State of Minnesota Pre-tax Benefits

• 2024 Flexible Benefits and Transit Expense Plan 
• 2023 Flexible Benefits and Transit Expense Plan

• SEGIP Enrollment Flyer
• MDEA / DCEA Basics
• Transit Expense Account Basics
• Why Enroll in a MDEA?
• Why Enroll in a DCEA?
• Why Enroll in a BVEA?
• Why Enroll in a PKEA?

• Transit Expense Plan FAQs
• Transit Debit Card FAQs
• MDEA/HRA Debit Card FAQs
• MDEA Carryover FAQs
• DCEA FAQs
• Unpaid Leaves of Absence FAQs
• Substantiation FAQs
• 2011 State HRA FAQs

• Medical Expense Eligibility List
• Over-the-Counter (OTC) Worksheet
• Medical/Dental Expense Account (MDEA) Worksheet
• Dependent Care Expense Account (DCEA) Worksheet

• Substantiation FAQs
• Beniversal Card Overview
• Digital Wallet Infographic

• Pre-tax Account Resources
• BRIMOBILE App Overview
• 4 Ways to Check Your Balance
• Your Guide to Faster Claim Submissions
• The Ultimate Receipt Guide

2024 MDEA/DCEA Enrollment & Change Form

• Enrollment: Use if you are a new hire or newly eligible employee who is enrolling in an MDEA and/or DCEA for the first time.
• Change: Use if you have a qualifying life event or are reinstating your MDEA/DCEA upon returning to work from a leave.

2024 Transit Enrollment & Change Form

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

2024 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.

Universal Reimbursement Form
Use to request reimbursement from your MDEA/DCEA, HRA, PKEA, or BVEA State plans.

Dependent Care Receipt
This form should be used when a receipt or statement is unavailable from the dependent care provider. Submit this form for DCEA reimbursement, along with a completed reimbursement form.

Certification of Medical Necessity
Submit this form once per year to receive reimbursement for dual-purpose items from your MDEA or HRA.

Mileage Expense Certification
Submit this form, along with a completed reimbursement form, to get reimbursed for transportation expenses for essential medical care (Rate subject to IRS changes), parking, and tolls from your MDEA or HRA.

Direct Deposit Authorization
Use to set up your reimbursements as direct deposit. (NOTE: Get your reimbursements faster by setting up through BRIWEB!)

PHI Authorization/Revocation
Use to authorize or revoke the use or disclosure of your Protected Health Information (PHI) to a person or entity.