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.
COVID-19 Updates
MDEA and DCEA Allowed Changes
COVID-19 Update
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
2021 Flexible Benefits and Transit Expense Plan Summary of Material Modifications: Change in Eligibility 2020 Flexible Benefits and Transit Expense Plan
2021 Enrollment & PLAN Information
2021 SEGIP Enrollment Flyer
2021 MDEA DCEA Infographic
2021 SEGIP Debit Card Infographic
2021 Mobile App Infographic
2021 TEP Infographic
Mobile App Tutorial
2021 Quick Answers
Carryover FAQ
MDEA / HRA Debit Card FAQ
BVEA Debit Card FAQ
Transit Expense Plan
Using the Debit Card
2021 Worksheets
2021 MedicalDental Expense Account (MDEA) Worksheet
2021 Over-The-Counter (OTC) Worksheet
Dependent Care Expense Account (DCEA)
2021 Health Reimbursement Account (HRA) Expense Worksheet
2020 Enrollment & PLAN Information
2020 SEGIP Enrollment Flyer
2020 MDEA DCEA Infographic
2020 SEGIP Debit Card Infographic
2020 Mobile App Infographic
2020 TEP Infographic
2020 Enrollment Presentation
2020 Quick Answers
Carryover FAQ
MDEA / HRA Debit Card FAQ
BVEA Debit Card FAQ
Transit Expense Plan
Using the Debit Card
2020 Worksheets
2020 MedicalDental Expense Account (MDEA) Worksheet
2020 Over-The-Counter (OTC) Worksheet
Dependent Care Expense Account (DCEA)
2020 Health Reimbursement Account (HRA) Expense Worksheet
Change/Termination Forms
2021 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.
2021 SOM Transit Change Form
Use for mid-year enrollment or changes, or to reinstate your PKEA and/or BVEA upon returning to work from a leave.
2021 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.
Reimbursement Forms
2020 MDEA DCEA HRA Reimbursement Request
2021 MDEA DCEA HRA Reimbursement Request
Use to request reimbursement from your MDEA/DCEA or State HRA plans
2020 Transit Reimbursement Form
2021 Transit Reimbursement Form
Use to request reimbursement from your PKEA or BVEA State plans.
Enrollment Forms
2021 MDEA DCEA Enrollment Form
Use if you are a new hire or newly eligible employee who is enrolling for the first time.
2021 Transit Enrollment Form
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.
Bank 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.
Repayment Authorization Form
Use to repay part of a debit card transaction
