For Hennepin County employees, their covered spouses and retirees
If you feel circumstances prevented you from earning the health insurance incentive or the co-pay listed on your PreferredOne card is incorrect, you may request an exception.
Submitting an exception request
- Read the frequently asked questions below BEFORE submitting a request
- Complete the Health Insurance Incentive Exception Request Form
- Submit completed application and documentation
- Fax 612-596-9984, Attention: Health Insurance Exception Request
- Interoffice Mail – HealthWorks, Mail Code 040, Attention: Health Insurance Exception Request
- U.S. Mail - Hennepin County Government Center A040, 300 S. 6th Street, Minneapolis, MN 55487-0040 Attention: Health Insurance Exception Request
- E-mail - email@example.com
What types of requests WILL be considered for exception?
Inability to meet health insurance incentive requirements due to
- Chronic disability
- Medical condition or emergency situation
- Extraordinary and unforeseeable circumstance arising as a result of events beyond participant's control
What types of circumstances will NOT be considered for exception?
Examples include but are not limited to:
- Leave of absence
- Vacation out of the area
- Residence out of the area
- Continuee/retiree did not read home mailings
- Employee did not share information with covered spouse
- Employee did not read email notification(s), HC News or website
- Wellness activities not documented on PreferredOne Wellness Activity Documentation portal
- Technical difficulties after close of business on deadline day
What is the review process?
- Request forms are reviewed once a week
- You may be asked to provide additional information or details
- HealthWorks will send a notice of approval or denial
Who can I contact if I have questions?
- Email HealthWorks or call 612-348-4628