENT CARE EXPENSES MUST BE INCURRED SO THAT BOTH PARENTS CAN WORK.  Elections are payroll deducted on a Pre-Tax basis and placed in the employee’s Dependent Care Flexible Spending Account.  As dependent care expenses are incurred, you may submit the expense and be reimbursed from the accumulated pre-tax money in your account.  Claims for dependent care expenses will only be reimbursed up the amount available in your account.  Unlike the medical spending accounts, the plan will not advance you reimbursement for dependent care expenses.

 

WHAT DEPENDENT CARE EXPENSES ARE ELIGIBLE FOR REIMBURSEMENT?

 

                Following are some common examples:

·       Care at licensed nursery schools, day camps, and day care center for dependent adults or children

·       Services from individuals who provide care in or outside of your home (cannot be dependents of you or your spouse or your children under age 23)

·       Dependent care centers that provide day care for dependent adults (not residential care)

·       Household services related to the care of the elderly or disabled adults who live with you

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