![]() |
Section 125 sets forth the nondiscrimination rules that apply to cafeteria plans. These rules determine whether salary reductions under the plan are taxable. Self-insured medical reimbursement plans that are offered under a cafeteria plan (which is generally the case) must also pass section 105(h) nondiscrimination testing, which determines whether reimbursements made under the plan are taxable.
While this Geek Out! page provides an overview of nondiscrimination testing, the IRS regulations are very complex and failure to comply can result in significant tax consequences. The advice of a qualified legal or tax professional is required to determine application of these rules to a particular employer and its group health plans.
Under Section 125, highly compensated employees, and key employees are not entitled to receive pre-tax benefits under a cafeteria plan if the plan discriminates in favor of those individuals with respect to benefits or eligibility to participate. If the plans are determined to be discriminatory, the value of the taxable benefit must be included in the gross income of what the regulation defines to be highly-compensated employees. This is referred to as cafeteria plan nondiscrimination testing under section 125 of the IRS code.
Section 125 testing must be performed on self-insured benefit programs that are paid on a pre-tax basis as a component of the cafeteria plan. This test is often performed after these programs pass 105(h) testing. The exception is a Premium Only Plan (POP), which is not subject to section 105(h) testing and is covered under a special safe harbor for section 125 testing.
Plans Subject to Section 125 Testing:
Other benefits paid through a cafeteria plan that are typically subjection to section 125 testing (and not covered in Compliancedashboard – Health & Welfare) include Group Term Life, Adoption Assistance, VEBAs and 401(k) plans. In addition, under the Affordable Care Act (ACA), non-grandfathered, fully insured group health plans must undergo nondiscrimination testing for plan years beginning on or after September 23, 2010. However, the IRS announced that compliance will not be required until the government has issued regulations or other guidance on how the rules apply to insured plans.
Please note that a cafeteria plan will not be discriminatory if it is maintained pursuant to a collective bargaining agreement. If the plan covers both union and nonunion employees, then this exception would only apply to the section of the plan that covers union employees. In addition, simple cafeteria plans, as defined in the ACA, are also deemed to meet the cafeteria plan nondiscrimination rules.
Employers must conduct three types of nondiscrimination tests every year.
1. Eligibility Test: Determines whether eligibility to participate in the plan favors highly compensated individuals (HCIs). It includes three requirements.
Testing Group
Generally, all employees must be included in the testing group, with the exception of:
In addition, employees who have not met the waiting period under the cafeteria plan may be excluded only if the plan restricts participation to employees who have completed three years of employment.
A POP plan need only satisfy the nondiscrimination rules under the Eligibility Test to satisfy the requirements of section 125 testing.
2. Contributions and Benefits Test: Determines whether contributions and benefits are available on a nondiscriminatory basis and whether highly compensated participants (HCPs) select more nontaxable benefits than non-HCPs. It includes three standards:
Testing Group
Employees who are actually eligible to participate in the plan and make applicable salary reductions to pay for those benefits. Employees covered by a collectively bargained plan may be excluded.
A Safe Harbor is available for medical plans, but not FSA plans. For purposes of the Contributions and Benefits Test, a cafeteria plan that provides health benefits will not be considered discriminatory if:
3. Key Employee Concentration Test: This test determines whether key employees (Keys) receive too large a share of total benefits under the plan.
Testing Group
Plan participants who have elected some qualified (nontaxable) benefit. Exclusions are the same as for the Eligibility Test above.
When determining who is highly compensated and thus in the prohibited group, employers should note that there is a slight variation between Section 125 testing, which is described below, and section 105(h) testing and 401(k) plan testing rules.
Highly Compensated Individual (HCI)
An HCI for purposes of section 125 testing is defined as:
Highly Compensated Participant (HCP)
Employees who are HCIs and eligible to participate in the plan.
Key Employee (Key)
A person is a key employee if he or she is:
Because individuals may be included in the testing group because of their relationship with the plan sponsor, common ownership of other companies through stock ownership, a partnership, etc. should be carefully reviewed to ensure accurate testing. For example, all employees of all corporations which are members of a controlled group should be treated as a single employer for nondiscrimination testing.
Under proposed cafeteria plan rules, plans must determine compliance as of the last day of each plan year. In practice, a plan may find it useful to test prior to the start of the plan year and periodically during the course of the year. This will permit the employer to make any needed adjustments in HCI and Key elections prior to the end of the plan year.
Corrections for a plan year cannot be made after the end of that plan year. With that in mind, the cafeteria plan document should be written to give the plan administrator the authority to change any employee’s salary reductions if it is necessary in order to comply with the nondiscrimination rules.
In addition, for plans subject to section 105(h) testing, section 125 tests are often performed after the plans pass 105(h) testing.
There are several plan design elements that should alert employers to the possibility that their cafeteria plans may not pass nondiscrimination testing. These include plans that:
Simple cafeteria plans are deemed to meet the cafeteria plan nondiscrimination rules (as well as those for Health FSAs).
In order to be considered a “simple cafeteria plan”, it must meet all of the following requirements:
The IRS has not issued regulations on simple cafeteria plans.
Material contained in ComplianceDashboard is a compilation of generally published information by the Department of Labor and other public agencies regulating employee benefit plans and employee benefit issues. It is not legal advice, and should not be construed as legal advice. If legal advice or other professional assistance is or may be required with regard to any issues referenced in this website, the services of a competent legal or tax professional should be immediately sought. The inclusion of links within the ComplianceDashboard website is for informational purposes only. ComplianceDashboard does not warrant the accuracy of information outside this website that is found as a result of following links contained herein, nor does the inclusion of those links herein constitute endorsement of the content of any other website. If you have questions regarding this disclaimer, please contact us at 877-328-7880.