Apply for Reimbursement - A summary of the activity

This activity allows you to enter a set of reimbursement claims for any reimbursement item to which you are entitled. You can enter the claim for yourself or the dependents, depending on the nature of the reimbursement. If the reimbursement item requires bills to be mandatory, you are to enter the bill details as well, for each claim that you submit.

Note: When no bill has been provided while entering a claim for a reimbursement item for which a bill is mandatory, you can indicate that an exception must be provided. When you select the “Submit” pushbutton, the system will process the claim for the item, without the bill.

Computation of Total Value and Sanctioned Amount: After you enter the details of all the claims for the item, you can request the system to calculate and display

     The total value of the claims you submitted, and

     The total sanctioned reimbursement amount for all the claims

The system determines the claim value of an item, for an employee/dependent, by checking

     The specific reimbursement item’s eligibility terms, followed by

     The eligibility terms are defined for department, gradeset, grade combination whichever is defined as entitlement eligibility parameter.

Getting familiar with the pages inside

Prerequisites

 Set Reimbursement Security

 Authorization of Employee Eligibility

What you can do in this activity

Apply for Reimbursement

Find out more

The full picture of an employee’s eligibility, for an item

What are the factors that influence an employee’s total balance?

How is an employee’s total balance calculated?

What is the maximum that an employee can claim?

Can an employee carry over his previous balance?

Can an employee claim for his dependents?

Can I apply for claims on behalf of my clients, if I am an external service provider?

What are the factors that influence my total balance?

An employee’s total reimbursement balance is determined by some or all of the following factors:

     The ceiling defined for grade, grade set, position, job, work location combination defined in the entitlement eligibility parameter, for the calendar year; this could be Actuals or Limited. If the ceiling is Limited, the maximum quantity or amount that the employee can avail, for the reimbursement item, is defined as well. Alternatively, there could be a general eligibility rule, applicable for all the employees of the organization unit, with no grade-specific ceiling defined.

     The authorized amount for a claim ID, if the previous claims have been authorized until date. The authorized amount could be equal to or less than

    The upper limit, per claim ID; this will be applicable when the “EligibilityType” is “Limited” or

   The percentage of the claim ID value that can be sanctioned; this will be applicable when the “Eligibility” type is “Limited”.

    The balance can be carry forward and encashed as set in the “Maintain Reimbursement Eligibility “ page in the “Create Reimbursement Item” activity.          The “Carry Forward/Encashment Limit“; this is the maximum limit of the reimbursement amount / value that can be carried forward or encashed.

     If the eligibility nature is “Common for All”, the amount or quantity availed by dependents also affects the employee’s balance

     If the reimbursement item is in quantity, the quantity is converted into currency and paid to the employee through cash, payroll or check. See quantity or amount. The value of the deduction from the employee’s balance will depend upon the rate for conversion into money. The conversion rate is specified as a rule, during reimbursement setup. Example: The reimbursement item Conveyance is claimed in quantity, which is Liter. If an employee claims 15 liters under a Claim ID, the system converts it to x dollars, depending on the conversion rate specified.

How is an employee’s total balance calculated?

Carry forward amount (max limit) + current years item eligibility amount + adjusted amount – authorized amount.  “Authorized amount for dependents“ is included in the calculation, provided

Claims can be made for dependents and

The eligibility nature is “Common for All”. 

Both these items of information are specified when a reimbursement item is created.

What is the maximum that I can claim?

     If the employee’s item eligibility is based on grade, the ceiling for the grade to which the employee belongs could be “Actuals” or “Limited”. “Actuals” implies that the eligibility is unlimited, and he or she is paid the actual expenses incurred. “Limited” implies that

     The maximum value that the employees under the gradeset/grade can avail is defined, for the reimbursement item.

     There is an upper limit for each claim ID, item for the given item. This will be displayed in the “Limit Per Claim” field, in the “Enter Employee Claim” page

     Only a specific percentage of the claim value will be sanctioned

Note: If there is a conflict between the sanction percentage and the limit per claim, the system chooses the lesser of the two values. For instance, the limit per claim ID is $1500, and the sanctioned percentage of each claim ID is 75%. If an employee submits a claim ID worth $1800, the sanctioned percentage will be $1350. However, if the employee submits a claim ID worth $3000, the sanctioned percentage will be $2250, but the system will choose the limit per claim ID, which is $1500, to sanction.

Can I carry over my previous balance?

This will depend upon the treatment of carryover balance specified for the reimbursement item.

     If the eligibility for the item is grade-specific, the treatment can be “carry forward”, “encashment” or “lapse” for each grade. Carry forward implies that the balance will be carried forward to the next calendar year. A limit to the maximum amount or quantity that can be carried over will be specified, as well.

Can I claim for my dependents?

This will depend on the following:

      Whether the claim can be made for the employee, dependents or both. This is defined for the specific reimbursement item

     The maximum number of dependents allowed, for the reimbursement item. This is defined for the specific reimbursement item

     Whether the dependents have been enrolled and their enrollment authorized, before their claims are entered

Note: An employee can only claim for dependents who are defined already as family members, through the “Record Information on Family Members” activity

      The sufficiency of the balance amount/quantity.

     If the eligibility nature requires the dependent’s balance to be maintained separately, there must be sufficient amount /quantity in this balance. Examples of independent dependents’ balance are “Separate for dependents” and "Separate for employee and common for dependent”:

     If the eligibility nature requires the dependent’s balance to be combined with the employee’s balance, the amount /quantity in this common balance must suffice.

Can I apply for claims, on behalf of my clients?

This is possible, if the following conditions are met

    The external service provider has been defined in the “Create Provider Details” activity

     In the “Payment To” field of the “Enter Claims” page, the choice is set to “External Service Provider”

Why don’t all the reimbursement items appear in the multiline?

The grade to which the employee belongs must be specified as eligible for the item, in the “Create Reimbursement Item” activity

Rule – create item

An employee’s eligibility to each reimbursement item must be authorized already, in the “Authorize Employee Eligibility” activity, during reimbursement setup. Otherwise, the reimbursement items do not appear in the “Enter Reimbursement Claim” page when the employee logs into the “Apply for Reimbursement” activity

The full picture of an employee’s eligibility, for an item

The reimbursement claim value of an item, for an individual employee/dependent, is determined first by

     The specific reimbursement item’s eligibility terms, followed by

     The eligibility terms of the grade or gradeset to which the employee belongs.

The Reimbursement Item’s Eligibility Terms: When a reimbursement item is created, the following information is specified:

    The applicability of the reimbursement items for dependents. The eligibility for a reimbursement item could be for the employee only, the dependents only or for both employee and dependents.

     The maximum number of dependents allowed for a reimbursement item

The Eligibility Terms of the Grade or GradeSet to Which the Employee Belongs: When a reimbursement item is defined, the following information is specified as well, for every grade or grade set in the organization unit:

     The permissible limit applicable for each grade or grade set; this could be Actuals or Limited. Alternatively, it could be a general eligibility rule applicable for all the employees of the organization unit. If “Limit”, the following are defined as well

     Sanction %. This is the percentage of the reimbursement claim value, which will be sanctioned for the item. This will be applicable when the “Eligibility” is “Limit”

Limit per Claim

    This is the upper limit for each reimbursement claim, for the given item. This will be applicable when the “Eligibility” is “Limit”

     The treatment of carryover balance. It can be “carry forward”, “encashment” or “lapse”, or a customized rule that will determine the treatment of the carryover balance

     The “Carry Forward/Encashment Limit“; this is the maximum limit of the reimbursement amount / value that can be carried forward or encashed.

Quantity or Amount

The eligibility for the reimbursement item is defined in the “Create Reimbursement Item” activity in one of the two forms:

      Quantity: this refers to the defining the value of eligibility in terms of consumables. Example, reimbursement of Fuel, which is a consumable, could be in terms of gallons or liters. When this choice is selected, you are to choose the unit of measurement in which the reimbursement will be provided

      Amount: this refers to defining the value of eligibility in terms of actual money spent. If this choice is selected, you are to specify the currency in which the reimbursement must be provided.

Eligibility Nature

This refers to the mechanics of eligibility applicable for the specific reimbursement item. This will depend upon the eligibility type

Example: If the Item Eligibility is “Only for dependents”, the eligibility nature can be either “common for dependents” or “separate for dependents”. See the table, which provides a complete picture. Given below is a description of each option.

      "Separate for Employee & Separate for Dependents": The eligibility limit you define will be separately applicable for each of the dependants and for the employee.

      “Common for Dependents”: The eligibility limit you define will be applicable for all the dependents put together.

      “Separate for Dependents”: The eligibility limit you define will be applicable for each of the dependents separately.

     “Common for All“: The eligibility limit you define will be applicable for all the dependants and the employee put together.

     "Separate for employee and Common for dependent”: The eligibility limit you define will be separately applicable for the employee. Also the limit defined will be applicable for the dependents put together.

      “Self”: The eligibility limit you define will be applicable for the employee only.

Eligibility Value

The eligibility value for a grade, gradeset or combination of both could be one of the following:

     “Actuals”; this means there is no upper limit to the reimbursement value that can be claimed. In other words, the reimbursement value is unlimited. 

     “Limited”; this means the reimbursement value can be claimed upto a given limit. You are to specify this limit in the next multiline field “Eligibility Value”

This information is defined in the “Create Reimbursement Item” activity

Sanctioned Amount

The amount or quantity that the system sanctions for a claim ID will be the lesser of the following two values: Limit Per Claim and Sanction%.

     Limit Per Claim: This is the upper limit that can be sanctioned for a claim ID. The upper limit is defined for the reimbursement item, in the “Create Reimbursement Item” activity.

      Sanction%: This is the percentage of each Claim ID value, which can be sanctioned. This percentage is defined for the reimbursement item, in the “Create Reimbursement Item” activity.

Example: The reimbursement item is Medicines, and the upper limit allowed for a Claim ID is $400. In addition, the sanction % of 75% is defined for the claim ID.

When the employee submits the claims, the value of his claim ID is $550. Although the sanctioned 75% implies that $412.5 can be paid to the employee, the system pays him $400 only.