Hennepin County

Hennepin County

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Overview & Updates

 

Flexible Spending Accounts

Flexible spending maximum contribution increase for 2021:

  • Health Care Expense Account: $2,750 per year

Employees who enroll in the county-sponsored health insurance for 2021 will receive a county contribution in their Health Care Expense Account as follows:

  • Employee-only coverage: $400 one-time contribution
  • Family coverage: $500 one-time contribution in 2021 AND $200 in 2022

Health Care Expense funds can be used for: health, dental and vision expenses

The county contribution is not dependent on the election of an employee’s HCEA contribution.

Participant Information

Hennepin County COVID-19 Updates
pdf (53.0kB)
Download
Health Care Expense Account/Dependent Care Assistance Account 2021
pdf (273.0kB)
Download
What is an FSA?
pdf (142.0kB)
Download
Account Options
pdf (170.7kB)
Download
Sample List of FSA Eligible Expenses
pdf (146.8kB)
Download
Tax Savings Example
pdf (92.6kB)
Download
FSA Store
pdf (301.0kB)
Download
IRS Publication 969
pdf (1.4MB)
Download
Parking/Vanpooling Information
pdf (286.6kB)
Download
Eligible Dependent Defined
pdf (49.9kB)
Download
Claims & Reimbursements
pdf (87.6kB)
Download
Submit Claims
pdf (158.2kB)
Download
Mobile App
pdf (217.4kB)
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

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 Form
pdf (1.3MB)
Download
Parking/Vanpooling Change Form
pdf (1.9MB)
Download
Parking/Vanpooling Claim Form
pdf (203.3kB)
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

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 2021
pdf (273.0kB)
Download
What is an FSA?
pdf (142.0kB)
Download
Account Options
pdf (170.7kB)
Download
Sample List of FSA Eligible Expenses
pdf (146.8kB)
Download
Tax Savings Example
pdf (92.6kB)
Download
FSA Store
pdf (301.0kB)
Download
IRS Publication 969
pdf (1.4MB)
Download
Parking/Vanpooling Information
pdf (286.6kB)
Download
Eligible Dependent Defined
pdf (49.9kB)
Download
Claims & Reimbursements
pdf (87.6kB)
Download
Submit Claims
pdf (158.2kB)
Download
Mobile App
pdf (217.4kB)
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

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 Form
pdf (1.3MB)
Download
Parking/Vanpooling Change Form
pdf (1.9MB)
Download
Parking/Vanpooling Claim Form
pdf (203.3kB)
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

Location

17 Court Street #500
Buffalo, NY 14202
View Map