Enter, or click to select, the ID number of the employee in this required field. Costpoint validates your entry against data entered in the Manage Employee Information screen. The employee's name displays in the adjacent, unlabeled field. The employee must have an election amount in the entered plan year.

Enter the plan year for which you want to record medical care reimbursement or make an inquiry. Costpoint validates your entry against the Medical Care FSA Setup table. The employee must have an election in the Manage Employee Medical Care FSA Elections screen for this plan year. This is a required field.

This non-editable field displays the annual election amount for this employee for this plan year. This amount comes from the Manage Medical Care FSA Plan Year screen.

This field displays the unused employee contribution amount in the previous plan year that can be used to reimburse claims on top of the election amount in this plan year.

This field is blank if the Allow Carryover of Unused Funds check box on the Manage Medical Care FSA Plan Year screen is not selected.

This non-editable field displays the employee's pay cycle, as specified on the Manage Employee Taxes screen. This field is hidden if Costpoint Payroll is not used for reimbursements.

If you are using Costpoint Payroll for reimbursements, this field displays the sum of deductions (using the deduction code from the Benefit Settings screen) from the Employee Earnings table for this employee for check dates within the start and end date of the plan year. Employee contribution information is not stored in the Maintain Medical Care History table. It is already stored in the Employee Earnings table.

If you are not using Costpoint Payroll for reimbursements, this field displays the sum of Employee Contributions for all rows in the table that contain a Transaction Code of Contributions/Deductions. If you do not use Costpoint Payroll to reimburse, Costpoint updates this field whenever you add new Contributions/Deductions rows to an existing record and stores such contributions in this table.

This field displays the sum of all rows in the table that contain a Transaction Code of Reimbursements. If you do not use Costpoint Payroll to reimburse, Costpoint updates this field whenever you add new Reimbursements rows to the table.

This field displays the amount of Contributions/Deductions less the Reimbursements amount. If you do not use Costpoint Payroll to reimburse, Costpoint updates this field whenever you add new rows.

If your company reimburses through Costpoint Payroll, this field displays the date on which the transaction was entered in Costpoint.

If not, click on the toolbar to display the current system date in this field. If this date is not correct, you can enter, or click to select, the correct date in MM/DD/YYYY format. This is a required field.

If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays either Reimbursements or Contributions/Deductions. If your company does not use Costpoint Payroll to reimburse, enter the transaction code (Reimbursements or Contributions/Deductions) that applies to this transaction.

This field is enabled only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the date on which the medical care expense was incurred. This date determines into the plan year into which this expense falls. If your company does not use Costpoint Payroll to reimburse, you can enter, or click to select, the incurred date. Your selection includes dates after the plan year ends.

This field is enabled and required only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the date on which the request for reimbursement was made. If your company does not use Costpoint Payroll to reimburse, you can enter, or click to select, the request date.

This field is enabled and required only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the dollar amount of the medical care request, regardless of the amount actually paid. If your company does not use Costpoint Payroll to reimburse, enter the request amount. The amount must be greater than zero.

This field is enabled and required only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the dollar amount of the medical care request that has been approved for payment, regardless of the amount actually paid. If your company does not use Costpoint Payroll to reimburse, enter the approved amount. The dollar amount must be greater than zero.

This field is enabled and required only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the amount that was actually paid, regardless of the request or approved amount. If your company does not use Costpoint Payroll to reimburse, enter the reimbursement amount. The value in this field must be greater than zero.

This field displays the date of the end of the pay cycle for which this transaction was completed. If your company does not use Costpoint Payroll to reimburse, this field is hidden.

This field is enabled and required only when the Transaction Code is Reimbursements. If your company uses Costpoint Payroll to reimburse medical care expenses, this field displays the date of the check that was used to make reimbursement. If your company does not use Costpoint Payroll to reimburse, you can enter, or click to select, the check date.

Enter any comment you want to attach to this row.