Enter, or click to select, the employee ID in this required field. Costpoint validates your entry against the Employee table set up on the Manage Employee Information screen. The employee's name displays in the adjacent, unlabeled field.

Enter, or click to select, the code for the benefit package that is currently assigned to the employee or the package that you want to assign to this employee. Costpoint validates your entry against data entered on the Manage Benefit Packages screen. The description of the benefit package displays in the adjacent field. This is a required field.

The default value of this field comes from the Gender field on the Manage Employee Information screen. A warning will display if the selection is Non-Binary or Unknown. The Benefit Gender field will be referenced in the Print Census Report.

This non-editable field displays the entire monthly premium amount for the insurance coverage that is part of this benefit plan/coverage option.

This non-editable field displays the employee's portion of the monthly premium amount.

This non-editable field displays the employer's portion of the monthly premium amount.

Click this button to refresh the totals in this group box.

Enter, or click to select, the benefit package for the employee's benefit plan/coverage option election.

Enter, or click to select, the code for the benefit plan you want to assign to this employee's benefit package. You must first set up the benefit plan in both the Manage Benefit Plans and the Manage Benefit Packages screens before you can assign it here. Costpoint checks the code against the Benefit Packages table.

Enter, or click to select, the code for the coverage option this employee selected. You can enter only one coverage option per benefit plan for a given date range. Costpoint checks the code against the Benefit Packages table.

The code for the rate table that applies to this coverage option, if any, displays in this non-editable field. Assign this code, if applicable, to this benefit plan on the Manage Benefit Plans screen.

The start date that was entered on the Coverage Options subtask on the Manage Benefit Plans screen automatically displays in this column after you specify the Coverage Option code. You can change this date. The employee's start date must be within the date range established on the Manage Benefit Plans screen.

The end date that was entered on the Coverage Options subtask of the Manage Benefit Plans screen automatically displays in this column after you specify the Coverage Option code. You can change this date or leave this field blank. The employee's end date must be within the date range established on the Manage Benefit Plans screen and must be later than the Start Date on this screen.

From the drop-down list, select the reason for the benefit enrollment. Valid values are:

• Open Enrollment
• Life Event

This non-editable field displays the monthly amount that the employee must pay for insurance premiums that are calculated on percentages or amounts on the Manage Benefit Plans screen for this coverage option.

This non-editable field displays the monthly amount that the company must pay for insurance premiums that are calculated on percentages or amounts on the Manage Benefit Plans screen for this coverage option.

This non-editable field displays the monthly premium amount for this coverage option for this benefit plan. Costpoint calculates this amount according to the method you selected on the Manage Benefit Plans screen.

This non-editable field displays the deduction code that was assigned to this benefit plan on the Manage Benefit Plans screen.

This non-editable field displays the description of the deduction code that was assigned to this benefit plan on the Manage Benefit Plans screen.

This non-editable field displays the deduction method associated with the deduction code assigned to this benefit plan on the Manage Benefit Plans screen.

If applicable, this field displays the employee’s Evidence of Insurability (EOI) status. Valid values are:

• Not Required
• Approved

Enter the name of the employee's first primary care physician, if this is a medical plan. This field is required if the Require PCP Name and Number option is selected for the benefit plan on the Enrollment/Coverage Rules tab of the Manage Benefit Plans screen.

Enter the primary care physician's identification number. This field is required if the Require PCP Name and Number option is selected for the benefit plan on the Enrollment/Coverage Rules tab of the Manage Benefit Plans screen.

Enter the name of the employee's second primary care physician, if this is a medical plan.

Enter the name of the employee's dentist, if this is a dental plan.

Enter the name of the pharmacy where this employee has prescriptions filled.