Hennepin County

Hennepin County

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Overview & Updates

 

Flexible Spending Accounts

Flexible Spending Account (FSA) annual contributions for 2023:

  • Health Care Expense Account:  $2,850
  • Dependent Care Assistance FSA: $5,000
  • Adoption Assistance FSA: $14,890
  • Parking Account:  $280 (per month)

Please note:  if you currently participate in an FSA and your debit card is expiring at the end of 2022, you will receive a new card in the mail from P&A Group.

Participant Information

Hennepin County COVID-19 Updates
pdf (53.0kB)
Download
Health Care Expense Account/Dependent Care Assistance Account 2022
pdf (276.3kB)
Download
Health Care Expense Account/Dependent Care Assistance Account 2023
pdf (255.1kB)
Download
What is an FSA?
pdf (266.8kB)
Download
Account Options
pdf (147.3kB)
Download
Sample List of FSA Eligible Expenses
pdf (152.2kB)
Download
Tax Savings Example
pdf (43.1kB)
Download
FSA Store
pdf (301.0kB)
Download
IRS Publication 969
pdf (1.4MB)
Download
Parking/Vanpooling 2022
pdf (286.6kB)
Download
Parking/Vanpooling 2023
pdf (269.9kB)
Download
Eligible Dependent Defined
pdf (49.9kB)
Download
Claims & Reimbursements
pdf (34.5kB)
Download
Submit Claims
pdf (158.2kB)
Download
Mobile App
pdf (331.9kB)
Download
FSA Glossary
pdf (123.5kB)
Download
FSA Calculator

Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.

Learn More
FSA Store

Browse pre-approved eligible expenses at FSA Store.

Visit FSA Store

Forms

FSA Worksheet
pdf (53.4kB)
Download
Letter of Medical Necessity Form
pdf (53.8kB)
Download
HIPAA Authorization Form
pdf (52.4kB)
Download
FSA Mid-Year Change/Enrollment Form
pdf (1.3MB)
Download
Parking/Vanpooling Mid-Year Change/Enrollment Form
pdf (1.9MB)
Download
Parking/Vanpooling Claim Form
pdf (202.9kB)
Download
Health Care Expense/Dependent Care Assistance Claim Form
pdf (231.6kB)
Download

Contact Us

Questions?

Chat with a customer service agent now.

Call Us

  • Mon-Fri 7:30am - 9:00pm CST
(716) 362-5442 or (833) 752-9413

Online Customer Support

Chat Now

Location

17 Court Street #500
Buffalo, NY 14202
View Map

Participant Information

Hennepin County COVID-19 Updates
pdf (53.0kB)
Download
Health Care Expense Account/Dependent Care Assistance Account 2022
pdf (276.3kB)
Download
Health Care Expense Account/Dependent Care Assistance Account 2023
pdf (255.1kB)
Download
What is an FSA?
pdf (266.8kB)
Download
Account Options
pdf (147.3kB)
Download
Sample List of FSA Eligible Expenses
pdf (152.2kB)
Download
Tax Savings Example
pdf (43.1kB)
Download
FSA Store
pdf (301.0kB)
Download
IRS Publication 969
pdf (1.4MB)
Download
Parking/Vanpooling 2022
pdf (286.6kB)
Download
Parking/Vanpooling 2023
pdf (269.9kB)
Download
Eligible Dependent Defined
pdf (49.9kB)
Download
Claims & Reimbursements
pdf (34.5kB)
Download
Submit Claims
pdf (158.2kB)
Download
Mobile App
pdf (331.9kB)
Download
FSA Glossary
pdf (123.5kB)
Download
FSA Calculator

Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.

Learn More
FSA Store

Browse pre-approved eligible expenses at FSA Store.

Visit FSA Store

Forms

FSA Worksheet
pdf (53.4kB)
Download
Letter of Medical Necessity Form
pdf (53.8kB)
Download
HIPAA Authorization Form
pdf (52.4kB)
Download
FSA Mid-Year Change/Enrollment Form
pdf (1.3MB)
Download
Parking/Vanpooling Mid-Year Change/Enrollment Form
pdf (1.9MB)
Download
Parking/Vanpooling Claim Form
pdf (202.9kB)
Download
Health Care Expense/Dependent Care Assistance Claim Form
pdf (231.6kB)
Download

Contact Us

Questions?

Chat with a customer service agent now.

Call Us

  • Mon-Fri 7:30am - 9:00pm CST
(716) 362-5442 or (833) 752-9413

Online Customer Support

Chat Now

Location

17 Court Street #500
Buffalo, NY 14202
View Map