Is health insurance considered a cafeteria plan?
John Hall
Updated on March 22, 2026
A Section 125 Cafeteria Plan is an employer-sponsored benefits plan that lets employees pay for certain qualified medical expenses – such as health insurance premiums – on a pre-tax basis. Typically, they can use the pre-tax money to pay for health insurance premiums, retirement deposits, or other benefit options.
What is not included in cafeteria plan?
Generally, qualified benefits under a cafeteria plan are not subject to FICA, FUTA, Medicare tax, or income tax withholding. Adoption assistance benefits provided in a cafeteria plan are subject to social security, Medicare, and FUTA taxes, but not income tax withholding.
Is an HRA part of a cafeteria plan?
Sometimes overlooked are health reimbursement arrangements (HRAs) or a cafeteria plan, employer-funded accounts that can be a solid first step in transitioning to a consumer-directed approach to health care. Employees can use an HRA to pay for their qualified medical expenses, along with those of a spouse and children.
Is a premium only plan a cafeteria plan?
A Section 125 premium-only-plan (POP), is a cafeteria plan which allows employees to pay their health insurance premiums with tax-free dollars. However, employees can also use POP plans to pay individual health insurance premiums with tax-free dollars.
What qualifies for cafeteria plan?
Any employer with employees who are subject to U.S. income taxes is eligible to sponsor a cafeteria plan. Employers can be C corporations, S corporations, LLCs, partnerships, governmental entities or sole proprietorships.
What are the four categories of cafeteria plans?
There are three different types of cafeteria plans.
- Flex Account. One of the most common cafeteria plans is a flex account, or flexible spending account (FSA).
- POP Plan. Next is a Premium Only Plan (POP).
- Dependent Care Account. Finally, the last type of cafeteria plan is a Dependent Care flexible spending account.
What benefits can be included in a cafeteria plan?
Cafeteria Plan
- A cafeteria plan is an employee benefit plan that allows staff to choose from a variety of pre-tax benefits.
- Cafeteria plan selections include insurance options such as health savings accounts (HSAs) contributions, group term life insurance, and disability insurance.
What is premium only plan?
A premium only plan (POP) is the most basic – and most popular – type of Section 125 Cafeteria Plan that allows employer-sponsored premium payments to be paid by the employee on a pre-tax basis instead of after-tax.
Who is not eligible for Section 125 plan?
The Section 125 rules specifically prohibit the following individuals from participating: • Self-employed individuals; • Partners within a partnership; and • More than 2 percent shareholders in a subchapter S corporation (S corporation).
Can a cafeteria plan be used for health insurance?
Employees can use a cafeteria plan to pay for individual health and disability insurance policies where premiums are list billed by the employer.
Can a domestic partner participate in a cafeteria plan?
Cafeteria plans can offer health insurance to employees, their spouses and their dependents. The domestic partner and dependents in this case may not be participants in a cafeteria plan because they are not employees, but the plan may provide benefits to them.
How are cafeteria benefits excluded from gross income?
One good thing is that benefits in a cafeteria plan are excluded from gross income as long as the plan meets certain requirements. However, many plans today are operated as a “salary redirection agreement”, meaning that they are a pre-tax payroll deduction.
What’s the difference between a cafeteria plan and a group plan?
When compared to a group health insurance plan, the primary distinction is that a cafeteria plan does not involve the employer as a policyholder. The employee is the only policyholder in a cafeteria plan.