Insurance Booklet INDUSTRY DIVISION. Issued 1 October 2017

Transcription

1 Insurance Booklet INDUSTRY DIVISION Issued 1 October 2017 The information in this document forms part of the Product Disclosure Statement for Club Plus Super Industry division dated 1 October 2017.

2 CONTENTS 1. Death, Terminal Illness and Total and Permanent Disablement Cover 3 2. Income Protection Cover Other insurance information 25 Insurance cover is issued by OnePath Life Limited ABN AFSL ( the Insurer ) and subject to the terms and conditions of the insurance policy issued to Club Plus Superannuation Pty Ltd ( Trustee ) by OnePath Life Limited (the Policy). This Insurance Booklet provides a summary of the key terms and conditions of the Policy. Where information is summarised in a brochure, information guide, or document other than the Policy itself, it does not represent a complete description of the terms on which the insurance cover is provided. The Policy represents the concluded agreement between the Trustee and the Insurer and, in the event of an inconsistency with this booklet the terms of the Policy prevail. You can contact Club Plus Super on if you would like a copy of the Policy. Some words or terms in this Insurance Booklet have a special meaning. There words have been capitalised and are explained in the glossaries. This Insurance Booklet for Club Plus Super Industry Division is issued by Club Plus Superannuation Pty Ltd ABN Australian Financial Services Licence , as Trustee for the Club Plus Superannuation Scheme ABN Club Plus Superannuation Pty Ltd holds a Registerable Superannuation Entity Licence.L and Club Plus Superannuation holds a Fund Registration. R Any advice in this document is of a general nature only and does not take into account your personal objectives, fi nancial situation or needs. Prior to acting on any information in this document,you need to take into account your own fi nancial circumstances, consider the PDS for any product you are considering and seek independent fi nancial advice if you are unsure of what action to take. The material contained in this Booklet was up to date when it was prepared. However, this information may be subject to change from time to time. If the change is not materially adverse, we will keep members informed via our website. You may request a copy of any updated material free of charge by contacting us on

3 DEATH, TERMINAL ILLNESS AND TOTAL AND 1 PERMANENT DISABLEMENT (TPD) COVER Cover when you join Club Plus Super What type of cover do I have? When you fi rst join the Industry Division of Club Plus Super, you may be automatically accepted for one unit of Death, Terminal Illness and TPD insurance cover, without medical assessment ( automatic cover ). The amount of your automatic cover is based on your age. You can vary your automatic cover by choosing to fi x cover, remove TPD cover by electing Death Only cover, increasing the number of units you hold or increasing your fi xed cover. You may also opt out of cover altogether. Death, Terminal Illness and TPD insurance cover is provided to Club Plus Super members 24 hours a day, seven days a week, anywhere in the world (provided you are an Australian Resident). What is the cost of automatic cover? Age Band (age next birthday) Death ($per unit per week) TPD ($per unit per week) and Over Death and TPD ($per unit per week) How much cover is automatically provided? The following table shows the level of Death, Terminal Illness and TPD cover provided for 1 unit based on your age. The amount of cover provided by a unit generally decreases as you age, but the number of units you hold remains consistent. This is different to fi xed cover, which means the amount of cover provided stays the same, but the amount you pay will increase as you age (see the costs for fi xed cover on page 9). Age next birthday Insured Amount of 1 Unit of Cover Death cover TPD cover $50,000 $50, $51,000 $50, $52,000 $50, $53,000 $50, $55,000 $50, $60,000 $50, $65,000 $50, $75,000 $50, $88,000 $50, $100,000 $50, $110,000 $50, $118,000 $50, $125,000 $50, $130,000 $50, $131,500 $50, $131,500 $49, $131,500 $47, $131,500 $45, $120,000 $41, $110,000 $36, $90,000 $30, $60,000 $24, $40,900 $21, $35,100 $19, $29,200 $17, $26,300 $15, $23,400 $13, $20,500 $12, $17,500 $11, $14,000 $10, $10,000 $9, $10,000 $8, $10,000 $7, $10,000 $6, $10,000 $5, $7,500 N/A

4 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) Changing your cover Can I reduce or cancel my cover? You can reduce or cancel your cover at any time by completing an Insurance Variation, Cancellation or Reduction form ( Insurance Variation form) available at the back of the booklet. You also have the option to just opt-out of TPD cover by electing to have Death Only cover. If you elect not to have insurance cover and want cover at a later date, you will need to apply for cover by completing the Personal Statement form (available at the back of the booklet). You will only be eligible for cover if you provide health, medical, fi nancial and/or employment information satisfactory to the Insurer and the Insurer accepts your application for cover. If you do not wish to have automatic cover and we receive your request to opt-out of cover within 60 days from the date cover starts (refer to When cover starts and ends on page 6), your cover will be cancelled effective from the cover start date and any associated premiums will be refunded to you. If you cancel your automatic cover after 60 days of the cover start date, premiums will be payable up until the date cover is cancelled. How can I increase my level of cover? When you join Club Plus Super, a Welcome Letter and Special Offer form will be sent. The Special Offer form allows a new member to apply once for one additional unit of Death, Terminal Illness and TPD cover without having to complete a Personal Statement form and provide evidence of health. To take advantage of this offer, the Special Offer form will need to be completed and returned to us within 60 days of the date of the Welcome Letter. Alternatively, additional cover can be applied for at any time, but you will need to complete the Personal Statement form (available at the back of this booklet). After you submit your application, you will go through a process called underwriting which is the term used to describe the process the Insurer undertakes to assess your application for cover. The Insurer may obtain and consider information relating to your health, medical, employment or fi nancial situation and anything else that is relevant to your application for cover. The Insurer may accept or decline your application, or offer cover based on non-standard terms. You can apply for up to a maximum of $5,000,000 of Death cover and $3,000,000 of TPD cover. You can apply for a higher amount of Death cover than TPD cover by obtaining additional Death only cover, but you cannot hold a higher amount of TPD cover than Death cover. You can apply for units of cover (described on page 3), or fi xed cover (described on page 9), but you cannot hold a combination of both. Read on about Life Events Cover, to fi nd out how you might be able to increase your cover without underwriting. What is Life Events Cover? Life Events Cover makes it easier for you to increase your cover when signifi cant life events occur. You can take up extra Death, Terminal Illness and TPD cover without having to provide evidence of health for the following signifi cant life events: milestone birthdays of 30, 40 and 50; marriage; birth or adoption of a child; taking out a mortgage to buy a primary residence or increasing an existing mortgage on a primary residence by at least $100,000; divorce; dependent child fi rst starting primary or secondary school; completion of an apprenticeship; death of spouse; and completion of a university undergraduate degree. The amount of additional cover provided under this option depends on whether you hold units of cover or fi xed cover: For unitised cover, the additional amount is one unit; For fi xed cover, the additional amount is the lesser of 25% of your fi xed amount of cover and $250,000. You can exercise this option once in any 12 month period with a maximum of three increases during your membership in Club Plus Super. We must receive your application within 60 days of the life event or within 60 days of the date of the Club Plus Super member statement you receive immediately after the life event (provided the life event occurred within 12 months of the date of the member statement), whichever is the later. If you are not in Active Employment on the date you apply for Life Events Cover, the additional cover will be Limited Cover. Limited Cover will be replaced with full cover on the date immediately after you have been in Active Employment for two consecutive months from the day increased cover starts. Please refer to the Insurance Glossary for the defi nition of Active Employment and Limited Cover. To apply, you will need to complete a Life Events Application form. Insurance booklet - Industry division - October

5 Can I transfer cover from another fund to Club Plus Super? If you have Death only or Death and TPD insurance through another superannuation fund (other than a selfmanaged super fund) you may be able to transfer that cover (Previous Cover) to Club Plus Super by completing the Insurance Transfer Form and satisfying the eligibility requirements. You can apply to transfer a maximum of $2,000,000 of Death only or Death and TPD cover. Any transferred cover will be added to your existing cover to the extent the combined cover will not exceed the maximum cover levels. The Insurer will assess your application and we will advise you of the outcome in writing. Please also note that you will not be able to Transfer your Previous Cover if: you have made or are entitled to make a claim or are eligible to be paid a benefi t in relation to the Previous Cover; or the Previous Cover has a premium loading. If your Previous Cover is subject to a special condition or exclusion, the condition or exclusion may continue to apply once the cover is transferred. How can I convert my unitised cover to fi xed cover? If you do not want your level of cover to reduce as you get older, you can apply for fi xed cover via the Insurance Variation form. By fi xing your cover, the amount of your unitised cover will be converted to a fi xed amount rounded up to the nearest multiple of $1,000. With fi xed cover, the amount of cover remains the same regardless of your age, but as you get older, the cost of cover generally increases. Claiming a benefi t Death and Terminal Illness benefi t Death cover pays you a lump sum benefi t if you die or have a Terminal Illness whilst you are insured for Death cover under the Policy. The Terminal Illness benefi t is an advance payment of the Death benefi t. So, if you are paid a Terminal Illness benefi t, any remaining amount of Death cover will be payable upon your death. You will be considered to be suffering from a Terminal Illness if two medical practitioners (at least one must be a specialist practising in the area of your illness) provide written certifi cation confi rming that you suffer from an illness or injury that is likely to result in your death within 24 months from the date of the written certifi cation. Please also note that in some cases the insurer may appoint one of the two medical practitioners. The Terminal Illness Benefi t is equal to the lesser of: the Death Benefi t as at the date of the latest written certifi cation from a medical practitioner; and $3,000,000. If your Death Benefi t is higher than $3,000,000, the benefi t paid on your death will be reduced by the amount of the Terminal Illness benefi t already paid. TPD benefi t TPD cover pays you a lump sum if, in the opinion of the Insurer, you meet the defi nition of Total and Permanent Disablement and provided your TPD cover has not ended. The TPD benefi t is equal to the value of your TPD cover as at the Event Date. Please refer to the Insurance Glossary for the defi nitions of Total and Permanent Disablement and Event Date. You can switch between unitised and fi xed cover at any time by completing the Insurance Variation form. Once you have fi xed cover, you can apply to switch back to unitised cover by satisfactorily answering the questions in the Insurance Variation form. If your application is accepted, the amount of your fi xed cover will be converted to the number of units required to replace your fi xed cover rounded up to the nearest whole unit. Insurance booklet - Industry division - October

6 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) When will my claim not be paid? benefi t is payable if the illness or injury resulting in your death, Terminal Illness or Total and Permanent Disablement is caused directly or indirectly, wholly or partially, from War or War Service occurring before or after the date the Policy commenced. Please refer to the Insurance Glossary for the defi nitions of War and War Service. If you submit a claim whilst you are outside Australia, the Insurer may require you to return to Australia (at your own expense) for assessment of your claim. This may include attending a medical appointment. The Insurer may waive this requirement where it is satisfi ed that you are unable to return to Australia due to medical reasons. In some cases, an insured member s automatic cover might be Limited Cover (see page 6). If you have Limited Cover: a Death benefi t will not be payable if your death is caused directly or indirectly, wholly or partially, by a Deliberate Self Infl icted Act and occurs within 13 months of when your cover commenced; and a TPD or Terminal Illness benefi t will not be payable if the injury or illness resulting in your TPD or Terminal Illness is caused directly or indirectly, wholly or partially, by a Deliberate Self Infl icted Act How do I claim a benefi t? If you (or your benefi ciaries) wish to make a claim for any insured benefi t provided by Club Plus Super, you (or your benefi ciaries) need to contact Club Plus Super. If you make a claim, you or your benefi ciaries will need to provide evidence that establishes your entitlement to the benefi t (at your own expenses), and we and/or the Insurer may conduct investigations to assess the value and validity of your claim. You may be required to undertake a vocational/employability assessment (for TPD claims) or be assessed by a medical practitioner appointed by the Insurer. The assessment may also involve the use of investigation agents, legal advisers and the collection of personal data that the Insurer believes is relevant. When cover starts and ends Am I eligible for cover? You must be an eligible person to obtain any type of cover under the Policy. A person is eligible for cover if the person: joins Club Plus Super because their employer pays their employer superannuation contributions to Club Plus Super; is either an Australian Resident, or a holder of a Visa residing in Australia; and is aged less than the cover expiry age which at present is 70 years, on the date cover is due to commence or recommence. To be eligible for automatic cover, you must also satisfy the following conditions (set out in the table below) on the date cover is due to commence or recommence (refer to When does automatic cover start? ). If you are applying for cover or additional cover via the Personal Statement form, you must be working in an occupation for which cover is available under the Policy. When does automatic cover start? Automatic cover starts on the later of the following dates: the date you commence work for your most recent Employer; the start date of the period relating to the fi rst employer contribution paid to your account in Club Plus Super; and the date your membership in Club Plus Super begins as a result of you commencing work with your Employer. For more information refer to the Insurance Claims fact sheet at clubplussuper.com.au/tools-resources/ fact-sheets. Insurance booklet - Industry division - October

7 Eligibility requirement for automatic cover You must not have previously received automatic cover in relation to the same account in Club Plus Super. You must not have received, be entitled to receive, be in a waiting period, or in the process of claiming a benefi t for terminal illness. You must not have received, be entitled to receive, be in a waiting period for, or in the process of claiming a benefi t for total and permanent disablement. You must be At Work. The fi rst employer contribution made to your account in the Club Plus Super by your Employer must: (a) relate to your fi rst 180 days of work with your Employer; and (b) be received by us within 180 days after the Superannuation Guarantee Deadline that applies to the fi rst day you worked for that Employer. What happens if you do not satisfy the eligibility requirement You are not eligible for automatic cover including additional cover available under the Special Offer. You can only obtain cover by applying for cover via the Personal Statement form and being underwritten by the Insurer. You are not eligible for automatic cover including additional cover available under the Special Offer. You cannot have TPD cover. You will be eligible to receive automatic cover for Death Only (provided you satisfy all other eligibility requirements). Any additional cover provided under the Special Offer will also be limited to cover for Death Only. If you are not At Work, your automatic cover including any additional cover provided under the Special Offer will be Limited Cover. This means you will not be insured for death, Terminal Illness or TPD caused directly or indirectly, wholly or partially, from a Pre-Existing Condition. Limited Cover will be replaced with full cover on the date immediately after you are At Work for two consecutive months after Limited Cover commenced. Please refer to the Insurance Glossary for the full defi nition of Limited Cover and Pre-Existing Condition. Your automatic cover including any additional cover provided under the Special Offer will be Limited Cover. Whilst you have Limited Cover, no benefi t will be paid if you: die within 13 months of cover commencing and your death is caused directly or indirectly, wholly or partially, by a Deliberate Self-Infl icted Act; or become Terminally Ill or TPD and your Terminal Illness is caused directly or indirectly, wholly or partially, by a Deliberate Self-Infl icted Act. You must apply to the Insurer by completing the Personal Statement form and being underwritten to have the above limitations removed. Interim Accident Cover When does cover end? If you have applied for cover or additional cover via the Personal Statement form, cover will start from the date the Insurer accepts your application in writing. However, you will receive Interim Accident Cover (at no cost) while your application is being assessed. Under Interim Accident Cover, a benefi t is payable if you die as a result of an Accident or the injury that results in your Total and Permanent Disablement was caused by an Accident, and provided your death or TPD Event Date occurs within 60 days of the date of the Accident. Refer to the Insurance Glossary for the full defi nition of Accident. Interim Accident Cover starts from the date the Insurer receives your application for cover and is available for up to a maximum of 60 days. You can only make a claim once under Interim Accident Cover. Interim Accident Cover is based on the type and level of cover or additional cover applied for (subject to maximum of $1,000,000). For full details contact the Club Plus Super Member Hotline on Your Death, Terminal Illness and TPD cover will cease on the earliest of: the date the Policy terminates; the date you reach the cover expiry age which at present is age 70; the date there is insuffi cient money in your account to cover the next premium payment; the date you commence active service with the armed forces of any country (except where you are a member of the Defence Force Reserve, provided you are not subject to a call out order); if you are a member of the Defence Force Reserve, the date you become the subject of a call out order under the Defence Act 1903 (Cth); the date you cease to be a member of Club Plus Super; the date you die; the date you are entitled to a TPD benefi t; Insurance booklet - Industry division - October

8 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) the date you are entitled to a Terminal Illness benefi t for an amount equal to your level of Death cover (if your level of Death cover is greater than the Terminal Illness benefi t payable, the remaining amount of Death cover continues); the date you have been on employer approved unpaid leave for more than 13 consecutive months; the date you commence non approved unpaid leave; the date we receive your written request to cancel your cover or the date specifi ed in your written request to cancel cover (whichever is later); the date the Insurer cancels your cover as permitted under law; and if you are not an Australian Resident, the date you are no longer eligible to work in Australia (be that because you no longer hold a Visa or for any other reason), or the date Australia ceases to be your permanent place of residence. If your cover ends, you may only be able to reinstate cover by submitting an application for cover and being underwritten by the Insurer. When does cover recommence? If your cover ends involuntarily due to an insuffi cient account balance to pay the insurance premium, your cover will be automatically reinstated if the following requirements are met: the fi rst employer super contribution received by Club Plus after your cover ended is received not more than 180 days after the Superannuation Guarantee Deadline that applies to the period to which the employer contribution relates ( reinstatement contribution ); you remained a member of Club Plus Super from the time cover ended until the time the required employer contribution is received; and you have not previously cancelled your cover. The type and level of cover you had immediately prior to it ceasing will recommence from the latest of the following dates: the date you last commenced or recommenced work with your most recent Employer; the date which is the start of the period to which your reinstatement contribution relates; and the day immediately after your cover under the Policy ended. The following conditions will apply to the reinstated cover: the reinstated cover will have the same conditions attaching to it as applied to the cover prior to it ending; if you are t At Work on the date cover recommences, the reinstated cover will be Limited Cover. Limited Cover will be replaced with full cover on the date immediately after you are At Work for two consecutive months after cover is reinstated; and if the reinstatement contribution relates to a period of work undertaken after 12 months have passed since your cover ended, the reinstated cover will be limited to the automatic cover level. Am I covered if I re-join Club Plus Super? If you cease to be a member of Club Plus Super and you subsequently commence working for an Employer who pays employer super contributions to Club Plus Super, or you have not commenced new employment but recommence employer contributions to Club Plus Super under the Choice of Fund legislation ( Choice Member ), you will be automatically accepted for one unit of Death, Terminal Illness and TPD cover. However, your automatic cover will be Limited Cover and will only be provided if you satisfy the following requirements: you have not received, be entitled to receive, be in a waiting period for, or in the process of claiming a benefi t for terminal illness or total and permanent disablement (if you are a eligible for a TPD benefi t under any life insurance policy you will receive automatic cover for Death only) except if you are a Choice Member, the fi rst employer contribution made to your new account in Club Plus Super: (a) relates to the fi rst 180 days of work with your Employer; and (b) is received by us within 180 days after the Superannuation Guarantee Deadline that applies to the fi rst day you worked for that Employer; and you have not previously cancelled your cover. Whilst you have Limited Cover, no benefi t will be paid if you: die within 13 months of cover commencing and your death is caused directly or indirectly, wholly or partially, by a Deliberate Self-Infl icted Act; or become Terminally Ill or TPD and your Terminal Illness is caused directly or indirectly, wholly or partially, by a Deliberate Self-Infl icted Act. Your cover will continue to be subject to Limited Cover terms until the Insurer approves an application to have the limitation removed. You can make such an application by completing the Personal Statement form and being underwritten by the Insurer. Insurance booklet - Industry division - October

9 EXAMPLE* James, aged 38, requires $500,000 worth of Fixed Death and TPD insurance cover. Death and TPD calculation = $500,000/$1,000 x = $15.52 per week *This example is for illustrative purposes only. Cost of cover The premium rates that apply to unitised cover and fi xed cover are set out in the tables below. At the end of each month, your insurance premiums are deducted from your account and the premiums are forwarded to the Insurer. Unitised Cover Premium Scale You pay a fi xed amount for each unit. The following table shows the premium cost per week for a unit of cover. Age Band (age next birthday) Death ($per unit per week) TPD ($per unit per week) and Over Death and TPD ($per unit per week) Fixed Cover Premium Scale With fi xed cover you choose the amount of Death & TPD insurance cover you require and the cost is calculated based on your age next birthday and your level of cover. The table below sets out the weekly cost of each $1,000 of cover. Age next birthday Weekly premium rates per $1,000 of cover Death ($) TPD ($) Death and TPD($) $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ N/A $ Insurance booklet - Industry division - October

10 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) Insurance Glossary Certain words have specifi c meanings in relation to the policy terms and conditions. Accident means: a fortuitous, external event which was unexpected and unintended causing death or total and permanent disablement (as the context so requires). Events that are not accidents The following situations are not accidents, and any claims arising from these situations are excluded: (a) any one or more of the following was a contributing cause of injury or death: - Pre-Existing Condition; - sickness or illness; - disease; - allergy; or - any gradual onset of a physical or mental infi rmity; (b) the injury or death was the result of a Deliberate Self-Infl icted Act or omission of the insured member; and (c) the insured member was injured or died as a result of an activity in respect of which they assumed the risk or courted disaster, irrespective of whether they intended injury or death. Active Employment means you are: (a) (b) (c) or (d) employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment or on Employer Approved Leave; and capable of performing all the duties of your occupation on a Full-time basis (even if not working Full-time); in the Insurer s opinion, actively performing all the duties of your occupation, free from any limitation due to illness or injury and not on leave; on Employer Approved Leave, or self-employed and on leave, taken for reasons unrelated to injury or illness, and in the Insurer s opinion, capable of actively performing all the duties of your occupation (being the occupation performed by the eligible person when they last worked), free from any limitation due to illness or injury. Activities of Daily Living means: (a) Dressing the ability to put on and take off clothing; (b) Toileting - the ability to use a toilet, including getting on and off; (c) Mobility - mobility, to the extent of being able to get in and out of bed or a chair; (d) Continence the ability to control bowel and bladder function; (e) Feeding the ability to get food from a plate into the mouth, without the assistance of another adult person or suitable aids. Activities of Daily Work means: (a) Bending The ability to bend, kneel or squat to pick something up from the fl oor and straighten up again. (b) Communicating the ability to: clearly hear with or without a hearing aid or alternative aid if required: comprehend and express oneself by spoken or written language with clarity; and interact with others by listening, comprehending and speaking on a day to day basis and in a work environment (c) Vision (reading) the ability to read, with or without correction with suitable lenses, to the extent that an ophthalmologist can certify that: visual acuity is equal to, or better than, 6/48 in both eyes; or constriction is within or greater than 20 degrees of fi xation in the eye with the better vision. (d) Walking the ability to walk more than 200m on a level surface without stopping due to breathlessness, angina or severe pain elsewhere in the body. (e) Lifting the ability to lift, carry or otherwise move objects weighing up to 5kg using one or both hands. (f) Manual Dexterity the ability, with reasonable precision and success, to: use at least one hand, its thumb and fi ngers, including the ability to pick up and manipulate small objects; and use a keyboard. Insurance booklet - Industry division - October

11 At Work means you: (a) are employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment or on Employer Approved Leave; and (b) are: in the Insurer s opinion, actively performing all the duties of your occupation, free from any limitation due to illness or injury and not on leave; or on Employer Approved Leave, or self-employed and on leave, taken for reasons unrelated to injury or illness, and in the Insurer s opinion, capable of actively performing all the duties of your occupation (being the occupation performed by you when you last worked), free from any limitation due to illness or injury, and (c) are capable of performing all the duties of your occupation on a Full-time basis (even if not working Full-time); and (d) are not in receipt of, or entitled to claim, income support benefi ts from any source including but not limited to workers compensation benefi ts, statutory motor accident benefi ts or disability income benefi ts (including government income support benefi ts of any kind). An eligible person who does not meet these requirements is correspondingly described as t At Work. Australian Resident means an Australian citizen, a New Zealand citizen or an Australian permanent resident within the meaning of the Migration Act 1958 (Cth) and Migration Regulations 1994 (Cth). Date of Disablement means: (a) except for TPD Defi nition 2 and TPD Defi nition 4, the fi rst day that all of the elements of the defi nition are satisfi ed; and (b) for TPD Defi nition 2 and TPD Defi nition 4, the fi rst day after the expiry of the Waiting Period. Defence Force Reserve means the Australian army, naval or air force reserves. Deliberate Self-Infl icted Act means a deliberate self-infl icted act of the insured member, including but not limited to attempted suicide or suicide, whether or not the person is sane at the time. Employer means an employer making employer contributions to Club Plus Super for an employee who is a member of Club Plus Super. Employer Approved Leave means a person is: (a) employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment; and (b) on leave that has been approved by the person s employer prior to the commencement of that leave (except for approved sick leave). Event Date means in relation to an insured member: (a) for TPD Defi nition 1, the date the insured member suffers the total and permanent loss of the use of two limbs (where limb is defi ned as the whole hand or the whole foot), the sight in both eyes, or the sight in one eye and the use of one limb; (b) for TPD Defi nition 2, the fi rst day of the Waiting Period during which the insured member, in the Insurer s opinion, solely because of injury or illness, has not worked; (c) for TPD Defi nition 3, the fi rst day the insured member in the Insurer s opinion, solely because of injury or illness, is totally and irreversibly unable to perform at least two of the Activities of Daily Living; (d) for TPD Defi nition 4, the fi rst day of the Waiting Period during which the insured member, in the Insurer s opinion, solely because of injury or illness, is unable to perform rmal Domestic Duties; (e) for TPD Defi nition 5, the fi rst day the insured member in the Insurer s opinion, solely because of injury or illness, is totally and irreversibly unable to perform at least four of the Activities of Daily Work. Insurance booklet - Industry division - October

12 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) Following the advice of a Medical Practitioner means the insured member is under the regular care and following the regular advice of their treating medical practitioner on an ongoing basis, including following all recommended courses of treatment and rehabilitation. Full-time means a person is working at least 35 hours per week. Gainful Employment means any occupation or work for reward or fi nancial benefi t, or the hope of reward of fi nancial benefi t, whether on a permanent or temporary basis, and whether or not of a lesser grade, status or level of remuneration or for lesser hours than the insured member s occupation or occupations or work. Gainfully Working means a person is: (a) employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment; or (b) on Employer Approved Leave. Home means the insured member s principal place of residence. Limited Cover means an insured member will only be covered for death, Terminal Illness and Total and Permanent Disablement (as applicable) which does not arise either directly or indirectly, wholly or partially, from a Pre- Existing Condition of the insured member. Medical Consultation means any activity undertaken for the detection, treatment or management of an illness, injury, medical condition or related symptom, including but not limited to the application of prescribed drugs or therapy (whether conventional or alternative). rmal Domestic Duties means the tasks performed by the insured member whose sole occupation is to maintain their family Home. These tasks are: cleaning of the Home; cooking of meals for the family; doing their family s laundry; shopping for their family s food; and taking care of dependent children (where applicable). rmal Domestic Duties do not include duties performed outside the insured member s Home for salary, reward or profi t. Pre-Existing Condition means an injury, illness, condition or related symptom, whether it was diagnosed by a medical practitioner or not, which in the Insurer s opinion: (a) the insured member (or a reasonable person in their position) was aware of, or should have been aware of; (b) the insured member had, or was intending to have, a Medical Consultation; or (c) a reasonable person in the circumstances of the insured member would have had a Medical Consultation, as at or prior to the date cover commenced, recommenced or increased (with respect to the increased insured amount of cover only). Previous Education, Training or Experience means any education, training or experience the person has undertaken prior to the Event Date. Reasonable Retraining or Rehabilitation means: (a) any further education, training, experience or rehabilitation the person has undertaken since the Event Date; or (b) any further education, training, experience or rehabilitation the person, in our opinion, has capacity to undertake and can be reasonably expected to do based on their Previous Education, Training Or Experience. Insurance booklet - Industry division - October

13 Superannuation Guarantee Deadline is the date that is represented in the column titled payment cut-off date in the table below, which corresponds to the relevant period of work: Period of work Payment cut-off date 1 July - 30 September 28 October 1 October - 31 December 28 January 1 January - 31 March 28 April 1 April - 30 June 28 July Terminally Ill or Terminal Illness means an illness or injury where all of the following (a), (b), (c), (d) and (e) are satisfi ed in respect of an Insured Member: (a) two Medical Practitioners certify in writing ( Written Certifi cation ) that the Insured Member suffers from an illness or has incurred an injury that, despite reasonable medical treatment, is likely to result in the Insured Member s death within 24 months from the date of Written Certifi cation ( Certifi cation Period ); (b) we are satisfi ed from medical or other evidence that the Insured Member will, despite reasonable medical treatment, die from the illness or injury within the Certifi cation Period; (c) at least one of the Medical Practitioners is a Specialist Medical Practitioner, and one of which may be appointed by the Insurer; (d) for each Written Certifi cation, the Certifi cation Period has not ended; and (e) the Written Certifi cation by both Medical Practitioners must be dated during the period the Insured Member is insured for Death Cover under the Policy. Total and Permanently Disabled, Total and Permanent Disablement, Totally and Permanent Disability and TPD TPD Defi nition 1 In the Insurer s opinion based on medical or other evidence satisfactory to the Insurer, solely because of injury or illness, the Insured Member: (a) suffers the total and permanent loss of the use of: (i) two limbs (where limb is defi ned as the whole hand or the whole foot); or (ii) the sight in both eyes; or (iii) one limb and the sight in one eye; and (b) as at the Date of Disablement, is incapable of ever working in any Gainful Employment for which he or she: Or (i) is reasonably suited by Previous Education, Training or Experience; or (ii) may become reasonably suited due to Reasonable Retraining or Rehabilitation. TPD Defi nition 2 An Insured member: (a) is Following the Advice of a Medical Practitioner in relation to their illness or injury for which they are claiming; (b) is Gainfully Working at any time during the 12 consecutive months immediately prior to the Event Date; and (c) in the Insurer s opinion based on medical or other evidence satisfactory to us, solely because of injury or illness, the Insured Member: Or (i) has not worked during the entire Waiting Period; (ii) as at the Date of Disablement is incapable of ever working in any Gainful Employment for which he or she: TPD Defi nition 3 A. is reasonably suited by Previous Education, Training or Experience; or B. may become reasonably suited due to Reasonable Retraining or Rehabilitation. In the Insurer s opinion based on medical or other evidence satisfactory to the Insurer, solely because of injury or illness, the Insured Member: (a) is totally and irreversibly unable to perform at least two of the Activities of Daily Living; and (b) as at the Date of Disablement is incapable of ever working in any Gainful Employment for which he or she: Or (i) is reasonably suited by Previous Education, Training or Experience; or (ii) may become reasonably suited due to Reasonable Retraining or Rehabilitation Insurance booklet - Industry division - October

14 1 DEATH, TERMINAL ILLNESS AND TOTAL PERMANENT DISABLEMENT (TPD) COVER (CONT.) TPD Defi nition 4 An Insured Member: (a) is not Gainfully Working at any time during the 12 consecutive months immediately prior to the Event Date; (b) is capable of performing rmal Domestic Duties (even if not actually performing such duties) during the entire 12 consecutive months immediately prior to the Event Date; and (c) in the Insurer s opinion based on medical or other evidence satisfactory to the Insurer, solely because of injury or illness, the Insured Member: Or (i) is Following the Advice of a Medical Practitioner in relation to their illness or injury for which they are claiming; and (ii) is unable to perform rmal Domestic Duties during the entire Waiting Period; and (iii) as at the Date of Disablement: A. is unlikely ever to perform any rmal Domestic Duties; B. is incapable of ever working in any Gainful Employment for which he or she: is reasonably suited by Previous Education, Training Or Experience; or may become reasonably suited due to Reasonable Retraining or Rehabilitation; C. is totally and irreversibly unable to leave their home unaided. TPD Defi nition 5 In our opinion based on medical or other evidence satisfactory to us, solely because of injury or illness, the Insured Member: (a) is under the regular care of a Medical Practitioner; (b) is totally and irreversibly unable to perform at least four of the Activities of Daily Work; and (c) as at the Date of Disablement: (i) is likely to require the ongoing care of a Medical Practitioner; and (ii) is incapable of ever working in any Gainful Employment for which he or she: A. is reasonably suited by Previous Education, Training or Experience; or B. may become reasonably suited due to Reasonable Retraining or Rehabilitation. In determining if the Insured Member satisfi es TPD Defi nitions 1 5, we may have regard to all relevant information available to us from the Event Date. This includes information relevant to the Insured Member s future capability to return to work. Any factors unrelated to the Insured Member s capability, solely because of injury or illness, will not be considered. These include external factors such as availability of work and geographical location as well as the personal circumstances of the Insured Member such as their length of time out of the workforce or any other factors which may be relevant to the likelihood of the Insured Member returning to work. Visa means a current and valid visa permitting residency (excluding a visa which allows permanent residency in Australia) or employment in Australia and issued in accordance with the Migration Act 1958 (Cth) or any amending or replacing act, including but not limited to sub class 457 working visa or sub class 457 working visa (with an 8107 condition). Waiting Period means: (a) for TPD Defi nition 2, a 91 consecutive day period; (b) for TPD Defi nition 4, a 183 consecutive day period. War includes, but is not limited to declared war, and armed aggression by one or more countries resisted by any country, combination of countries or international organisations. War Service includes, but is not limited to participation in an action to defend a country or region from civil disturbance or insurrection, or in an effort to maintain peace. Insurance booklet - Industry division - October

15 2 INCOME PROTECTION COVER Cover when you join Club Plus Super What type of cover do I have? When you fi rst join the Industry Division of Club Plus Super, you may be automatically accepted for Short Term Income Protection cover without having to supply evidence of health ( automatic cover ). In the event that a sickness or injury temporarily prevents you from working, Short Term Income Protection cover provides you with a monthly benefi t to replace your income for up to two years. How much cover do I have? Automatic cover pays you a monthly benefi t of up to 90% of your Pre-Disability Salary plus a Super Contribution Benefi t of up to 9.5% of your Pre-Disability Salary, subject to a maximum of $16,000 per month. Benefi ts are payable after a waiting period of 21 days. Your Pre-Disability Salary is determined by calculating your average monthly salary over the 12 months prior to the Date of Disablement. Please note if you have agreed with your Employer to salary sacrifi ce part of your income, the part of your income that you have sacrifi ced will not be included in your Pre-Disability Salary if your Employer is not making Superannuation Guarantee (SG) contributions on that amount, and your premium will be refl ected accordingly. The benefi t amount will depend on how much of your income your Employer takes into account when determining their SG liability for you. Please refer to the Insurance defi nitions section for the full explanation of Pre-Disability Salary. What is the cost of automatic cover? The cost of insurance is based on the amount that your Employer pays in SG contributions to Club Plus Super. The amount deducted from your member account each week will equate to 9.48% of SG contributions made by your Employer. Insurance booklet - Industry division - October

16 2 INCOME PROTECTION COVER (CONT.) Changing your cover Can I change my automatic cover? You can reduce or cancel your automatic cover at any time by completing the Insurance Variation, Cancellation or Reduction form ( Insurance Variation form). If you elect not to have insurance cover and want cover at a later date, you will need to apply for cover by completing the Personal Statement form. You will only be eligible for cover if you provide health, medical, fi nancial and/or employment information to the Insurer and the Insurer accepts your application for cover. If you do not wish to have automatic cover and we receive your request to opt-out of cover within 60 days from the date cover starts (refer to When cover starts and ends on page 18), your cover will be cancelled effective from the cover start date and any associated premiums will be refunded to you. If you cancel your automatic cover after 60 days of the cover start date, premiums will be payable up until the date cover is cancelled. You also have the option to increase the waiting period that applies to your Short Term IP cover by completing the Insurance Variation form. The optional waiting periods are 45 days and 90 days. Reduced premiums apply under the extended waiting periods. If you take up an optional waiting period, and later wish to reduce the waiting period, you must complete the Personal Statement form and provide to the Insurer health, medical, fi nancial and/or employment information. Long Term Income Protection Cover You have the option to apply for Long Term IP cover, which pays you a benefi t up to age 65 after a two-year waiting period, complementing your Short Term IP cover. Under Long Term IP cover, you can receive a monthly benefi t of up to 75% of your Pre-Disability Salary plus the Super Contribution Benefi t of up to 9.5% of your Pre-Disability Salary, subject to a maximum of $30,000 per month. If you have been receiving a benefi t under Long Term IP cover for 12 consecutive months, the amount of the benefi t will increase by the lesser of the annual Consumer Price Index and 5% per annum (subject always to the maximum benefi t of $30,000 per month). This increase will apply upon the expiry of each 12-month period that a benefi t is continuously paid to you. After your claim ends, the benefi t reverts to the amount that applied before you went on claim. To apply for Long Term Cover, please complete the Personal Statement at the back of this booklet. How can I increase my level of cover? Additional cover can be applied for at any time, but you will need to complete the Personal Statement form (available at the back of this booklet). After you submit your application, you will be underwritten which is the term used to describe the process the Insurer undertakes to assess your application for cover. The Insurer may obtain and consider information relating to your health, medical, employment or fi nancial situation and anything else that is relevant to your application for cover. The Insurer may accept or decline your application, or offer cover based on non-standard terms. You can apply for additional IP cover of up to a maximum benefi t of $30,000 per month (inclusive of the Super Contribution Benefi t). However, the maximum benefi t payable under Short Term Cover is always limited to the lesser of: $30,000; and 90% of your Pre-Disability Salary plus the Super Contribution Benefi t. The maximum benefi t payable under Long Term IP cover is at all times equal to the lesser of: $30,000; and 75% of your Pre-Disability Salary plus the Super Contribution Benefi t. Can I transfer cover from another fund to Club Plus Super? If you have IP cover through another superannuation fund (other than a self-managed super fund) you may be able to transfer that cover (Previous Cover) to Club Plus Super by completing the Insurance Transfer Form and satisfying the eligibility requirements. You can apply to transfer a maximum of $30,000 per month of IP cover and the transferred cover will replace any existing IP cover you hold with Club Plus. The Insurer will assess your application and we will advise you of the outcome in writing. Please also note that you will not be able to Transfer your Previous Cover if: you have made or are entitled to make a claim or are eligible to be paid a benefi t in relation to the Previous Cover; or the Previous Cover has a premium loading. If your Previous Cover is subject to a special condition or exclusion, the condition or exclusion may continue to apply once the cover is transferred. Insurance booklet - Industry division - October

17 Claiming a benefi t When am I eligible to claim a benefi t? A benefi t for Total Disability or Partial Disability is only payable if: your IP cover has not ended as at the Date of Disablement; you are Gainfully Working on the day immediately before the Date of Disablement; you have been Totally Disabled for at least 14 days out of the fi rst 19 consecutive days of the waiting period; and you have been Totally Disabled or Partially Disabled for the remainder of the waiting period. You can claim a Total Disability Benefi t if you cannot work at all and you satisfy the defi nition of Totally Disabled. You may be able to claim a Partial Disability Benefi t if you return to work in a reduced capacity and you satisfy the defi nition of Partially Disabled. Please refer to the Insurance Glossary for the full defi nitions of Totally Disabled and Partially Disabled. The Partial Disability Benefi t is calculated as follows: (A - B) x C A Where: A is your Pre-Disability Salary; B means the greater of: the monthly value of the Salary that you are earning; and the monthly income which in the Insurer s opinion you are capable of earning, during the month that you are entitled to a Partial Disability Benefi t; and C means the benefi t which would be payable if you were Totally Disabled. You can only be paid for one claim at any one time, even if you suffer from more than one illness or injury. Insurance premiums will continue to be deducted whilst you are on claim. What is the Super Contribution Benefi t? While you are receiving a Total Disability Benefi t, Superannuation Guarantee contributions of 9.5% of your Pre-Disability Salary may be paid directly into your Club Plus Super account on your behalf. If you are receiving a Partial Disability Benefi t, the Super Contribution Benefi t will be reduced on a pro rata basis proportionate to the amount of the Partial Disability Benefi t payable during the relevant month. When do benefi t payments commence? Benefi ts are payable monthly in arrears after the end of the relevant waiting period. The waiting period starts on the later of: the day you are Totally Disabled; the day you consult a medical practitioner and receive medical certifi cation confi rming that you are Totally Disabled; and the day after you stop working, provided this day is after your cover started with Club Plus Super. If you return to work during the waiting period, the waiting period starts again. However, if you return to work, once performing your usual duties and working hours for up to 5 consecutive days, the waiting period will not recommence but those days of work will be added to the waiting period. When do benefi t payments end? Benefi ts will end on the earliest of the following events: The end of the payment period under Short Term IP cover the payment period is 2 years and under Long Term IP cover the payment period is to age 65; You are no longer Totally Disabled (applies to Total Disability Benefi ts); You are no longer Partially Disabled (applies to Partial Disability Benefi ts); When you die; You reach the cover expiry age, which is 70 years under Short Term IP cover and 65 years under Long Term IP cover; If you travel or reside outside Australia for more than six consecutive months whilst on claim; and If as at the Date of Disablement you were employed for a fi xed term (as a contractor or otherwise), when the fi xed term expires. Insurance booklet - Industry division - October

18 2 INCOME PROTECTION COVER (CONT.) When will my benefi t be reduced? The amount of your Total Disability Benefi t or Partial Disability Benefi t will be reduced by the following payments made for the purpose of replacing loss of income due to illness or injury: payments from any other disability income, illness or injury policies including group insurance policies or from a superannuation fund; payments from an employer whilst you are on claim including sick leave but excluding annual leave, long service leave, termination payments and paid parental leave; or payments from any compulsory insurance schemes such as Workers Compensation or Accident Compensation or similar legislation or common law for loss of income. The amount of your Super Contribution Benefi t will be reduced by any super contribution paid by another insurer or any compulsory insurance schemes such as Workers Compensation or Accident Compensation for the purpose of replacing your compulsory employer superannuation entitlements. When will my claim not be paid? benefi t is payable if the illness or injury resulting in your Total Disability or Partial Disability is caused directly or indirectly, wholly or partially, from any of the following: War or War Service occurring before or after the date the Policy commenced; You becoming pregnant, giving birth or miscarrying. However, if you are continuously disabled for more than 90 days after your pregnancy ends, you will be eligible to claim a benefi t from the end of the 90 day period (or after the expiry of the waiting period, if later); or Your Deliberate Self-Infl icted Act. benefi t will be paid where you suffer Total Disability or Partial Disability whilst imprisoned or the subject of a custodial sentence as a consequence of being convicted or committing a criminal offence. If you submit a claim whilst you are outside Australia, the Insurer may require you to return to Australia (at your own expense) for assessment of your claim. This may include attending a medical appointment. The Insurer may waive this requirement where it is satisfi ed that you are unable to return to Australia due to medical reasons. What if my disability recurs after I return to work? If your claim ends because you return to the work you were performing before your disability, and within 6 months of that claim ending, you suffer a recurrence of the disability that was the cause of the original claim, you can lodge a further claim. The Insurer will treat your further claim as a continuation of your original claim and the waiting period and payment period will not start again. This means benefi ts can start immediately from the date you become disabled again and the payment period will be reduced by the duration of your original claim. If your disability recurs more than 6 months after your claim ended, any further claim will be treated as a new claim and the waiting and payment period will recommence. How do I claim a benefi t? It is important to notify us of your intention to make a claim as soon as it is reasonably possible for you to do so. Every claim for a benefi t under the Policy must be made in the form prescribed by the Insurer and shall be accompanied by such evidence including but not limited to proof of your identity, medical reports from your treating doctors, fi nancial information and ongoing claim forms, as required by the Insurer. The claim form is available by calling benefi t is payable until the Insurer has assessed the claim and agreed that a benefi t should be payable under the Policy. All certifi cates and evidence required by the Insurer to assess your claim must be provided at your own expense. When cover starts and ends Am I eligible for cover? A person is eligible for cover if the person: joins Club Plus Super because their employer pays their employer superannuation contributions to Club Plus Super; is either an Australian Resident, or a holder of a Visa residing in Australia; and aged less than the cover expiry age which at present is 70 years for Short Term IP cover and 65 years for Long Term IP cover, on the date cover is due to commence or recommence. To be eligible for automatic cover, you must also satisfy the following conditions (set out in the table overleaf) on the date cover is due to commence or recommence. Insurance booklet - Industry division - October

19 Eligibility requirements for automatic cover What happens if you do not satisfy the eligibility requirements You must not have previously received automatic cover in relation to the same account in Club Plus Super. You must be At Work on the date automatic cover starts (refer to When does automatic cover start? below). The fi rst employer contribution made to your account in Club Plus Super by your employer must: (a) relate to your fi rst 180 days of work with your Employer; and (b) be received by us within 180 days after the Superannuation Guarantee Deadline that applies to the fi rst day you worked for that Employer. You are not eligible for automatic cover. You can only obtain cover by applying for cover via the Personal Statement form and being underwritten by the Insurer. Your automatic cover will be Limited Cover. This means you will not be insured for Total Disability or Partial Disability caused directly or indirectly, wholly or partially, from a Pre-Existing Condition. Limited Cover will be replaced with full cover on the date immediately after you are At Work for two consecutive months after Limited Cover commenced. Please refer to the Insurance Glossary for the full defi nition of Limited Cover and Pre-Existing Condition. Your automatic cover including any additional cover provided under the Special Offer will be Limited Cover. You must apply to the Insurer by completing the Personal Statement form and being underwritten to have the above limitations removed. If you are applying for cover or additional cover via the Personal Statement form, you must be working in an occupation for which cover is available under the policy. When does automatic cover start? Automatic cover starts on the later of the following dates: the date you commence work for your most recent Employer; the start date of the period relating to the fi rst employer contribution paid to your account in Club Plus Super; and the date your membership in Club Plus Super begins as a result of you commencing work with your Employer. When does cover end? Your Income Protection cover will cease on the earliest of: the date the Policy terminates; the date you reach the cover expiry age which is 70 years under Short Term IP cover and 65 years under Long Term IP cover; in respect of Short Term Cover, the earlier of: - the date you cease work with your Employer; and - the end date of the period relating to the last employer contribution paid to your account in Club Plus Super; in respect of Long Term Cover, the date there is insuffi cient money in your account to cover the next premium payment; the date you commence active service with the armed forces of any country (except where you are a member of the Defence Force Reserve, provided you are not subject to a call out order); if you are a member of the Defence Force Reserve, the date you become the subject of a call out order under the Defence Act 1903 (Cth); the date you cease to be a member of Club Plus Super; the date you die; the date you have been on employer approved unpaid leave for more than 13 consecutive months; the date you commence non approved unpaid leave; Insurance booklet - Industry division - October

20 2 INCOME PROTECTION COVER (CONT.) the date we receive your written request to cancel your cover or the date specifi ed in your written request to cancel cover (whichever is later); the date the Insurer cancels your cover as permitted under law; and if you are not an Australian Resident, the date you are no longer eligible to work in Australia (be that because you no longer hold a Visa or for any other reason), or the date Australia ceases to be your permanent place of residence. If your cover ends, you may only be able to reinstate cover by submitting an application for cover and being underwritten by the Insurer. What happens if I leave my Employer? If your Short Term IP cover ends because you stop working for your Employer, and you later commence new employment with an Employer (who makes SG contributions to Club Plus Super), you can receive automatic cover provided you have at all times remained a member of Club Plus Super, you satisfy the eligibility requirements for automatic cover (refer to Am I eligible for cover on page 18) and you have not previously cancelled your cover. Am I covered if I re-join Club Plus Super? If you cease to be a member of Club Plus Super and you subsequently commence working for an Employer (who makes SG contributions to Club Plus Super), or you have not commenced new employment but recommence employer contributions to Club Plus Super under the Choice of Fund legislation ( Choice Member ), you will be automatically accepted for automatic cover (refer to Cover when you join Club Plus Super on page 15). However, your automatic cover will be Limited Cover and will only be provided if you satisfy the following requirements: you are not a Claiming Member; except if you are a Choice Member, the fi rst employer contribution made to your new account in Club Plus Super: (a) relates to the fi rst 180 days of work with your Employer; and (b) is received by us within 180 days after the Superannuation Guarantee Deadline that applies to the fi rst day you worked for that Employer; and you have not previously cancelled your cover. Your cover will continue to be subject to Limited Cover terms until the Insurer approves an application to have the limitation removed. You can make such an application by completing the Personal Statement form and being underwritten by the Insurer. Cost of cover The premium rates are set out in the tables below. Short Term Cover Premiums are based on the relevant waiting period, and are calculated as a percentage of your employer SG contributions received. Premium Rates are a % of Employer SG Contribution Waiting Period (Days) Benefi t Period (Years) Premium Rates 9.48% 8.08% 4.82% EXAMPLE* Jo earns $30,000 per year (approximately $577 per week) and her employer makes SG contributions of $2,850 per year ($54.80 per week). The cost for automatic Short Term Income Protection is calculated as 9.48% of the SG contribution which is $ per year ($5.20 per week). If Jo decides to increase the waiting period from the default 21 days to 45 days, her premium reduces to $ per year ($4.43 per week). *This example is for illustrative purposes only. Insurance booklet - Industry division - October

21 Age next birthday Voluntary Long Term - 2 year Male Female NA NA 65 NA NA Long Term Cover The table (to the left) shows the cost of Long Term Cover based on a two year waiting period, your age and sum insured. The premium is expressed in the form of fi xed cover units in $100 per week benefi t multiples. EXAMPLE* Jake will be 22 years old on his next birthday and earns $60,000 per year ($5,000 per month). Under Long Term Income Protection insurance he can be covered for up to 75% of income ($45,000 per year or $3,750 per month) plus SG contributions of $5,700 per year (or $475 per month). Therefore his total monthly benefi t is $4,225. The premium states weekly premium rate per $100 of monthly benefi t. Therefore the calculation will be based on the total monthly benefi t of $4,225 (75% of salary plus SG). The calculation is $4,225/100 x = $2.98 per week. *This example is for illustrative purposes only. Insurance booklet - Industry division - October

22 2 INCOME PROTECTION COVER (CONT.) Insurance Glossary Certain words have specifi c meanings in relation to the policy terms and conditions. At Work means you: (a) are employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment; and (b) are: (i) in the Insurer s opinion, actively performing all the duties of your occupation, free from any limitation due to illness or injury and not on leave; or (ii) on Employer Approved Leave, or self-employed and on leave, taken for reasons unrelated to injury or illness, and in the Insurer s opinion, capable of actively performing all the duties of your occupation (being the occupation performed by the eligible person when you last worked), free from any limitation due to illness or injury, and (c) are capable of performing all the duties of your occupation on a Full-time basis (even if not working Full-time); and (d) are not in receipt of, or entitled to claim, income support benefi ts from any source including but not limited to workers compensation benefi ts, statutory motor accident benefi ts or disability income benefi ts (including government income support benefi ts of any kind). An eligible person who does not meet these requirements is correspondingly described as t At Work. Australian Resident means an Australian citizen, a New Zealand citizen or an Australian permanent resident within the meaning of the Migration Act 1958 (Cth) and Migration Regulations 1994 (Cth). Claiming Member means a person who: (a) had a claim admitted; (b) is eligible to receive a benefi t; (c) is in a waiting period for a benefi t; or (d) is in the process of claiming a benefi t; for terminal illness, total and permanent disablement, total disability or partial disability on or before the automatic cover commencement date. Date of Disablement means the later of: 1. the date that a medical practitioner certifi es, as the date that you have no capacity to perform one or more duties of your Usual Occupation necessary to produce income, which cannot be before the date of Medical Consultation by that medical practitioner; and 2. the date you cease working in your Usual Occupation. Defence Force Reserve means the Australian army, naval or air force reserves. Deliberate Self-Infl icted Act means a deliberate self-infl icted act of the insured member, including but not limited to attempted suicide or suicide, whether or not the person is sane at the time. Employer means an employer making employer contributions to Club Plus Super for an employee who is a member of Club Plus Super. Following the advice of a Medical Practitioner means the insured member is under the regular care and following the regular advice of their treating medical practitioner on an ongoing basis, including following all recommended courses of treatment and rehabilitation. Full-time means a person is working at least 35 hours per week. Gainfully Working means a person is employed or self-employed for reward or fi nancial benefi t, or the hope of reward or fi nancial benefi t, in any business, trade, profession, vocation, calling, occupation or employment. Limited Cover means an insured member will only be covered for Total Disability or Partial Disability which does not arise either directly or indirectly, wholly or partially, from a Pre- Existing Condition of the insured member. Medical Consultation means any activity undertaken for the detection, treatment or management of an illness, injury, medical condition or related symptom, including but not limited to the application of prescribed drugs or therapy (whether conventional or alternative). Insurance booklet - Industry division - October

23 Partial Disability/Partially Disabled means solely as a result of injury or illness, the insured member is: (a) unable to perform one or more of the duties necessary to produce income from their Usual Occupation, (b) is working in their Usual Occupation or another occupation, and has monthly salary less than their Pre-Disability Salary; and Following The Advice Of A Medical Practitioner in relation to their illness or injury for which they are claiming. Pre-Disability Salary means: - with respect to a benefi t payable under Short Term Cover, the average monthly value of salary the insured member received from his or her Usual Occupation over the 12 month period preceding the Date of Disablement or the actual period of time the insured member worked if less than 12 months (provided the period of work occurred in the 12 month period preceding the Date of Disablement and subject to a minimum averaging period of 6 months), calculated by the Insurer based on the satisfactory evidence available to the Insurer at the relevant time. OR If as at the day immediately before the Date of Disablement the insured member is on employer approved unpaid leave for a period of 13 months or less, it means average monthly value of salary the insured member received from his or her Usual Occupation over the 12 month period immediately prior to the commencement of the employer approved unpaid leave. - with respect to a Benefi t payable under Long Term Cover, the total monthly value of salary received by the insured member from his or her Usual Occupation averaged over the 12 month period preceding the Date of Disablement, or the actual period of time the insured member worked if less than 12 months (provided the period of work occurred in the 12 month period preceding the Date of Disablement and subject to a minimum averaging period of 6 months), calculated by the Insurer based on the satisfactory evidence available to the Insurer at the relevent time. Pre-Existing Condition means an injury, illness, condition or related symptom, whether it was diagnosed by a medical practitioner or not, which in the Insurer s opinion: (a) the insured member (or a reasonable person in their position) was aware of, or should have been aware of; (b) the insured member had, or was intending to have, a Medical Consultation; or (c) a reasonable person in the circumstances of the insured member would have had a Medical Consultation, as at or prior to the date cover commenced, recommenced or increased (with respect to the increased insured amount of cover only). Superannuation Guarantee Deadline is the date that is represented in the column titled payment cut-off date in the table below, which corresponds to the relevant period of work: Period of work Payment cut-off date 1 July - 30 September 28 October 1 October - 31 December 28 January 1 January - 31 March 28 April 1 April - 30 June 28 July Totally Disabled/Total Disability means solely as a result of injury or illness, the insured member: (a) ceases to be Gainfully Working including a person who has ceased temporarily to receive any gain or reward under a continuing arrangement for the person to be Gainfully Working; (b) is medically certifi ed as being incapable of performing one or more duties of his or her Usual Occupation necessary to produce salary; (c) is not engaged in any occupation (whether or not for reward), and (d) is Following The Advice Of A Medical Practitioner in relation to injury or illness for which they are claiming. To avoid doubt, an insured member can satisfy (a) above despite the fact that he or she is on employer approved leave or employer approved unpaid leave as at the Date of Disablement. Insurance booklet - Industry division - October

24 2 INCOME PROTECTION COVER (CONT.) Usual Occupation means the occupation(s) in which the insured member is regularly engaged at the time they suffer an injury or illness which leads to their Total Disability. For periods of Total Disability or Partial Disability which occur while the insured member who: is an employee and was on employer approved leave; OR is self-employed and was on leave, it means the last occupation(s) the insured member performed immediately before the leave commenced. Visa means a current and valid visa permitting residency (excluding a visa which allows permanent residency in Australia) or employment in Australia and issued in accordance with the Migration Act 1958 (Cth) or any amending or replacing act, including but not limited to sub class 457 working visa or sub class 457 working visa (with an 8107 condition). War includes, but is not limited to declared war, and armed aggression by one or more countries resisted by any country, combination of countries or international organisations. War Service includes, but is not limited to participation in an action to defend a country or region from civil disturbance or insurrection, or in an effort to maintain peace. Insurance booklet - Industry division - October

25 3 OTHER INSURANCE INFORMATION Your duty of disclosure Club Plus Super (the Trustee) who enters into a life insurance contract in respect of your life has a duty, before entering into the contract, to tell OnePath Life Limited (the Insurer) anything that the Trustee knows, or could reasonably be expected to know, may affect the Insurer s decision to provide the insurance and on what terms. The Trustee has this duty until the Insurer agrees to provide the insurance. The Trustee has the same duty before it extends, varies or reinstates the contract. The Trustee does not need to tell the Insurer anything that: reduces the risk the Insurer insures you for; or is of common knowledge; or the Insurer knows or should know as an insurer, or the Insurer waives your duty to tell the Insurer about. In order for the Trustee to comply with the duty of disclosure, we require you to tell us (the Trustee and the Insurer), anything you know, or could reasonably be expected to know, that may affect the Insurer s decision to insure you and on what terms. If you do not tell the Trustee and Insurer something that you know, or could reasonably be expected to know, may affect the Insurer s decision to provide the insurance and on what terms, this may be treated as a failure by the Trustee entering into the contract to tell the Insurer something that we must tell the Insurer. If you do not tell the Insurer something In exercising the following rights, the Insurer may consider whether different types of cover can constitute separate contracts of life insurance. If they do, the Insurer may apply the following rights separately to each type of cover. If you do not tell the Insurer and the Trustee anything you are required to, and the Insurer would not have provided the insurance or entered into the same contract with the Trustee if you had told the Insurer and the Trustee, the Insurer may avoid the contract within 3 years of entering into it. If the Insurer chooses not to avoid the contract, the Insurer may, at any time, reduce the amount of insurance provided. This would be worked out using a formula that takes into account the premium that would have been payable if you had told the Insurer and the Trustee everything you should have. However, if the contract provides cover on death, the Insurer may only exercise this right within 3 years of entering into the contract. If the Insurer chooses not to avoid the contract or reduce the amount of insurance provided, the Insurer may, at any time vary the contract in a way that places the Insurer in the same position it would have been in if you had told the Insurer and the Trustee everything you should have. However this right does not apply if the contract provides cover on death. If the failure to tell the Insurer is fraudulent, the Insurer may refuse to pay a claim and treat the contract as if it never existed. The Insurer s Privacy Statement In this section we, us and our refers to OnePath Life Limited and other members of the ANZ Group. You and your refers to policy owners and life insured s. We collect your personal information from you in order to manage and administer our products and services. Without your personal information, we may not be able to process your application or provide you with the products or services you require. We are committed to ensuring the confi dentiality and security of your personal information. Our Privacy Policy details how we manage your personal information and is available on request or may be downloaded from onepath.com.au/privacy-policy In order to undertake the management and administration of our products and services, it may be necessary for us to disclose your personal information to certain third parties. Unless you consent to such disclosure we will not be able to consider the information you have provided. Providing your information to others The parties to whom we may routinely disclose your personal information include: an organisation that assists us and/or ANZ to detect and protect against consumer fraud; any related company of ANZ which will use the information for the same purposes as ANZ and will act under ANZ s Privacy Policy; organisations performing administration and/or compliance functions in relation to the products and services we provide; Insurance booklet - Industry division - October

26 3 OTHER INSURANCE INFORMATION (CONT.) organisations providing medical or other services for the purpose of the assessment of any insurance claim you make with us (such as reinsurers); our solicitors or legal representatives; organisations maintaining our information technology systems; organisations providing mailing and printing services; persons who act on your behalf (such as your agent or fi nancial adviser); the policy owner; regulatory bodies, government agencies, law enforcement bodies and courts. We will also disclose your personal information in circumstances where we are required by law to do so. Examples of such laws are: The Family Law Act 1975 (Cth) enables certain persons to request information about your interest in a superannuation fund; There are disclosure obligations to third parties under the Anti-Money Laundering and Counter- Terrorism Financing Act Information required by law ANZ may be required by relevant laws to collect certain information from you. Details of these laws and why they require us to collect this information are contained in our Privacy Policy at onepath.com.au/privacy-policy Life risk sensitive information For life risk products, where applicable, we may collect health information with your consent. Your health information will only be disclosed to service providers or organisations providing medical or other services for the purpose of underwriting, assessing the application or assessing any claim. Privacy Policy Our Privacy Policy contains information about: when we or ANZ may collect information from a third party; how you may access and seek correction of the personal information we hold about you; and how you can raise concerns that we or ANZ has breached the Privacy Act or an applicable code and how we and/or ANZ will deal with those matters. You can contact us about your information or any other privacy matter as follows: In writing: GPO Box 75, Sydney NSW privacy@onepath.com.au We may charge you a reasonable fee for obtaining this information. If any of your personal information is incorrect or has changed, please let us know by contacting Customer Services on More information can be found in our Privacy Policy which can be obtained from our website at onepath. com.au/privacy-policy Privacy law changes from 12 March 2014 From 12 March 2014, we and the ANZ Group must provide you with the following information about overseas recipients of personal information. Overseas recipients We or ANZ may disclose information to recipients (including service providers and related companies) which are (1) located outside Australia and/or (2) not established in or do not carry on business in Australia. You can fi nd details about the location of these recipients in ANZ s Privacy Policy at anz.com/privacy Privacy consent Where you wish to authorise any other parties to act on your behalf, to receive information and/or undertake transactions please notify us in writing. If you give us or ANZ personal information about someone else, please show them a copy of this document so that they may understand the manner in which their personal information may be used or disclosed by us or ANZ in connection with your dealings with us or ANZ. Insurance booklet - Industry division - October

27 Club Plus Super Privacy Policy Your right to privacy Club Plus Super understands the importance of protecting your right to privacy and have prepared this statement to help you understand how we aim to protect the privacy of your personal information. Please note that although we refer to Club Plus Super throughout this document, generally it is Australian Administration Services Pty Ltd (AAS) that collects and uses your details on our behalf. AAS is the company that administers Club Plus Super. The Privacy Act 1988 regulates the way Club Plus Super and our service providers, such as our insurer, handle personal information, including very sensitive information such as health details. The Act contains thirteen Australian Privacy Principles that regulate, among other things, how organisations collect, store and protect the quality of personal information. It also regulates how these organisations should use and share personal information with other organisations. The Australian Privacy Principles form part of all our procedures and policies and the way our members accounts are administered. The Club Plus Super Privacy Policy is available on our website clubplussuper.com.au/privacy-policy. What personal information will Club Plus Super keep about me? Club Plus Super collects personal information from members to administer their accounts. The type of personal information collected about you includes your name, address, date of birth, telephone number and tax fi le number. Club Plus Super collects personal information when members lodge their forms, such as membership application and change of personal details forms, or if members send documents containing personal information. There may also be circumstances when your employer may send personal details to Club Plus Super for you. For example, if you provide your tax fi le number to your employer, you will be deemed to have authorised your employer to provide your tax fi le number to Club Plus Super. Why does Club Plus Super need my personal information? The personal information Club Plus Super collects about you is used to establish your Club Plus Super Membership account, process payments to your account, correspond with you and provide you with superannuation benefi ts and options. The provision of some benefi ts and options to you requires the provision by you of your personal information and, should you choose not to provide necessary information, it may not be possible to provide those benefi ts and options to you. There are other organisations that are connected to the services we provide to you and which may have access to your personal information. They include: Mailing companies organisations contracted to do all mailing for Club Plus Super; Archiving companies organisations contracted to ensure that all documents are stored in a secure environment; Auditors, lawyers, the administrator and Regulators; Insurance companies insurers that provide insurance cover for Club Plus Super members; Organisations that ensure Club Plus Super is complying with legislation and contractual obligations. Can I see the personal information Club Plus Super has about me? Under the Australian Privacy Principles, you have a right to know what information Club Plus Super holds about you, and you are entitled to see this information to ensure it is correct. To obtain this information, please contact Club Plus Super. The Privacy Act gives limited circumstances in which some or all access to this information may be denied. If this applies to you, Club Plus Super will explain this to you when you ask for your information. Privacy Offi cer Telephone: (02) privacy@clubplussuper.com.au Fax: In writing: Privacy Offi cer Club Plus Super GPO Box 3774 Sydney NSW 2001 Insurance booklet - Industry division - October