ANZ Smart Choice Super

Transcription

1 ANZ Smart Choice Super MetLife Insurance Limited Legg Mason Superannuation Plan INSURANCE GUIDE FOR EMPLOYERS AND THEIR EMPLOYEES 25 MAY 2015 Death and Total and Permanent Disablement Cover

2 ANZ Smart Choice Super Entity details in this Insurance Guide Name of legal entity Registered numbers Abbreviated terms used throughout this Insurance Guide OnePath MasterFund ABN RSE R Fund OnePath Custodians Pty Limited ABN AFSL RSE L OnePath Custodians, Trustee, us, we, our MetLife Insurance Limited ABN AFSL Insurer Australia and New Zealand Banking Group Limited ABN AFSL ANZ Legg Mason Asset Management Australia Limited ABN Employer Legg Mason Superannuation Plan Employer Plan Important information When an employer joins ANZ Smart Choice Super, nominated employees become members of the Fund. OnePath Custodians is the Trustee of the Fund and the issuer of this Insurance Guide. The Trustee is a wholly owned subsidiary of ANZ. ANZ is an authorised deposit taking institution (Bank) under the Banking Act 1959 (Cth). Although the Trustee is owned by ANZ, the Trustee is not a Bank. Except as described in this Insurance Guide, an investment in ANZ Smart Choice Super is not a deposit or other liability of ANZ or its related group companies and none of them stands behind or guarantees the Trustee or the capital or performance of the investment. An investment in ANZ Smart Choice Super is subject to investment risk, including possible repayment delays and loss of income and principal invested. The factual information and general advice provided in this Insurance Guide is of a general nature and has been prepared without taking into account your objectives, financial situation or needs. Before acting on the information or advice, you should consider whether it is appropriate for you, having regard to your objectives, financial situation and needs. You should obtain a copy of the Product Disclosure Statement (PDS) for ANZ Smart Choice Super Employers and their Employees before making any decision about whether to acquire, or continue to hold, the superannuation product. You can obtain a copy of the PDS by contacting Customer Services on The Fund is governed by a trust deed (Trust Deed). Together with superannuation law, the Fund s Trust Deed sets out the rules and procedures under which the Fund operates and the Trustee s duties and obligations. If there is any inconsistency between the Trust Deed and the PDS or this Insurance Guide, the terms of the Trust Deed prevail. A copy of the Trust Deed is available from us free of charge. The Trustee invests all contributions in a master life policy issued by OnePath Life Limited (OnePath Life) which then invests in selected investment funds. The master life policy is governed by the Life Insurance Act 1995 (Cth) and is a contract between the Trustee and OnePath Life. OnePath Life is required to conduct its business in accordance with the law and give priority to the interests of policy holders, hold the assets it receives from the Trustee in statutory funds separate from its own assets and comply with the prescribed capital and solvency standards. If an employer has selected insurance cover as part of ANZ Smart Choice Super, the insurance cover is provided by OnePath Life or another insurer approved by the Trustee. In the case of this Insurance Guide, cover is provided by MetLife Insurance Limited (the Insurer) under group policies issued to the Trustee. In respect of such policies, the Trustee reserves the right to change insurer, or vary the benefits or Insurance Fee rates from time to time. Where the Insurer imposes loadings or exclusions as a result of the member s health, pastimes or other individual circumstances, the Insurer will write to the Trustee and provide specific details relating to the member s cover. The Trustee will advise the member where this occurs. The Trustee is responsible for the contents of this Insurance Guide. The ANZ Smart Choice Super Product Disclosure Statement Employers and their Employees ( ANZ Smart Choice PDS ) is comprised of the following documents: ANZ Smart Choice Super Product Disclosure Statement Employers and their Employees dated 25 May 2015; ANZ Smart Choice Super Additional Information Guide Employers and their Employees dated 25 May 2015; ANZ Smart Choice Super Insurance Guide For employers and their employees dated 25 May 2015; and in respect of members of the Legg Mason Superannuation Plan, the following: ANZ Smart Choice Super MetLife Insurance Limited Legg Mason Superannuation Plan Insurance Guide - For employers and their employees dated 25 May 2015 ( this Insurance Guide ). The purpose of this Insurance Guide is to give you more information and/or specific terms and conditions referred to in the PDS. You should consider all that information before making a decision about ANZ Smart Choice Super. If you invest in ANZ Smart Choice Super, you can access a copy of the PDS, the Additional Information Guide and any matter that is applied, adopted or incorporated in the PDS from our website at anz.com/smartchoice To the extent that you are provided with cover as set out in this Insurance Guide, these terms and conditions will prevail over those set out in the ANZ Smart Choice Super Insurance Guide For employers and their employees dated 25 May This Insurance Guide, the link to which was included in your Welcome Letter, contains all the information about the insurance applicable to your Employer Plan. You may also request a copy of all information (including this Insurance Guide) free of charge by contacting Customer Services. The information provided in this Insurance Guide is general information only and does not take account of your personal financial situation or needs. You should obtain financial advice tailored to your personal circumstances. Trustee contact details OnePath Custodians Pty Limited ABN AFSL RSE L Pitt Street Sydney NSW 2000 GPO Box 5107 Sydney NSW 2001 Phone anzsmartchoice@anz.com Website anz.com/smartchoice

3 2 3 Contents Insurance in ANZ Smart Choice Super 4 What type and amount of cover is available? 4 When are you eligible for cover? 4 What is Default Cover? 4 What is Voluntary Cover? 5 When does cover commence? 5 What are the Benefits? 5 When we won t pay Benefits 6 Who is a Benefit paid to? 6 What are the costs of insurance? 6 When does your cover cease? 7 What happens when you leave your Employer? 7 Additional Features 7 How to make a claim 7 Duty of disclosure 8 Insurance risks 8 Appendix 9

4 Insurance in ANZ Smart Choice Super This Insurance Guide has been prepared to provide general information about the insurance your Employer has arranged with the Trustee on behalf of its employees who are members of your Employer Plan. It explains the terms and conditions of the insurance policy (Policy) the Trustee has entered into with the Insurer for those members of your Employer Plan who are insured. This Insurance Guide summarises the insurance arrangements for your Employer Plan. Each Policy, Policy Schedule and endorsements to the Policy form the complete terms and conditions between the Insurer and the Trustee. This Insurance Guide sets out the main terms of the Policy covering your Employer Plan within ANZ Smart Choice Super. This Insurance Guide is not a legally binding contract of insurance with the Insurer. Insurance cover is subject to eligibility, acceptance and other terms and conditions of the Policy. In the event of any inconsistency between the terms and conditions of the Policy and this Insurance Guide, the Policy terms and conditions will prevail. The Trustee may change the Insurer and/or terms (including Insurance Fee rates) of the insurance cover at any time with appropriate notice. Details of the type of insurance cover and the value of cover in place for you will be shown on your Welcome Letter and subsequent Annual Statements each year. If you have not received a Welcome Letter, please contact Customer Services on To view, manage and consolidate your super, simply register for ANZ Internet Banking or our smartphone app, ANZ gomoney, by calling Customer Services on or visiting an ANZ branch. If you are an existing ANZ Internet Banking customer, simply log in and enter your new ANZ Smart Choice Super account number in the Link/Delink a personal account option under Update Details. Any material alteration to the terms and conditions outlined in this Insurance Guide will be advised in writing. ANZ gomoney is a registered trademark of ANZ. When reading this Insurance Guide, some expressions (shown capitalised, and bold when first used) have a special meaning. The meaning is either explained in context, or in the Appendix to this Insurance Guide. What type and amount of cover is available? Your Employer can select: Death only Cover Death and Total and Permanent Disablement (TPD) Cover, and/or Income Protection (IP) Cover (if applicable) for your Employer Plan. Your Employer may also choose an amount of Default Cover to apply to your Employer Plan. The type of cover, and the amount of Default Cover, your Employer has selected for your Employer Plan is set out in the Appendix. The particular benefits arranged for you will be specified in the Welcome Letter sent to you. Benefits described in this Insurance Guide that are not listed in your Welcome Letter may not be available to you. You may also be eligible to apply for additional cover or cover that differs from the Default Cover applicable to your Employer Plan. This is Voluntary Cover. Please refer to the What is Default Cover? and What is Voluntary Cover? sections of this Insurance Guide for further details. Generally, if you are a member who is eligible for insurance, you will be covered 24 hours a day, 365 days a year, worldwide. The Appendix will specify whether there are any restrictions on cover while you are overseas. When are you eligible for cover? To be eligible for the insurance cover established for your Employer Plan, you will generally be required to meet pre-determined eligibility criteria. These criteria, which are set out in the Policy may include the following items: Your age; Occupation; Employment status; Residency status; and/or Hours of work. For the specific eligibility criteria that applies to your Employer Plan, refer to the Appendix. What is Default Cover? Your Employer may have chosen Default Cover for your Employer Plan. Default Cover is cover that is provided automatically to eligible members, without the member needing to provide any evidence of health. If you are eligible, the level of Default Cover you receive will be determined by the Benefit Design for your Employer Plan, which is set out in the Appendix. Default Cover will be provided up to a maximum amount, called the Automatic Acceptance Limit (AAL). The Insurer may have the right to vary or remove the AAL. Refer to the Appendix for further details about the AAL. Depending on the Benefit Design for your Employer Plan, your Sum Insured may also automatically increase or decrease. Any automatic increase in the Sum Insured will be limited to that allowed under the AAL. Note: If the Benefit Design uses your salary to calculate a benefit, your Employer must notify us of all salary changes as they occur. If we are not notified of a change in salary, and no additional Insurance Fee has been paid, in the event of a claim the Insurer may pay a lower benefit based on the salary previously advised, or the salary at the last review date.

5 If you are not eligible to obtain Default Cover, or you have Default Cover, but want a greater amount of cover (including an amount above the AAL), you must apply to the Insurer by submitting an application for Voluntary Cover. For further information see What is Voluntary Cover? below. What is Voluntary Cover? Depending on the Benefit Design your Employer has chosen, if you are not eligible for Default Cover, you may be able to apply for: Death only Cover; Death and TPD Cover; and/or IP Cover (if applicable). The Appendix sets out the types of cover you can apply for and any eligibility criteria you must meet to be able to apply for cover. You cannot apply for TPD Cover without Death Cover. You can also apply to increase your existing Sum Insured, up to the Maximum Benefit Level. The Appendix sets out the Maximum Benefit Level that applies to your Employer Plan. A different Maximum Benefit Level may apply to the different types of Cover available. You can apply to increase the Sum Insured of your Death Cover only or TPD Cover only, or the Sum Insured for both your Death and TPD Cover. However, you cannot apply to increase the Sum Insured of your TPD Cover above that of your Death Cover. All applications for Voluntary Cover will be subject to the Insurer s acceptance, following the provision of medical evidence as required by the Insurer. The Insurer reserves the right to offer modified acceptance terms or decline applications for Voluntary Cover for any reason. If the Insurer accepts the Voluntary Cover, they may provide written acceptance to a Forward Underwriting Limit. If this is available for your Employer Plan, further details will be provided in the Appendix. To apply for Voluntary Cover, please contact Customer Services on You may be contacted by Customer Services for additional evidence or further information. While your application is being considered by the Insurer, you may be eligible for Interim Accident Cover (if applicable). Refer to the Appendix for more information. When does cover commence? The commencement date of your cover depends on whether it is Default Cover or Voluntary Cover. Default Cover The commencement date of Default Cover is determined by the terms and conditions applicable to your Employer Plan. In some cases this will also be determined by the category established for you by your Employer. Refer to the Appendix for more information. Voluntary Cover Voluntary Cover, including a variation in cover, commences on the date the Trustee notifies you in writing. Reducing or cancelling your cover You can reduce the amount of your cover, or cancel your cover, at any time by contacting Customer Services on You cannot reduce your TPD Sum Insured below your Death Sum Insured. If you reduce or cancel your cover (including Default Cover), your cover may not be automatically increased or re-instated if you wish to do so at a later time. You must apply for any increase in cover. If you cancel your cover within the first 30 days of it commencing, some or all of the premiums you have paid for the cancelled cover may be refunded to your superannuation account in some circumstances. What are the Benefits? Death Benefit and Terminal Illness Benefit Subject to any restrictions that apply to your cover, your lump sum Death Benefit will be paid if you die while your Death Cover is in force. The amount of your Death Benefit will be your Sum Insured for Death Cover on the date of death plus your superannuation account balance. You can claim a lump sum Terminal Illness Benefit (if available) if you become Terminally Ill while your Death Cover is in force. The Appendix sets out the definition of Terminally Ill. You must meet the Insurer s claim requirements and satisfy the Insurer on medical and other evidence that you meet the definition of Terminal Illness before the insured benefit will be paid. Other restrictions may also apply to your Employer Plan. Refer to the Appendix for more information. Total and Permanent Disablement (TPD) Benefit You can claim a lump sum TPD Benefit if you become Totally and Permanently Disabled while your TPD Cover is in force. The Appendix sets out the definition of Total and Permanent Disablement applicable to your Employer Plan, and in some cases to your particular category. You must meet the Insurer s claim requirements and satisfy the Insurer on medical and other evidence that you meet the definition of Total and Permanent Disablement before the insured benefit will be paid. Other restrictions may also apply to your Employer Plan. Refer to the Appendix for more information. Amount of Death Benefit and TPD Benefit The Sum Insured for each type of cover you have cannot exceed the Maximum Benefit Level for that type of cover, as set out in the Appendix. Generally, payment of a Terminal Illness Benefit will reduce the Sum Insured of your Death Cover. If your Sum Insured for Terminal Illness Cover and Death Cover are the same amount, your Death Cover will cease. Refer to the Appendix for more information. 4 5

6 Payment of a TPD Benefit will also reduce the Sum Insured of your Death Cover. If your Sum Insured for TPD Cover and Death Cover are the same amount, your Death Cover will cease. The Sum Insured for your TPD Cover cannot exceed the Sum Insured for your Death Cover. TPD Tapering may apply to your TPD Cover. TPD Tapering is the gradual reduction of the amount of TPD Cover to zero, generally in the final five years before reaching age 65 or the benefit expiry age. If TPD Tapering applies to you, more information on this can be found in the Appendix. Income Protection (IP) Benefit (if applicable) IP Cover is designed to provide you with a monthly amount while you are Totally Disabled or Partially Disabled, to assist you to meet your day-to-day living expenses during your recovery period, giving you time to focus on your health and recovery. You can claim the monthly Total Disability Benefit if you become Totally Disabled for longer than the Waiting Period, while your IP Cover is in force. If your Employer has selected IP Cover for your Employer Plan, the Appendix sets out the definition of Total Disability and the Waiting Period that applies to your Employer Plan. You can claim the monthly Partial Disability Benefit if you become Partially Disabled while your IP Cover is in force. If your Employer has selected IP Cover for your Employer Plan, the Appendix sets out the definition of Partial Disability that applies to your Employer Plan. You must meet the Insurer s claim requirements and satisfy the Insurer on medical and other evidence that you meet the definition of Total Disability or Partial Disability before the insured benefit is paid. The Insurer may also have ongoing claim requirements. If your Employer has selected IP Cover to apply to your Employer Plan, the Appendix will set out: how the monthly amount of your Total Disability Benefit and Partial Disability Benefit will be calculated; the period of time during which the Insurer will pay a Total Disability Benefit or Partial Disability Benefit. This is known as the Benefit Payment Period; the Waiting Period. The monthly benefit starts to accrue from the day after the end of the Waiting Period; and any other terms that apply. When we won t pay Benefits The Insurer won t pay benefits in certain circumstances. These circumstances are set out in the Appendix. It is important that you be aware of when a benefit will not be paid. Pre-existing Conditions In some circumstances you will not be covered for Pre-existing conditions that existed when your cover commenced. If this applies to your Employer Plan, further information will be provided in the Appendix. Who is a Benefit paid to? The insurance cover is provided by the Insurer through policies of insurance issued to the Trustee and cover is offered to eligible members of ANZ Smart Choice Super. Where the Insurer admits your claim, the insurance benefit is paid to the Trustee and the Trustee will allocate the benefit to your superannuation account. If you have met a condition of release under superannuation law, these monies will be available to you for withdrawal or dealt with in accordance with the Fund s Trust Deed. If the Insurer rejects, reduces or defers a claim, the Trustee may reduce the benefit payable to take into account the Insurer s refusal, reduction or deferral. For more information on conditions of release, refer to the Additional Information Guide, which forms a part of the ANZ Smart Choice Super Employers and their Employees PDS. What are the costs of insurance? Insurance Fees The Insurance Fees applicable to your Employer Plan are set out in the Appendix. The Insurance Fee that applies to you may depend on a variety of factors, including but not limited to: the type and level of cover; your age and gender; your salary; any relevant rating factors applicable to your Employer Plan; and/or your health and pastimes. Payment of Insurance Fees Insurance Fees are calculated daily and deducted monthly in advance from your account balance. If you have insufficient funds in your account to cover the Insurance Fee, you will be advised in writing. You will be given 30 days to contribute the required funds to your account before your cover may be cancelled. Your Employer may agree to pay your Insurance Fees on your behalf, by way of an Employer additional contribution to reimburse for the Insurance Fees deducted from your account. Your Employer may also cancel such an arrangement at any time. Under these conditions, including if you leave your Employer, you may be liable to pay the Insurance Fee, including any unpaid fees owing. If your Employer agrees to pay Insurance Fees for your Default Cover, and you wish to cancel or opt out of such cover, you should co-ordinate this with your Employer. The actual Insurance Fee payable for your cover will be advised in the Welcome Letter provided upon joining ANZ Smart Choice Super, and then for each subsequent year in the Annual Statement issued as at 30 June. If your employer pays your insurance fees, and you wish to cancel your insurance, you will need to make this request through your employer. Further details on your Insurance Fees are detailed in the Appendix.

7 Insurance Fee Waiver In some cases the Insurer may waive the payment of Insurance Fees for IP Cover (where applicable) for you which fall due while you are receiving a benefit. If this applies to your Employer Plan, further information will be provided in the Appendix. Stamp Duty Stamp duty is included in the Insurance Fees. Taxes and Expenses Insurance Fees are inclusive of any applicable: administration fees the Insurer charges; Federal, State or Territory taxes, or other government charges; and expenses incurred in administering any function required by a Federal, State or Territory Government under any legislation in relation to the Policy. There is no GST charged on Insurance Fees. The Insurer may vary or otherwise adjust any amounts (including but not limited to Insurance Fees, charges and benefits), under the insurance policies in the manner and to the extent the Insurer determines to be appropriate to take account of the tax. When does your cover cease? Your cover will end on the earliest of the dates set out in the Appendix. These dates include the earlier of: the date the Policy ends; and the date you die. It is very important that you be aware of the dates your cover will end, as your cover will end without you being notified by the Trustee or the Insurer. What happens when you leave your Employer? On termination of employment with your Employer, your superannuation account in ANZ Smart Choice Super will continue, but your insurance cover under your Employer Plan will cease. You may be able to take up personal insurance cover with the Insurer through a continuation option. Refer to the Appendix for further information. Alternatively, you may apply for insurance cover in ANZ Smart Choice Super provided by OnePath Life Limited. The terms of cover (including the eligibility conditions) provided by OnePath Life for Death and TPD Cover and IP Cover are set out in the ANZ Smart Choice Super Insurance Guide For employers and their employees, which can be accessed at anz.com/smartchoice You should consider this information before deciding whether to apply for insurance with OnePath Life. Additional Features If your Employer has selected additional features for your Employer Plan, these will be detailed in an Additional Features section of the Appendix. You should be aware that in order to access some of these features, a time period within which to apply may be applicable. How to make a claim In the event of a claim, the process has been made as easy as possible. For more information about making a claim: contact Customer Services on Customer Services at anzsmartchoice@anz.com visit the ANZ website at anz.com/smartchoice The Insurer requires you, your Employer or us to notify them in writing of any claim within the time limit specified in the Policy. (Please refer to the Appendix for further details.) If the Insurer does not receive notice in writing within the required time, the Insurer may reduce or refuse to pay the benefit to the extent its assessment of the claim is prejudiced. The Insurer will generally send us or your Employer claim forms as soon as reasonably possible after receiving notice of a claim. The sending of claim forms does not constitute an admission of liability in respect of any claim lodged. Claim forms must be completed as soon as it is reasonably practicable for you to do so. The Insurer generally asks for medical information and evidence to enable the claim to be assessed. If a claim is lodged, you may be required to be interviewed and attend medical and vocational assessments and rehabilitation and the Insurer may obtain information by surveillance. You, your Employer and we are also required to provide the Insurer with all information required in order to determine your eligibility for benefits. If you are residing or travelling overseas, in the event of a claim the Insurer may require you to return to Australia for medical treatment and assessment. The Insurer will not pay any costs relating to your return to Australia. 6 7

8 Duty of disclosure Before you enter into a contract of life insurance with the Insurer, you have a duty under the Insurance Contracts Act 1984 (Cth) to disclose to the Insurer every matter that you know or could reasonably be expected to know, that is relevant to the Insurer s decision whether to accept the risk of insurance and, if so, on what terms. You have the same duty to disclose those matters to the Insurer before you renew, extend, vary or reinstate your cover. Your duty however does not require disclosure of a matter that: diminishes the risk to be undertaken by the Insurer; is of common knowledge; the Insurer knows or, in the ordinary course of business, ought to know; or as to which compliance with the duty of disclosure is waived by the Insurer. The duty of disclosure continues to apply until the Insurer accepts (or declines) your application and confirmation is issued in writing. Non-disclosure If you do not disclose to the Insurer every matter that you know or could reasonably be expected to know, that would be relevant to the Insurer s decision whether to accept the risk of the insurance and if so, on what terms, the Insurer may avoid the contract, or avoid cover in respect of you within three years of entering into it, provided that the Insurer would not have entered into that contract or accepted cover for you had full disclosure been made. If your non-disclosure is fraudulent the Insurer can avoid the contract or your cover at any time. Where the Insurer is entitled to avoid a contract of life insurance or avoid cover, the Insurer may elect not to avoid it but apply either of the following options: reduce the sum that you would have been insured for in accordance with a formula that takes into account the premium that would have been payable if you had disclosed all relevant matters to the Insurer; or vary the contract or cover in such a way as to place the Insurer in a position that the Insurer would have been in had you disclosed all relevant matters or not made a misrepresentation. Where your contract or cover is in respect of Death Cover, the Insurer may only apply the first of the two options and the Insurer must do so within three years of the Insurer entering into the contract or providing you with cover. Insurance risks As your Employer has included insurance as part of its superannuation arrangements, under ANZ Smart Choice Super, there are a number of insurance risks you should be aware of: if the Insurance Fees are not paid to the Insurer within the time limits under the Policy, the Insurer may cancel or terminate the insurance cover by written notice to the Trustee without notice to you; your insurance cover will not automatically continue when you leave your Employer; if you are transferred to an Eligible Rollover Fund (ERF) or the Australian Taxation Office (ATO), your cover will cease (see the Additional Information Guide for more details); the amount or type of insurance cover selected by your Employer may not be sufficient to provide adequate insurance cover in the event of injury or illness; your Insurance Fee or benefit may be adjusted if your age is misstated; if your benefit is calculated using your salary while you are in the Employer Plan, we are reliant upon your Employer s notification of any salary changes. Where we are not notified of a change in salary and no additional Insurance Fee is paid, in the event of a claim, the Insurer may pay a lower benefit based on the salary that was previously advised or salary at the last review date; and if you or your Employer do not disclose to the Insurer every matter that they know or could reasonably be expected to know, that would be relevant to the Insurer s decision whether to accept the risk of the insurance and if so, on what terms, the Insurer may avoid the contract within three years of entering into it. If you or your Employer s non-disclosure is fraudulent, the Insurer may avoid the contract at any time. Refer to the Duty of Disclosure section within this Insurance Guide for more details.

9 Appendix This Appendix forms part of the Insurance Guide dated 25 May 2015 for the Legg Mason Superannuation Plan. 8 9 Types of Cover made available Eligibility for Insurance Cover What is the Maximum Benefit Level for Death Cover and TPD Cover? Death Cover and Total and Permanent Disablement (TPD) Cover. IP Cover is not available under this Policy. Eligibility for membership shall be on such conditions as notified to the Insurer in the Scheme Questionnaire completed by the Trustee or the Employer and agreed to by the Insurer (as varied from time to time by agreement). Compulsory for all employees on commencement of employment. $2,000,000 Default Cover What Default Cover (Benefit Design) is Available? Eligibility for Default Cover Automatic Acceptance Limit for Default Death and TPD Cover When does Default Cover commence? Benefit Formula: Category A1 (All Staff) & B1 (Western Asset Management): 4 x Fixed Annual Remuneration (FAR) Membership shall entitle the Group Person to insurance cover (the type of cover to be nominated by the Trustee) equal to : the Sum Insured [subject to the Sum Insured not exceeding the Automatic Acceptance Limit (where applicable)]; and/or the Monthly Benefit [subject to the Monthly Benefit not exceeding the lesser of the Maximum Monthly Benefit or the Automatic Acceptance Limit (where applicable)]. Death and TPD A Trustee shall only be eligible to receive in respect of a Member those Benefits specified on the nomination for membership for which the Insurer has agreed to provide cover. Cover is available under the Policy for Death Benefits and TPD Benefits. TPD Benefits are available as a rider to the Death Benefit. Cover for Death Benefits automatically entitles the Policyowner to cover for Death by Accident Benefits at no additional premium. 1. The Insurer will accept for membership any Group Person who: is Employed and actively carrying out their Occupation on a full time basis at the date of nomination; is a member of the Employer Plan; conforms to the eligibility conditions that are listed in this Appendix (see Eligibility for Insurance Cover ) or agreed to between the Trustee and the Insurer from time to time; and is nominated by the Trustee. An at work certificate must be supplied by the Trustee to the Insurer upon request. 2. Any Group Person: whom the Trustee fails to nominate within 30 days of first being eligible for membership; or who was not actively carrying out their Occupation on the date of entry nominated by the Trustee, with the exception of those Group Persons who complete 60 days continuous work from the date of return to their Occupation, will not be accepted for membership under the Policy. In this regard there is no requirement for the Insurer to communicate rejection of the nomination to the Trustee or the nominated Group Person. The non accepted status will not be altered where the Insurer has accepted premiums in respect of that Group Person. However, the Insurer reserves the right to accept that person for membership under Voluntary Cover. Death and TPD: $1,000,000 Subject to payment of premium and receipt of any other certificates or information required by the Insurer, Default Cover commences on the date of nomination for membership.

10 Voluntary Cover What types of Voluntary Cover can members apply for? When does Voluntary Cover commence? Death by Accident Benefit (Interim Accident Cover) Death Cover and Death and TPD Cover for: any Group Person: whom the Trustee fails to nominate within 30 days of first being eligible for membership; or who was not actively carrying out their Occupation on the date of entry nominated by the Trustee, with the exception of Group Persons who complete 60 days continuous work from the date of return to their Occupation; any Group Member for a Sum Insured in excess of the Automatic Acceptance Limit. Death and TPD Increase in Sum Insured By notice in writing from the Trustee to the Insurer, the Trustee may apply for an increase or decrease in the Death and/or TPD Benefit Sum Insured in respect of any Member. Subject to payment of premium and receipt of any other certificates or information required by the Insurer, Voluntary Cover shall commence on and from the date of acceptance by the Insurer. 1. Death by Accident Benefits are only payable in respect of: a. Group Persons: i. whom the Trustee fails to nominate within 30 days of first being eligible for membership; or ii. who was not actively carrying out their Occupation on the date of entry nominated by the Trustee; with the exception that those Group Persons who complete 60 days continuous work from the date of return to their Occupation, b. Group Persons in respect of whom the nominated Sum Insured exceeds the Automatic Acceptance Limit; and provided that the person s nomination for membership requested Death Benefit cover. 2. If during the period of risk set out below, any person referred to above dies as a result of an Injury (provided death occurs within 365 days of the Injury), the Insurer will pay to the Trustee: where the person is a Group Person referred to in paragraph (1)(a) above, the amount nominated as the Sum Insured under that Group Person s nomination for membership; or where the person is a Group Person referred to in paragraph (1)(b) above, that part of the amount nominated as the Sum Insured that exceeds the Automatic Acceptance Limit. 3. The Death by Accident Benefit is of a temporary nature and the risk will commence with respect to: a Group Person referred to in paragraph (1)(a) above, upon receipt by either the Insurer or the Trustee of a properly completed personal statement and declaration of health in respect of that Group Person; or a Group Person referred to in paragraph (1)(b) above, from the date that person was accepted for membership under the Default Cover. 4. The risk will cease upon the earliest of the following events: with respect to a Group Person referred to in paragraph (1)(a) above, upon acceptance (upon any terms) or rejection of that Group Person for membership; or with respect to a Group Person referred to in paragraph (1)(b) above, upon acceptance (on any terms) or rejection of the risk in respect of cover in excess of the Automatic Acceptance Limit; upon withdrawal of the person s nomination by the Trustee; 90 days from the commencement of risk of the Death by Accident Benefit. 5. Notwithstanding any other provisions of the Policy, where a Group Person referred to in paragraph (1)(b) above dies as a result of an Injury, the Death by Accident Benefit is in addition to the Death Benefit payable (up to the Automatic Acceptance Limit) in respect of that Group Person. Where a person is both a Group Person referred to in paragraph (1)(a) above and paragraph (1)(b) above, for the purpose of this provision the person shall be deemed only to be a Group Person referred to in paragraph (1)(a) above.

11 Death Cover Amount of Death Benefit If whilst cover under the Policy is in force in respect of a Member and that Member dies, then subject to the provisions of the Policy the Insurer will pay to the Trustee the Sum Insured for that Member Terminal Illness Benefit Is Terminal Illness Benefit available? TPD Cover Amount of TPD Benefit What is the definition of TPD? For members taking up new TPD Cover on or after 1 July 2014 What is the definition of TPD? For members with existing TPD Cover prior to 1 July 2014 IP Cover Does IP Cover apply? No. If whilst cover under the Policy is in force in respect of a Member and that Member suffers from TPD, then subject to the provisions of the Policy the Insurer will pay to the Trustee the Sum Insured for that Member. Total and Permanent Disablement shall mean: a. The Member suffering the loss of use of two limbs or the total and permanent loss of sight of both eyes or the loss of use of one limb and the total and permanent loss of sight of one eye (where limb is defined as the whole hand or the whole foot) and having provided proof to the Insurer s satisfaction that All the Member has become incapacitated to such an extent as to render the Member unlikely ever to engage in any gainful profession, trade or occupation for which the Member is reasonably qualified by reason of education, training or experience; or b. The Member having been absent from their Occupation through Injury or Illness for six consecutive months and having provided proof to the Insurer s satisfaction that All the Member has become incapacitated to such an extent as to render the Member unlikely ever to engage in any gainful profession, trade or occupation for which the Member is reasonably qualified by reason of education, training or experience. Total and Permanent Disablement shall mean: the Member suffering the loss of use of two limbs or the total and permanent loss of sight of both eyes or the loss of use of one limb and the total and permanent loss of sight of one eye (where limb is defined as the whole hand or the whole foot), or the Member having been absent from their Occupation through Injury or Illness for six consecutive months and having provided proof to the Insurer s satisfaction that the Member has become incapacitated to such an extent as to render the Member unlikely ever to engage in any gainful profession, trade or occupation for which the Member is reasonably qualified by reason of education, training or experience. No. When the insurer won t pay Special Conditions The payment of any Benefit in respect of a Member shall always be subject to any special terms and conditions of acceptance for membership of that Member. Insurance Fees Insurance Fees Payable When can the Insurer vary the Insurance Fee (premiums)? See Insurance Fee Schedule. The Insurer may vary the amount of premiums payable upon giving one month s written notice to the Trustee at any time, provided that any variation shall be effective only from the next Annual Review Date. The Insurer reserves the right to increase that portion of premiums referable to Death and TPD Benefits in respect to any or all Members upon written notification to the Trustee in the event of any invasion or an outbreak of war (whether declared or not) which involves Australia, New Zealand or the Member s country of residence. Should that right be exercised and the Trustee fails to pay any increase in premium the Insurer will not be liable to pay any Death or TPD Benefit with respect to a Member where the event giving rise to the claim arose either directly or indirectly from the invasion or war.

12 When Does Cover Cease When does Cover cease? a. Subject to the following provisions, then notwithstanding any other provision contained in this Policy, the Insurer s liability to pay any Benefits in respect of a Member shall cease upon the occurrence of the earlier of any of the following events: upon the death of that Member (this shall not affect the right of the Trustee to make a claim for a Death or Death by Accident Benefit in respect of that Member); on the day before the Member commences duty with the armed services of any country; in respect of a Group Member, upon the Member attaining the Maximum Insurable Age; in respect of a Group Member 60 days from the date the Group Member ceases to be a member of the Employer Plan; upon written notice from the Insurer to the Trustee, where any premium or instalment of premium has not been paid within 60 days after the Due Date for payment of that amount; in respect of Temporary Disability Benefits only upon the expiry of the Benefit Period in respect of that Member; upon the cancellation or termination of the Policy for any reason; or upon cancellation of cover in respect of that Member. b. If a Group Member is given leave of absence from his or her Employment without salary the Insurer will continue to accept liability for Death and TPD for a maximum period of one year providing that Member is not joining the armed forces and the Trustee continues to remit premiums. c. Nothing in the above provisions shall affect the right of the Trustee to make a claim for a Benefit after the event giving rise to cessation of liability, where the Death or TPD (as applicable) occurred prior to that event of cessation. The right to make a claim in respect to TPD Benefits will not be affected where: the event giving rise to cessation of liability was cessation of membership of the Employer Plan; and the Injury or the Illness giving rise to the claim occurred prior to the cessation of membership of the Employer Plan; and on the day of cessation of liability, the Member was absent from their Occupation as a direct result of that Injury or Illness; and the sole reason for cessation of membership of the Employer Plan was due to the Member being unable to attend to their Occupation as a direct result of that Injury or Illness; and the requirement for the Member to be absent from their Occupation for 6 consecutive months had not been met prior to cessation of membership of the Employer Plan but would have been met had the Member continued to have been employed in their Occupation. d. Nothing under this heading shall avoid the need for the claim to be made in accordance with Insurer s claim requirements. e. The Insurer may cancel the cover provided under the Policy in respect of any Member at any time where any premium (or any instalment of premium) due in relation to that Member has not been paid within 30 days of the Due Date.

13 What happens when an employee leaves their employer? Continuation Option Death Cover Where a Group Member ceases to be member of the Employer Plan, that person may within 60 days of that event effect with the Insurer upon his or her own life a term insurance policy on the Insurer s usual terms provided: that person has not attained the age of 60 years; that person has not left their Employment for duty with the armed forces; the Trustee has not received or become entitled to receive a TPD Benefit in respect of that person; the person is not ceasing Employment for reasons of ill health; the person provides the Insurer with evidence of health relevant to AIDS which is satisfactory to the Insurer. This may include the Insurer requiring evidence in the form of: an AIDS Declaration; The term insurance policy will be for Death Cover only, expiring no later than age 65 and the sum insured will not exceed the Death Benefit Sum Insured in relation to that person under the Policy Claims Claim Requirements The Trustee must notify the Insurer in writing as soon as is reasonably practicable of an event that may entitle the Trustee to a Benefit. The Insurer will not accept liability for any claim which is not notified in writing: In respect of TPD Benefits, within 1 year after the Member commenced their absence from their Occupation as a result of the Injury or Illness giving rise to the claim. In respect of Death and Death by Accident Benefit, within 1 year after the death of the Member. Additional features Are there Additional features available? No. Definitions Automatic Acceptance Limit means the amount determined by the Insurer and notified to the Trustee from time to time as referable to the respective Benefit. Annual Review Date means the 1st day of July each year during the currency of the Policy. Benefit means any benefit payable under the Policy. Death Benefit means the death benefit payable under the Policy. Death by Accident Benefit means the death by accident benefit payable under the Policy. Due Date means the 1st day of July each year during the currency of the Policy. Employed/Employment means being engaged in full time employment or business activity but does not include any person so engaged on a temporary basis unless expressly agreed to by the Insurer. Group Member means a Group Person accepted by the Insurer for membership under the Policy. Group Person means a person nominated by the Trustee for membership under the Policy. Illness shall include a sickness, disease or disorder. Injury means bodily injury which is caused solely and directly by external, violent and accidental means, is independent of any other cause and is not caused by the person s own hand or suicide irrespective of whether the person is sane or insane. Maximum Insurable Age means on attainment of age 65 years. Member means a person who has been nominated by the Trustee and accepted by the Insurer for membership in accordance with the provisions of the Policy. Occupation means the employment or activity in which the person/member is principally Employed. Sum Insured means the dollar amount of cover nominated by the Trustee and agreed to by the Insurer in relation to each respective Benefit for each Member as increased or reduced from time to time. In regard to Death and TPD Benefits for Group Members the amount shall not exceed the Automatic Acceptance Limit except where specifically agreed to in accordance with the provisions of the Policy. TPD Benefit means the TPD benefit payable under the Policy.

14 Insurance Fee Schedule How to calculate your annual Insurance Fee (premium) Your Insurance Fee calculation could be either: gender based and unitised to a set rate, or gender based and set at a rate based on your age next birthday (ANB). Unitised rate calculation The unitised rates provided are for the Default Cover you receive on joining your Employer Plan. These unitised rates are customised and set for your Employer s Plan and agreed between the Employer, the Insurer and us. The premium you pay for Death Only or Death and TPD may be dependent upon some or all factors such as your age, gender, type of cover, and amount of cover. The following formula shows how to calculate annual premiums using the relevant unitised rates from the table below. (Unitised rate x sum insured) 1,000 = annual Insurance Fee (premium) The cost of your insurance cover may differ to the premium rates shown in the table below as the rates that will apply to you may be affected by medical or other loadings applied by the Insurer and are indicative only. The premium rates shown are inclusive of any applicable taxes that may be charged. For example: Default Death and TPD John is male and has $300,000 of Default Death and TPD Cover. The applicable Insurance Fees for his cover will be as per the Default Death and TPD table below: Death: $0.94 TPD: $0.40 As his level of cover is $300,000, the annual Insurance Fee that he will pay is: Age Next Birthday calculation Where Default Cover is provided, Voluntary Cover rates are to be used should you wish to apply for additional cover. This may require you to be underwritten for the additional amount of cover. The premium you pay for Voluntary Death Only or Death and TPD Cover is dependent upon your age (as at 1 July, or on the effective date of any change to your level of insurance cover), gender, type of cover, and amount of cover. The following formula shows how to calculate an annual premium using the relevant rates based on your Age Next Birthday (ANB) from the table on the next page. (ANB Premium rate x sum insured) 1,000 = annual insurance fee (premium) The cost of your insurance cover may differ to the rates shown in the table on the next page as the rates that will apply to you may be affected by medical or other loadings applied by the Insurer and are indicative only. The rates shown are inclusive of any applicable taxes that may be charged. For example: Voluntary Death and TPD John now wishes to apply for $300,000 of Voluntary Death and TPD Cover so that he will have $600,000 of Death and TPD Cover in total. As at 30 June 2014 John is 38 years old. His next birthday is on 3 February 2015, at which time he will be 39. As John s Age Next Birthday is 39, the applicable Insurance Fees for his cover will be: Death: $0.63 TPD: $0.19 As his additional level of cover is $300,000, the annual Insurance Fee for the Voluntary Death and TPD Cover is: [$300,000 X ( )] / 1,000 = $246 [$300,000 X ( )] / 1,000 = $402 Insurance Fee Table for Default Death Only Cover and Death and TPD Cover Per $1000 of Sum Insured Male Death Female Death Male TPD Female TPD