Would say that is the reason that most cancer plans set up on section 125 are expense incurred plans and not lump sum..However, I do not do Payroll plans. I prefer to work one on one with folks.I would not recommend placing a cancer/indemnity plan premiums in a pre-tax Section 125, not worth the small savings. The IRS allows for tax-free receipt of the payment, but the individual needs to substantiate the actual medical expense. Think about the policy that pays an amount, say $50,000 upon diagnosis. May be tough to substantiate the full amount that soon.