What is a cafeteria plan?

Cafeteria plan definition and meaning

A cafeteria plan is an employer-sponsored benefit that meets the requirements of section 125 of the Internal Revenue Code (IRC). The most distinct aspect of a cafeteria plan is that it permits employees to pay for specific benefits on a pretax basis.

More about what a cafeteria plan is and its purpose

Employees who opt for a cafeteria plan must be allowed to choose at least one taxable benefit (for example, cash in the form of salary) and one qualified benefit, such as group health insurance.

To qualify, the benefit cannot defer compensation, meaning it cannot be paid at a later date. Additionally, contributions for the benefit are generally excluded from the employee’s gross income. This means the employer does not withhold certain taxes from the employee’s payment/contribution for the benefit. These taxes would have applied had it not been for the cafeteria plan.

The origin and purpose of cafeteria plans  

The Revenue Act of 1978 formally incorporated section 125 into the IRC. While cafeteria plans were available prior to 1978, employees had to pay taxes on employer contributions. The Revenue Act of 1978 resolves this by making both employer and employee contributions nontaxable, provided the amounts stay within the prescribed legal limits.

Ultimately, cafeteria plans deliver tax savings to both employees and employers.

Types of benefits offered under a cafeteria plan

Qualified benefits include:

• Health insurance
• Dental and vision insurance
• Disability insurance
• Accidental death and dismemberment
• Group-term life insurance
• Adoption assistance
• Health savings account (HSA)
• Health flexible spending account (FSA)
• Dependent care assistance

A cafeteria plan excludes benefits not regulated by Section 125 of the IRC, including educational assistance, commuter benefits, and health reimbursement arrangements.

Types of benefits offered under a cafeteria plan

Qualified benefits include:

• Health insurance
• Dental and vision insurance
• Disability insurance
• Accidental death and dismemberment
• Group-term life insurance
• Adoption assistance
• Health savings account (HSA)
• Health flexible spending account (FSA)
• Dependent care assistance

A cafeteria plan excludes benefits not regulated by Section 125 of the IRC, including educational assistance, commuter benefits, and health reimbursement arrangements.

What employers should know about cafeteria plans

• The employer must establish a written plan document outlining details of the plan, including eligibility rules, benefits offered, and plan administrator and trustees.
• Every eligible participant must receive a summary plan description, which explains their rights, responsibilities, and benefits under the plan.
• Generally, qualified benefits are not subject to federal income tax, Social Security tax, Medicare tax, and federal unemployment (FUTA) tax. However, employers should check state and local laws for applicable tax rules regarding cafeteria plans.
• It’s important to look for exceptions in the tax rules. For example, life insurance coverage that goes beyond $50,000 is subject to Social Security and Medicare taxes, but not federal income tax and FUTA.
• Only common-law employees can participate in a cafeteria plan; it excludes the self-employed.

Pros and cons of cafeteria plans

Advantages:

• Employees and employers save on payroll taxes.
• Employers can secure a competitive edge in the talent marketplace by offering the attractive benefits package that cafeteria plans provide.
• Employees can choose from a suite of benefits based on their individual or family needs.
• The plan must adhere to nondiscrimination rules to ensure it doesn’t favor highly compensated employees.

Disadvantages:

• A cafeteria plan must follow strict rules and regulations.
• The third-party administrator (TPA) charges a fee to establish the plan in accordance with legal compliance standards.
• Employees typically can’t change their cafeteria plan elections until the next plan year begins.
• The “use-it-or-lose-it” rule generally applies to cafeteria plans. This means the employee forfeits unused funds remaining at the end of the year, though certain plans offer carryover and grace period provisions.

Cafeteria plan laws to keep in mind

As mentioned, plan sponsors must comply with IRC Section 125. Other laws affecting cafeteria plans include the following:

• Employee Retirement Income Security Act (ERISA)
• Consolidated Omnibus Budget Reconciliation Act (COBRA)
• Affordable Care Act (ACA)
• Health Insurance Portability and Accountability Act (HIPAA)
• Genetic Information Nondiscrimination Act (GINA)

Additionally, employers should consider applicable state and local laws, including those pertaining to nondiscrimination and wages and hours.

Communicating cafeteria plans to employees

In a 2023 MetLife survey, 50% of employees “say having a better understanding of their benefits would make them more loyal to their employer.”

Therefore, it’s important that employees understand the benefits available to them. Otherwise, it can lead to underutilization of the benefits, resulting in financial waste for the employer. What’s more, employees may lose out if they don’t know about the program or how to properly navigate it.

To prevent these outcomes, employers should clearly communicate the cafeteria plan program to their employees. Below are aspects to cover:

• The purpose of the cafeteria plan
• A general idea of how the plan works
• Advantages for employees and their families
• Potential drawbacks employees should know about
• How employees can sign up (and change their elections)
• Whom to contact for more information about the cafeteria plan

Terms related to: Cafeteria plan

• Hospital Indemnity Insurance (HI)
• Consolidated Omnibus Budget Reconciliation Act (COBRA)
• Medicare
• High-deductible health plan (HDHP)
• Pre-tax deductions
• Summary plan description (SPD)

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