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

Select this check box if the dependent/beneficiary record is currently active.

Select this check box to indicate that the dependent/beneficiary record has the same address as the employee. If you select this check box, Costpoint sets all fields in the Address group box to those of the employee (as specified on the Address tab of the Manage Employee Information screen).

Enter the dependent's/beneficiary's last name.

Enter the dependent/beneficiary's first name.

Enter the dependent's/beneficiary's middle name.

Enter the prefix, if one is used, associated with the dependent/beneficiary's name. You can enter a maximum of six characters. Examples of prefixes include:  Mr., Mrs., Ms., Dr., and Rev.

Enter the suffix, if one is used, associated with the dependent's/beneficiary's name. Enter a maximum of six alphanumeric characters. Examples of suffixes include:  Jr., Sr., II, III, Ph.D., and M.D.

Upon validation, this field displays the name of the dependent/beneficiary in Last Name, First Name, Middle Initial format. This is how the name displays on reports or screens. To change the format of the name, enter alphanumeric characters in any format you want. This field is required.

Select this option if you are entering a record for an employee's dependent (rather than a beneficiary).

Select this option if this record applies to an employee's beneficiary (rather than a dependent).

Select this option if you are entering a record for a person who is both a dependent and a beneficiary of this employee.

From the drop-down list, select the dependent's/beneficiary's relationship to the employee:

• Husband
• Wife
• Daughter
• Son
• Stepdaughter
• Stepson
• Other

Your selections for the Relationship to Employee option Type group box on this screen, and the Coverage Rules group box on the Enrollment/Coverage Rules tab of the Manage Benefit Plans screen, together determine who is covered under which health plan.

For example:

• If you select the Dependents Eligible check box in the Coverage Rules group box, any dependent set up on this screen is automatically covered in the plan.
• If you select the Dependent Spouse or Child check box in the Coverage Rules group box, only spouses and/or children are automatically covered in the plan.

If you selected Other in the Relationship to Employee field, enter alphanumeric text in this field to explain.

Select this check box if this dependent is a student. Full-time students may be eligible for coverage extension.

Select this check box if the dependent is handicapped. Handicapped dependents may be eligible for coverage extension.

Enter, or click to select,  the date of this dependent's/beneficiary's birth, in MM/DD/YYYY format.

Enter the nine-digit Social Security number of this dependent/beneficiary.

Enter up to three lines of street address information excluding the city, state/province, country, and postal code. These fields are optional.

Enter the employee's city.

Enter, or click to select, the state abbreviation/province code for the employee in this field.

Enter the employee's ZIP code or postal code.

Enter, or click to select, the employee's country code (for example, USA) in this field.

Enter the area code and home telephone number, in any format, for this dependent/beneficiary.

If this dependent/beneficiary has a work telephone number, enter the area code and telephone number, in any format, in this field.

Enter a maximum of 40 alphanumeric characters of information you want to include in this dependent's/beneficiary's record.