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Benefits & caps

Benefit plans define an amount and a period — annual, half-yearly or quarterly. Balances are tracked per employee per period, and the cap is checked at the moment a claim is submitted rather than discovered at approval.

  • Annual, half-yearly and quarterly periods
  • Balance enforced at submission time
  • Eligibility rules per plan
  • Employees see their own remaining balance

How a plan works

A benefit plan has a code, a name, a maximum amount and a period. A quarterly medical plan capped at $200 gives each employee $200 to spend in each of the four quarters; unused amounts do not roll forward unless you choose to configure a plan that way. An annual flexible-benefit plan behaves the same way over a calendar year.

Balances are per employee, per plan, per period. When a claim in a benefit-backed category is approved, the used amount for that period goes up. When a claim is cancelled or rejected, it comes back down.

Enforcement happens early

The remaining balance is resolved when the claim is submitted: the reimbursable amount is set to the lesser of the claim and what is left in the period, and the form says so before the employee commits. This matters, because the alternative — resolving it at approval — means somebody spends their own money, files, waits three days and only then learns they were over their cap.

Eligibility

Plans can be restricted so that not everyone is eligible. Contractors and vendors who need portal access but do not receive company benefits can be excluded, in the same way they can be excluded from leave allocation.

Visibility

Employees see their own benefits page: each plan they are eligible for, the cap, what they have used this period and what remains. Admins see the same data across the company and can adjust plans as policy changes.