Sec. 125

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Beginning in 1975, we started offering "Cafeteria" fringe benefit plans to our public school clients. This was before the Sec. 125 "Cafeteria" Fringe Benefit Plan law was written in 1978. Since that beginning with one school district in 1975, we now provide Sec. 125 plan benefits for numerous public schools and corporations in Kansas, Oklahoma, Missouri and Texas.

Our Sec. 125 plan business in the public schools has become the basis for a lot of our growth in the Sec. 403(b) market. The servicing of and our visibility in providing Sec. 125 benefits to our public school employees provides a natural extension into the Sec. 403(b) market.

Through our Sec. 125 plans, we are able to offer employees coverage in group term life insurance, disability insurance, dental insurance, vision insurance, cancer insurance and in Kansas, health insurance through a preferred provider network. Also, we offer flexible spending accounts for dependent care and medical reimbursement.

With more than 20 years of experience in the Sec. 125 business, we are able to provide our representatives expert assistance in developing the Sec. 125 market in their area.

Section 125 Forms
Select and print forms as needed. Acrobat Reader required to view forms. To aquire this free application click here.

FSA Letter of Medical Necessity

FSA Letter of Medical Necessity.pdf

Size: 85.98 KB

Posted on Monday, November 08, 2010

Fillable form used for items that are reimbursable for expenses that are prescribed by a physician.

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Ameritas Eye Care Claim Form

Ameritas Vision Flat Max 250 eye claim form (2)[1].pdf

Size: 66.62 KB

Posted on Friday, August 13, 2010

Claim form for Ameritas Eye Care.

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COBRA Continuation Form

Cobra Continuation.pdf

Size: 27 KB

Posted on Wednesday, November 02, 2005

Form for COBRA benefits.

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Disability (Salary Protection) Reliance Standard Claim Form

Disability and Wellness claim form.pdf

Size: 86.61 KB

Posted on Wednesday, November 02, 2005

For disability claims due accident or illness. This is also the claim form used for Medical Income Benefit.

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Employee Change/Termination Form

EMPLOYEE CHANGE FORM.pdf

Size: 11.69 KB

Posted on Wednesday, November 02, 2005

Used for changes related to insurance coverages.

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Revision of Benefit Election Form

REVISION OF BENEFIT ELECTION FORM.doc.pdf

Size: 24.87 KB

Posted on Wednesday, November 02, 2005

Change form for Sec. 125 family status changes.

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Flexible Spending Claim Form

FSA Claim Form.pdf

Size: 161.48 KB

Posted on Wednesday, November 02, 2005

Fillable form used for Flexible Spending Claims.

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Life Change Form

RSL BBA Enroll Change Form Reviewed and App 2008.doc

Size: 72.5 KB

Posted on Wednesday, November 02, 2005

Change form for term life insurance.

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