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Fax 781. 848. 8477 Personal Information Name Employer Street Plan Year City ST Zip SSN E-Mail Phone Payroll Information I am paid Weekly IF APPLICABLE I am a Bi-Weekly Municipal Employee Semi-Monthly School Employee Monthly Other Department/Location Benefits Selected FSA Dependent/ Day Care Account FSA Medical/Dental Care Account I elect to contribute for the Plan Year. AUTHORIZATION FOR PRE-TAX PAYROLL REDUCTION Cafeteria Plan Advisors Inc* 420 Washington St* Suite 100 Braintree MA 02184 Pho ...

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Are FSA contributions subject to state taxes?

All of these accounts HRAs, FSAs and HSAs are tax-advantaged, meaning the contributions, or the funds you put into the account, are untaxed. You can put the funds toward eligible expenses for medical, vision and dental care.

What is a 125 medical spending account?

For instance, a section 125 plan or cafeteria plan allows employees to pay qualified medical, dental, vision, or dependent care expenses on a pre-tax basis, which can reduce their taxable income as well as their employers Social Security (FICA) liability, federal income, and unemployment taxes (FUTA), and state

What is Section 125 of the Internal Revenue Code FSA?

A Section 125 plan is the only means by which an employee is permitted to use pre-tax dollars to contribute towards employer sponsored benefits (e.g. health insurance premiums, dental or vision premiums, disability premiums, life insurance, and FSA accounts).

What income is not taxable in Pennsylvania?

Some types of income are exempt from Pennsylvania state income tax, including child support, alimony, unemployment payments, and some capital gains on the sale of a primary residence. Some deductions are allowed for contributions to educational savings accounts and medical or health savings accounts.

Are FSA contributions taxable in PA?

Note: In Pennsylvania, contributions to Health Care and Limited-Purpose FSAs are exempt from state income tax. Dependent Care FSAs are subject to Pennsylvania state income tax but remain exempt from federal tax.

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