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This activity allows you to create a reimbursement group, to which similar or analogous reimbursement items can be assigned.
Reimbursement Group: A reimbursement group is a grouping of reimbursement items into one cohesive group, with an upper limit assigned for the group. The items under the group, however, maintain their individual upper limits.
Advantage of Grouping: Grouping is meaningful when a collective reimbursement-ceiling amount is specified for a cluster of reimbursement items An employee may be eligible for some of the reimbursement items under the group. The system ensures that the accumulated value of all the reimbursement items to which the employee is eligible does not exceed the upper limit assigned for the group. The group’s upper limit, therefore, serves as the ceiling for the total amount/value that the employee can claim for the entire cluster of reimbursement items.
In addition, the system ensures that the employee’s claim amount for an individual reimbursement item does not exceed the upper limit for this item.
Example: The total reimbursement ceiling for the reimbursement group Medical could be $40000. This group could consist of the following reimbursement items: Hospitalization, Lab Tests, Consultation and Medicines.
The grade G9 of the organization ABC Group. is mapped to the group Medical. Each employee under G9 is eligible for a cluster of the items under the group. The system checks the following
The total claim amount does not exceed $40, 000
The claim amount for an individual reimbursement item under the group does not exceed the upper limit for this reimbursement item.
Employee Jack Clintwood, under G9, is eligible for the following
Medicines = $15, 000
Consultation = $10, 000
Lab tests = $15, 000
Employee Robert Evans, also under G9, is eligible for the following
Hospitalization = $40, 000
Consultation = $10, 000
Both employees are eligible for a total reimbursement claim amount of $40, 000, although the system ensures that the individual reimbursement item ceilings are maintained as well.
Prerequisites: Grouping is possible only when all the reimbursement items under the group have the following is common.
The same currency, when the claim is monetary, example Dollars
The same unit of measurement, when the claim is a consumable item For example, if the consumable item is Petrol, the unit of measurement must be Liters for all the reimbursement items under the group
Basic Reimbursement Group Information: You are to identify the reimbursement group by a unique code and short and long descriptions. You are to also indicate whether the eligibility limit will be in:
Currency value, or
Quantity-based (this refers to consumable items, example, Petrol)
The broad rule for eligibility for the reimbursement items under the group can be specified in the form of a stored procedure rule. If this is not applicable, you can specify the eligibility for a grade or gradeset
Grade or Grade Set Details: If eligibility rules cannot be defined at a general level, they are to be specific to grades or gradesets. You can enter the specific eligibility rules for each grade or grade set, through this activity.
Modifying the Specifications of a Reimbursement Item: As mentioned earlier, all the reimbursement items under the group must share the same currency or unit of measurement. If you are to change these specifications for an individual reimbursement item through the “Modify Reimbursement Item” activity, the group can no longer be used with this reimbursement item under it.
After entering the required details, selecting the Save button will save the entries as a new reimbursement group.
The Scope of this Activity: This activity is also used to map the reimbursement group to an employment unit and view the details of the reimbursement group. The steps to be carried out are as follows:
Creating Reimbursement Group
Mapping of Employment Unit
Viewing Reimbursement Group
Getting familiar with the pages inside
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Go to page… |
…to carry out task |
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Create Reimbursement Group |
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Group Employment Unit Mapping |
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Maintain Reimbursement Eligibility |
Maintaining reimbursement group eligibility |
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View Reimbursement Group |
Definition of Reimbursement Items.
Definition of Grade set and Grades for the interacting Organization Structure.
Definition of Parent Reimbursement Group (if Required)
What you can do in this activity
Create a Reimbursement Group
Map the Information to Employment Units
Maintaining reimbursement group eligibility
View the Reimbursement Group Details