Section 125 Cafeteria Plans
Requirements Premium
Only Plan
(POP)		 Medical
Reimbursement
(FSA)		 Adult/Child
Dependent
Care (FSA)		 Adoption
Assistance
FSA
Plan Document Yes Yes Yes Yes
Employee Contributions Employee share of
health insurance		 Unlimited
dollar amount
(set by employer)		 Up to
$5,000 per year		 Up to $12,650 per year, per adoption in 2012.
Employer Contributions Not required Not required Not required Not required
Use It Or Lose It No* Yes Yes Yes
Employee Tax Savings+ $22 to $40
for every
$100 contributed		 $22 to $40
for every
$100 contributed		 $22 to $40
for every
$100 contributed		 $15 to $38
for every
$100 contributed
Employer Tax Savings++ 7.65% of
employee
contribution		 7.65% of
employee
contribution		 7.65% of
employee
contribution		 None
Claims None Yes Yes Yes
Annual IRS Form 5500 Filing (No tax due) No Yes, generally if funded and/or over 100 participants No No
* Loss of employee contribution may occur when underlying insurance coverage is dropped without a valid change-of-status (i.e., family status, full-time to part-time work or change in premium amount).
+ Savings include employee FICA, federal tax, and state income tax where applicable, except for New Jersey.
++ Savings will be less for employee earnings in excess of FICA base.