They are all pre-tax except heath insurance deductions. If you itemize and your total medical costs is a certain percentage above your adjusted income, then you may deduct those costs on your taxes. If you take money from pre-tax accounts, there will be penalties involved. If you take money from your 401K before you are 59.5 years of age, then there is a ten percent tax penalty.

Once upon a time, health insurance through your employer had to be after-tax. Then about 20 years ago, the government allowed business owners the choice to offer health care as either pre-tax or after-tax.

At this time, I know of no employer that handles their group health insurance with anything but pre-tax money. If the insurance is on your paystub, it is probably not deductible.

The 401(k), HSA, FSA, and other Cafe 125 (Section 125) deductions are also pre-tax.