You use the Plan Reimbursement window to define special requirements for plans that offer reimbursable goods and services and to set up spending account plans.

You can define the date through which you accept reimbursement requests for the plan and the last date in the plan year for which an expense will be reimbursed.

You can also define the certifications that are required or preferred for reimbursement of a good or service. You can limit the personal and familial relationship types, such as a spouse or a child, whose expenses are reimbursable under the terms of a plan.

   To define a reimbursement plan:

1. Query the Plan for which you are defining reimbursement criteria.

2. In the Compare Claims field, select a code to indicate if the application validates a reimbursement request against the participant's current request balance or the coverage elected for the plan year. Choose either:

   • Compare claims to balance accumulated (reserved for future use)

   • Compare claims to coverage elected

3. Check the Allows Reimbursement field to indicate that you allow participants to submit reimbursement requests for the goods and services in this plan.

   Timing Tab

4. Choose the Timing tab.

5. Select the Plan Year Start Date for the year period you are associating with this reimbursement plan.

   The End Date for this year period automatically displays based on the plan years you established during your implementation.

6. Select the date by which Expenses Must Be Incurred On Or Before.

   This is the last date in the plan year on which a participant can incur an expense and still have the expense reimbursed. Typically, this is the last day of the year period.

7. Select the date by which a Request Must Be Received On Or Before.

   This is the date through which you accept claim reimbursement requests for this year period. For example, your enterprise may accept reimbursement requests for two months after the end of the previous plan year.

   Good or Service Tab

   Note: Goods and services are required for reimbursement request processing.

8. Choose the Good or Service tab.

9. Select a Good or Service that is reimbursable for this plan.

   Use the Goods and Services window to define those items you approve for reimbursement.

10. Check the Recurring Claims field if participants can instruct you to automatically make payments for recurring claims without submitting a reimbursement request for every incurred expense.

    Note: This field is reserved for future use.

11. Choose the Certification button to open the Reimbursement Certifications window.

    You can define the certifications that you require or prefer to validate a reimbursement request for a good or service.

12. Select a certification Type--such as a paid invoice or a receipt--that you require or prefer to validate a reimbursement request.

    You can add to the list of certification types by using the Lookup Type BEN_REIMBMT_CTFN_TYP in the Application Utilities Lookups window.

13. Check the Required field if you deny a claim reimbursement when a participant fails to provide this certification type.

    • If special circumstances apply, select a Reimbursement Certification Rule to indicate those instances where you allow reimbursement when a participant has not submitted a required certification. Use the Lack Certification Allow Reimbursement formula type to write this rule.

14. Close the Certifications window.

    Relationship Tab

15. Choose the Relationship tab.

16. Select the Relationship Type of the persons related to the primary participant who can also submit reimbursement requests.

17. Save your work.

    Forfeiture Tab

18. Check the Forfeitures Apply field if the application forfeits a person's unspent credits for this plan at the end of the plan year.

    You run the Process Forfeitures concurrent request to determine a participant's forfeitures.

19. Select Provider as the Distribution Method to forfeit unspent contributions to the plan provider.

20. Select Use Compensation Level Factor as the Contribution Determination Code.

21. For the Distribution Determination Code, select:

    • Use Compensation Level Factor to calculate distributions based on a benefits balance or a defined balance in Oracle Payroll.

    • Use Approved Reimbursement Requests to calculate distributions based on the amount distributed to the participant using the Reimbursement Requests window.

22. Enter a GL Account for Debit and Credit to record the Oracle General Ledger accounts you use to track forfeiture totals for the plan.

23. Check Post to GL if you post forfeitures to the Oracle General Ledger credit account you entered in the previous step.

    Note: This feature is reserved for future use.

24. After you run the Process Forfeitures concurrent request, you can view forfeiture totals for the plan by clicking the Forfeiture Values button.

    • Open the View Enrollment Results window, query a person, and choose the Rates button to see forfeiture results for a participant.