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State of Minnesota
Employee Benefits

These materials are for employees of the State of Minnesota. If you are not an employee of the State, please see Participant Plan Information or Participant Forms.

Eligible Expense List

We’ve made it easy to find out which products and services are covered under your plan, including important qualifying details. View alphabetically or by search word.

View Searchable Expense List


Change/Termination Forms

Flexible Benefits Change in Participation
Use if you have a qualifying life event or are reinstating your MDEA/DCEA upon returning to work from a leave.

Transit Change in Participation
Use for mid-year enrollment or changes, or to reinstate your PKEA and/or BVEA upon returning to work from a leave.

Change Form to Limited MDEA or HRA
Use if you and/or your spouse will be contributing to an HSA for the upcoming plan year and need to change your general purpose MDEA to a Limited Purpose account.

Enrollment Forms

2017 Flexible Benefits Enrollment
Use if you are a new hire or newly eligible employee who is enrolling for the first time.

2017 Transit Enrollment
Use if you are a new hire or newly eligible employee who is enrolling for the first time. If you are paying for your parking and/or bus pass expenses directly through your agency, do not use this form to enroll.

Other Forms

Direct Deposit 
Use to set up your reimbursements as direct deposit.

Lost Check Affidavit
Use if you lost a reimbursement check and need to request a replacement.