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.
Plan Summary
2018 Flexible Benefits and Transit Expense Plan
Enrollment & PLAN Information
2018 SEGIP Enrollment Flyer
2018 MDEA DCEA Infographic
2018 SEGIP Debit Card Infographic
2018 SEGIP Mobile App Infographic
2018 TEA Infographic
2018 Enrollment Presentation
Worksheets
Medical/Dental Expense Account (MDEA)
Over-The-Counter (OTC) Expense Worksheet
Dependent Care Expense Account (DCEA)
Health Reimbursement Account (HRA) Eligible Expense Worksheet
Quick Answers
$500 Carryover FAQ
MDEA / HRA Debit Card FAQ
BVEA Debit Card FAQ
Transit Expense Plan
Using the Debit Card
Reimbursement Forms
2018 MDEA DCEA HRA Reimbursement Form
Use to request reimbursement from your MDEA/DCEA or State HRA plans.
2018 Transit Reimbursement Form
Use to request reimbursement from your PKEA or BVEA State plans.
Change/Termination Forms
2018 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.
2018 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.
2018 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
2018 MDEA DCEA Enrollment
Use if you are a new hire or newly eligible employee who is enrolling for the first time.
2018 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 Form
Use if you lost a reimbursement check and need to request a replacement.
