Premium Only Plan (POP)

What is a Premium Only Plan?

A Premium Only Plan (POP) is an IRS-approved way for you to pay for your share of your employer-sponsored insurance premiums with before-tax dollars. If you are paying premiums for health insurance, dental or vision care, or group-term life insurance (under $50,000), every one of those dollars will not be taxed as long as you’re enrolled in your company’s POP.

How does it benefit me?
  • You will have more money in your paycheck because you are not paying taxes on insurance premiums.
  • On average, an employee can achieve 25% to 30% in tax savings (Federal income, Social Security, Medicare and possibly State and Local income taxes).
  • You can elect to pay insurance premiums on a pre-tax basis for your spouse and any legal dependents.
What else do I need to know?
  • Once you have elected to participate, you cannot change your election for the of the plan year, unless you have a change in status, like getting married, having a baby, or an employment change.
  • Because a POP lowers your contribution to the Social Security system, it’s possible that future Social Security benefits may be slightly reduced.

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Frequently Asked Questions

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How do I enroll in the POP?

You will be given an enrollment form to complete. The form gives you a choice to either participate in the POP or to waive your right to participate in the POP. If you participate you will receive a copy of the Summary Plan Description which describes how the plan works.

Can I decide to stop participating in a POP mid-year?

During the plan year, you may not change your election unless you have a “Change in Status.” Currently, Federal Law considers the following events to be eligible changes in status.

  • Marriage, divorce, legal separation or annulment, death of a spouse
  • Change in the number of dependents including birth, adoption, placement for adoption, or death of a dependent
  • Any of the following events for you, your spouse or dependent: termination or commencement of employment, a strike or lockout, commencement or return from an unpaid leave of absence, a change in worksite, or any other change in employment status that affects eligibility for benefits
  • A change in residence for you, your spouse, or dependent that affected eligibility for benefits
  • One of your dependents satisfies or ceases to satisfy the requirements for coverage due to attainment of age, student status, or any similar circumstance
  • A cost or coverage change in benefits that affected eligibility for you, your spouse or dependent
  • A prospective election change to terminate group coverage for you, your spouse or dependent(s) during the open enrollment period offered by the State Marketplace for individual medical coverage
  • If you work for a large employer and you are a variable-hour employee, you may experience a reduction of hours and loss of benefit status due to the Affordable Care Act’s Look Back Measurement period calculation. This is an eligible change of status reason to end your participation in the Premium Only Plan. Check with your employer to find out if you are in this exact circumstance.

What if I have a financial hardship, can I stop participating in a POP then?

Unfortunately, no. Financial hardship is not an acceptable/eligible change of status reason. If enrolled in the Premium Only Plan, you may not change your salary reduction election by terminating insurance coverage for you, or your covered dependents, mid-plan year if you are responsible for a portion of the insurance premium.

How do I change my POP election if I have an eligible change in status?

If you need to make a change of election for any eligible reason, you must complete a Change of Status form. This form needs to be completed within 30 days of your event to increase, decrease or stop your payroll contributions on a pre-tax basis.