Apply the following steps to:
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decide whether cafeteria-plan development is needed and, if so,
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establish whether a cafeteria plan is involved and, if so,
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determine chargeable wages.
REMINDER: Most cafeteria plans have a salary reduction agreement. However, there are instances
when an employee uses payroll deductions to purchase cafeteria-plan benefits in addition
to, or instead of, cafeteria plan benefits provided under a salary-reduction agreement
or employer contribution. If the paystub indicates there are voluntary contributions,
determine the benefits offered under the employer’s cafeteria plan and what benefits
were provided through voluntary employee contributions. Treat the amount of the employee’s
contributions under a cafeteria plan as wages, per SI 00820.102C.4. in this section.
NOTE: It is not necessary to separately document responses to the questions in the following
chart, except where indicated.
STEP
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ACTION
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1
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Are pay slips available to verify wages?
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If no, verify wages using other forms of primary evidence of wages in SI 00820.130A.1, except do not seek secondary evidence prior to contacting the employer for wage
verification when documenting cafeteria plans.
STOP
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2
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Does a cafeteria-plan precedent exist for this employer?
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If yes, use it to compute chargeable wages and go to Step 8.
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3
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Ask the individual if they participate in a cafeteria plan.
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If yes or uncertain, or there is any indicator of a cafeteria plan, such as those in SI 00820.102B.5. or one of the “CAF” codes in Step 9, go to Step 4.
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If no, and there is no other indication of a cafeteria plan, compute chargeable wages accordingly.
STOP.
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4
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If “FICA wages” or a comparable term is shown, count the amount shown as chargeable
wages. Go to Step 9.
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For calendar years other than 2011 and 2012 - If “FICA wages” are not shown, compute
chargeable wages by multiplying the FICA tax shown (including Medicare tax) by 13.071
(use the Cafeteria Plan Worksheet in SI 00820.102G, if desired.) Go to Step 9.
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For calendar years 2011 and 2012 only - If “FICA wages” are not shown, compute chargeable
wages by multiplying the FICA tax shown (including Medicare tax) by 17.699. Go to
Step 9.
EXCEPTION: If you are aware of a reason other than a cafeteria plan that causes FICA wages to
differ from the gross wages shown, or that causes the FICA tax to differ from 7.65%
of gross wages or 5.65% in calendar years 2011 and 2012 only, (i.e. voluntary employee
contribution) go to Step 5.
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If neither “FICA wages” nor “FICA tax” (or a comparable term) is shown, go to Step
5.
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5
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Is the employer's payroll office located in your service area?
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6
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Request a precedent from the employer's servicing FO. If none exists, ask the servicing
FO to develop one per SI 00820.102D.2. in this section. Upon receipt of the precedent, compute chargeable wages. Retain
a copy of the precedent.
Go to Step 8.
NOTE: If a precedent cannot be established (e.g., employer will not cooperate), do not
attempt to determine whether certain pay slip entries represent cafeteria-plan itemizations;
If employer will not verify wages, then develop wages using the appropriate source
per SI 00820.130.
STOP.
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7
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Contact the employer and develop a precedent per SI 00820.102D.2. in this section.
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If a precedent can be established (including a negative precedent), use it to compute chargeable wages, retain it, and
go to Step 8.
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If a precedent cannot be established (e.g., employer refuses to cooperate), and employer will not verify wages, then develop
wages using the appropriate source per SI 00820.130.
STOP.
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8
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Document that a precedent exists and that there is, or is not, a cafeteria plan on
EVID, or a Report of Contact and lock it. Store the precedent in the Claims File User
Interface (CFUI) using the Evidence Portal (EP) or in eView.
For non- SSI Claims system (i.e., non-MSSICS) situations, document on an SSA-5002
(Report of Contact) and store it in the Non-Disability Repository (NDRED) using EP
or the Certified Electronic Folder (CEF), as appropriate.
Go to Step 9.
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9
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In the CG field, input the applicable code (below) followed by the month and year.
In the remarks field of the SSID, show the employer's name, if applicable, and include
any other useful information. Delete entries that no longer apply. (This aids in any
future S2 alert developments.)
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CAF1 - Claimant or recipient participates in a cafeteria plan.
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CAF2 - Ineligible spouse participates in a cafeteria plan.
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CAF3 - Eligible spouse participates in a cafeteria plan.
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CAF4 - Father participates in a cafeteria plan.
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CAF5 - Mother participates in a cafeteria plan.
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CAF8 - Essential person who is not a living-with spouse or parent participates in a cafeteria
plan.
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CAF9 - Essential person who is a living-with spouse or parent participates in a cafeteria
plan.
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CAFN - No cafeteria plan exists.
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CAFS - Sponsor of alien participates in a cafeteria plan.
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