Claim Entitlements Configuration

• The Claim Entitlements configuration within the Claim Applet is essential for defining and managing employee entitlements across various claim categories. This section allows system administrators to specify entitlement limits, rules, and conditions to ensure claims are processed accurately and within organizational policies.

Importance of Claim Entitlements in the E-Claim Module

• Streamlined Claim Validation: Automates the process of checking claim limits, reducing manual errors.

• Improved Budget Control: Ensures claims stay within predefined limits, preventing overspending.

• Enhanced Employee Experience: Provides clarity on available benefits, reducing confusion during claim submissions.

• Seamless Integration: Links with other applet configurations, such as Claim Accounts and Approval Settings, to ensure a cohesive workflow.

Example Use Case

Scenario: A company introduces a new professional development allowance of $1,500 for all employees.

• The system administrator creates a new entitlement under Claim Entitlements, specifying the allowance amount and recurrence pattern.

• HR assigns the entitlement to eligible employees.

• Employees can now submit claims for professional development expenses, such as course fees, within the set limits.

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Overview of Claim Entitlements

Claim entitlements determine the allowable limits for employees to submit claims under specific categories. These entitlements ensure compliance with budgetary constraints and streamline claim processing by automating validation checks. The configuration includes several key tabs and features that facilitate entitlement management.

Key Tabs in the Claim Entitlement Configuration

1. Main Details

   • Purpose: To define the basic information of the claim entitlement.

   • Fields:

     • Entitlement Name: The name of the entitlement (e.g., "Healthcare Benefits - Optical").

     • Code: A unique identifier for the entitlement.

     • Top-Up Amount: The total entitlement allocated.

     • Recurrence Pattern: Specifies if the entitlement is recurring (e.g., yearly, monthly).

     • Start and End Dates: Defines the duration of the entitlement.

   • Importance: Ensures employees are aware of their benefits and the applicable timeframes.

   • Example: Setting a yearly optical benefit of $200 that renews every January.

2. Employees

   • Purpose: To assign entitlements to specific employees.

   • Functionality:

     • Select employees who qualify for the entitlement.

     • Filter employees by department, job role, or branch for targeted assignment.

   • Importance: Facilitates personalized entitlement management.

   • Example: Assigning a professional development allowance only to managerial staff.

3. Resigned Employees

   • Purpose: Tracks entitlements for employees who have left the organization.

   • Functionality:

     • Review unused entitlements for reconciliation.

     • Prevent entitlement allocation for former employees.

   • Importance: Ensures accurate financial reporting and prevents misuse.

4. Account Conversion

   • Purpose: Manages shared thresholds between related entitlements.

   • Functionality:

     • Link entitlements with shared limits.

     • Automate balance conversions between linked entitlements.

   • Importance: Streamlines entitlement tracking and prevents exceeding combined limits.

   • Example: Linking "Healthcare Benefits - Optical" and "Healthcare Benefits - Other" to a shared limit of $1,000.

5. HR Claim Approval

   • Purpose: Designates HR personnel responsible for approving specific entitlements.

   • Functionality:

     • Add or remove approvers.

     • Define approval levels for each entitlement.

   • Importance: Ensures claims are reviewed by authorized personnel.

   • Example: Assigning HR managers to approve educational reimbursement claims.

6. Employee Balance

   • Purpose: Provides a comprehensive view of entitlement balances for all employees.

   • Functionality:

     • Monitor used and available balances.

     • Export balance reports for audits.

   • Importance: Enhances transparency and accountability.

   • Example: Checking if an employee has sufficient travel allowance before approving a claim.

7. Claim Items

   • Purpose: Lists specific items or services covered under the entitlement.

   • Functionality:

     • Define claimable items.

     • Set limits and conditions for each item.

   • Importance: Ensures clarity on what can be claimed.

   • Example: Allowing airfare and accommodation under the travel entitlement but excluding meals.

In the next section, we will explore the Claim Item Categories and their role in organizing claimable items within the e-Claim module.