Participant Plan Information

These materials are for flexible benefits or health reimbursement (HRA) participants who are NOT SEGIP or Minnesota State employees

(SEGIP and Minnesota State employees, please find your materials here: SEGIP materialsMinnesota State Materials.)

We are in the process of updating all expense lists to remove the OTC Rx requirement and note feminine hygiene products as eligible. In the meantime, you may consider these expenses eligible and submit them for reimbursement online, via the Mobile App or by fax or mail with a completed claim form and the itemized receipt.

2020 worksheets

Health Care FSA Worksheet
Over the Counter Worksheet
Dependent Care Worksheet
Limited Purpose FSA Worksheet
Health Reimbursement Account (HRA) Eligible Expense Worksheet

730 2nd Avenue South, Suite 400
730 Building
Minneapolis, MN 55402-2446

Accessibility Options: