ChildCare Division. Contents. Insurance Guide. Preparation Date: 01/01/2015

Transcription

1 ChildCare Division Insurance Guide Preparation Date: 01/01/2015 Trustee and Issuer: The trustee and issuer of the Emplus Superannuation Fund (ABN Fund Registration Number R ) is: Equity Trustees Limited ABN , AFSL No , RSE Licence No. L Level 2, 575 Bourke Street Melbourne Victoria 3000 Freecall: Ph: (03) Fax: (03) Fund Administrator Millennium3 Financial Services Pty Ltd ABN , AFSL No Unit 7, 50 Borthwick Avenue Murarrie QLD 4172 Freecall: Ph: (07) Fax: (07) Fund Promoter: Emplus Superannuation Administration Pty Ltd ABN Level 2, 18 Metroplex Avenue Murarrie QLD 4172 Freecall: Ph: (07) Fax: (07) Disclaimer The information in this document forms part of the Product Disclosure Statement - Personal Division for the Emplus Superannuation Fund, prepared 01/01/2015, a copy of which is available from the website, or by contacting the Fund Administrator on or at info@emplus.com.au. Version: This Insurance Guide is designed for employees (and spouses) of Participating Employers being employers engaged in the Childcare Industry or any other entity that the Trustee may agree to admit as a Participating Employer to the Fund pursuant to the Product Disclosure Statement - ChildCare Division, from time to time. If you are not an employee (or spouse) as described above, the provisions detailed in this Guide will not apply to you. Contents The Fund 3 What Is Emplus? 3 Trustee 3 Fund Administrator 3 Fund Promoter 3 Insurer 3 Insurance Benefits 3 Benefits 3 An Important Obligation 3 Categories Of Cover 4 What Types Of Insurance Benefits Are Available? 4 Will I Receive Default Cover? 6 Who Is Eligible For Cover? 6 How Much Insurance Benefit Is Provided? 7 How Much Does The Insurance Benefit Cost? 10 Changes In Premiums 13 Do I Need To Provide Any Information About My Health In Order To Have Insurance Cover? 13 When Does Insurance Cover Commence? 14 When Does Insurance Cover Cease? 14 Changing Employers Within The ChildCare Industry? 14 Leaving The ChildCare Industry? 14 How Can I Increase Cover Without Providing Medical Evidence? 15 What Exclusions Apply? 16 Can I Continue My Insurance Cover When I Leave The Fund? 16 Making Claims 16 Insurer Risks 17 Duty Of Disclosure 17 How To Obtain A Copy Of The Insurance Policy 17 Insurance Cover Summary 18 Directory 20 Emplus ChildCare Division Insurance Guide Page 1

2 Any reference to: "Fund Administrator" means Millennium3 Financial Services Pty Ltd (ABN ) (AFSL No ) "Asset Consultant" means Millennium3 Financial Services Pty Ltd (ABN ) (AFSL No ). "Childcare Industry" means organisations, employers, employees, and individuals engaged in the performance of work in or in connection with, or incidental to, child care, including long day care, family day care, in home care, outside school hours care and occasional care services "Emplus/Fund" means the Emplus Superannuation Fund (RSE Registration No R ) i.e. this superannuation fund. Insurance Guide means this document. "Product Disclosure Statement" or "PDS" means the Product Disclosure Statement for the ChildCare Division of Emplus Superannuation Fund, prepared 01/01/2015. "Standard Cover Insurer" means OnePath Life Limited (ABN ). "Superannuation Legislation" means the Superannuation Industry (Supervision) Act 1993 and regulations made under it. "Trustee/us/we/our " means Equity Trustees Limited (ABN ) (AFSL ) (RSE Licence No L ). How to contact us Customer Service Centre Millennium3 Financial Services Pty Ltd Post: PO Box 3528, Tingalpa DC,QLD4173 Phone: (07) or Freecall Fax: (07) info@emplus.com.au Internet: Trustee Equity Trustees Limited Post: GPO Box 2307, Melbourne, VIC 3001 Phone: (03) Fax: (03) Internet: You may request further information about this product by contacting the Fund Administrator at the address or telephone number shown above. Other relevant contact details are provided in the Directory inside the back cover of this Insurance Guide. We are obliged to give you further information which has been previously made generally available to the public and might reasonably influence your decision whether to acquire this product. Information in this Insurance Guide is subject to change from time to time. We will notify you of any changes that have a materially adverse impact on you or other significant events that affect the information in this Insurance Guide. Such updated information may be obtained: From the Fund Administrator s website at By calling the Customer Service Centre on or (07) during business hours By writing to the Customer Service Centre at PO Box 3528, Tingalpa DC Qld 4173 In addition, we will provide this information to you in hardcopy free of charge upon your request. The information contained in this Insurance Guide is general advice only. It does not take into account your individual objectives, financial situation or needs. Because of that, you should consider the appropriateness of this product having regard to your objectives, financial situation and needs, and we recommend you seek advice from a licensed financial adviser before investing. Important notes Past investment performance should not be used as a guide for future investment performance. You should not base your decision to invest in this product on past investment performance. The investment returns of this product are not guaranteed and you may get back less than the amount that you have invested. Updated investment performance figures may be obtained: From the Fund Administrator s website at By calling the Customer Service Centre on or during business hours By writing to the Customer Service Centre at PO Box 3528, Tingalpa DC Qld 4173 Unless otherwise stated, all fees quoted in the Insurance Guide are inclusive of Goods and Services Tax, after allowing for an estimate for Reduced Input Tax Credits, and all amounts are in Australian dollars. Neither the Trustee, the Fund Administrator, nor any of the investment managers and their respective employees, agents or officers listed in this Insurance Guide, nor any other party associated with the Fund guarantees the performance of the Fund, or the repayment of capital, or any particular rate of return. If you leave the Fund or withdraw moneys from any one or more investment option within a few years of joining, you may get back less than the amount you have invested because of the level of returns earned by the investment option (including negative returns) and the Fund s fees and charges. The Trustee is the issuer of this Insurance Guide. All of the parties named in this document have consented to be named and have not withdrawn their consent prior to the printing of this Insurance Guide. Emplus ChildCare Division Insurance Guide Page 2

3 The Fund WHAT IS EMPLUS? Emplus is a Public Offer Superannuation Fund, being a regulated superannuation fund under the Superannuation Industry (Supervision) Act 1993 (SIS), eligible for concessional tax treatment. As well as insurance and investment options, Emplus has a facility to arrange for the easy transfer of assets from your previous superannuation fund, with no requirement to make a set number or amount of contributions. The Fund may be suitable for: Employers, as a way of providing superannuation for their employees Self-Employed people, as a way of providing for their retirement Employees wishing to plan for retirement People who have a rollover or redundancy payment and are looking for a simple and flexible investment Spouses of members who wish to make contributions towards their retirement. TRUSTEE Equity Trustees Limited Equity Trustees Limited ( EQT ) was established by a special act of the Victorian Parliament in 1888 as a licensed trustee and executor service provider. EQT is a financial services institution offering a comprehensive range of financial products and services aimed at growing, managing and protecting wealth. Specialist services include estate management, providing financial and taxation advice, personal investment, superannuation and trustee services. For more than 100 years, EQT has expanded its services to meet the wealth management requirements of its clients. As a trustee company, EQT prides itself on offering a truly personalised service and is committed to acting in the best interests of its clients via prudent wealth management solutions. EQT s traditional values of prudence, responsibility and service are central to how it manages the investments and financial affairs of its clients. EQT funds under trusteeship and administration are in excess of $20 billion. EQT is a publicly listed company on the Australian Stock Exchange. FUND ADMINISTRATOR Millennium3 Financial Services Pty Ltd The Fund Administrator is responsible for all data and record management, all statutory and member reporting, and the processing of all receipts and payments. While being responsible for the maintenance of the Fund s financial data, the Fund Administrator does not have any control over, nor access to, the Fund s bank accounts, nor is the Fund Administrator able to issue cheques or payments. This is subject to the control of the Trustee, and the Trustee is not a related entity of any other party associated with the management of this superannuation Fund. insurance and superannuation adviser groups in Australia and their practice now encompasses over 700 financial advisers throughout Australia. The purpose of Millennium3 s business is to provide professional services to the financial services sector including accountants, financial planners, life insurance brokers, general insurance brokers, and finance brokers. Millennium3 s objective is to maximise the financial wellbeing of their clients by providing quality service and advice in a cost effective and professional manner. Millennium3 Financial Services Pty Ltd is part of one of the largest life insurance and superannuation adviser groups in Australia. Millennium3 Financial Services Pty Ltd is ultimately owned by the ANZ Banking Group. FUND PROMOTER Emplus Superannuation Administration Pty Ltd As Fund Promoter, Emplus Superannuation Administration s role encompasses the general marketing and sales functions for the Fund, and advising the Trustee in respect of the ongoing management and public promotion of the Fund. INSURER OnePath Life Limited The Insurer is a registered life insurance company under the Life Insurance Act 1995 (Cth). The Insurer provides group insurance cover for death, terminal illness, total & permanent disablement and income protection for qualifying members, joining all divisions of the Fund. Insurance Benefits The Fund provides a range of different insurance benefits. This section provides details of what insurance benefits are available, who is eligible, and how it works. BENEFITS Full details of the insurance benefits provided through the Fund by the Insurer, including eligibility criteria and definitions, are contained in the Insurer's insurance policy. This Insurance Guide summarises the significant aspects of the Insurer's policy as it affects insurance benefits arranged by the Fund. Please note that details of insurance benefits are subject to change. Such changes will be notified to you in accordance with our legal obligations (see inside the front cover of this Insurance Guide). In all cases, insurance cover for a member is subject to acceptance by the Insurer and to the terms and conditions of the insurance policies issued by the Insurer to the Trustee. AN IMPORTANT OBLIGATION It is important that you note that it is your obligation to ensure that your account always has sufficient funds to pay the insurance premiums otherwise your cover will lapse. The Trustee is not responsible for ensuring that your insurance cover does not lapse due to insufficient funds or for informing you in the event that your cover is about to, or has, lapsed. The Fund Administrator is Millennium3 Financial Services Pty Ltd ( Millennium3 ). Millennium3 is one of the largest life Emplus ChildCare Division Insurance Guide Page 3

4 CATEGORIES OF COVER When first admitted to the Fund pursuant to this PDS, employees of participating employers are divided into three categories for insurance cover. Your employer nominates the category that is appropriate for your circumstances. These categories are: Category A: Category B: Category C: Executives and Head Office Staff Qualified Child Care Workers and Permanent Staff Unqualified Child Care Workers, Casual Staff and Support Staff If we are advised that your employment category has changed, then your insurance cover will also change for example, if you move from Casual Staff to Qualified Permanent Staff, then your insurance cover will change from those provided under Category C to those provided under Category B. Once admitted into the Fund you may elect to opt-out of this insurance cover. Voluntary cover You may vary your cover by taking our additional insurance - see the How Much Insurance Benefit is Provided section for more details. WHAT TYPES OF INSURANCE BENEFITS ARE AVAILABLE? Insurance Benefits on Death A lump sum benefit will be payable to your beneficiaries in the event of your death while you are an insured member of the Fund. Terminal Illness Benefits If you are covered for Death only or Death & TPD insurance, you are automatically covered for Terminal Illness. A Terminal Illness Benefit will be payable if you have Death cover and you are not expected to live for more than twelve months, as diagnosed by two medical practitioners, one of whom is nominated by the Insurer. The maximum terminal illness benefit payable under the insurance policy is the less of the insured benefit or $1,000,000. If the insured benefit is greater than $1,000,000, the balance is paid out on the death of the insured member so long as the insurance policy is still in force, the insured member's cover has not ended and the member has not reached his/her benefit expiry age for the death benefit. Please note that while a Terminal Illness Benefit will be payable under the insurance policy if you meet the definition in the insurance policy, the insurance benefit (if any) and your account balance may only be cashed from the Fund if you also meet the definition of "Terminal Medical Condition" as defined in superannuation law. To be eligible for a Terminal Medical Condition benefit, the following requirements need to be satisfied: two registered medical practitioners have certified, jointly or separately, that the Member suffers from an illness or has incurred an injury that is likely to result in the Member's death within 12 months of the certification; at least one of the registered medical practitioners is a specialist practicing in the area related to the illness or injury suffered by the Member; and the certificates are not more than 12 months old. Insurance Benefits on Total and Permanent Disablement A lump sum benefit will be paid to your account if you suffer a total and permanent disablement as defined in the insurance policy while you are an insured member of the Fund, and your claim is accepted by the Insurer. The benefit can in turn be paid to you provided that you suffer permanent incapacity or satisfy some other condition of release under superannuation law (see the Member Guide ChildCare Division). The Insurer will assess claims in accordance with the terms of the insurance policy. The insurance policy defines what constitutes Total and Permanent Disablement. Different parts of the definition apply depending on your employment status and the hours you work. Total and Permanent Disablement (TPD) is defined in the insurance policy to mean one of the following: TPD Definition 1; An insured member satisfies all of the following (a), (b) and (c): a) is Gainfully Working on the day immediately prior to the Event Date; and b) was employed for at least the Minimum Average Hours; 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: (i) has not worked during the entire Waiting Period; and (ii) as at the Date of Disablement is unlikely ever to return to any Gainful Employment for which he or she is reasonably suited by education, training or experience, or would be suited by Reasonable Training. TPD Definition 2; OR An insured member satisfies either (a) or (b) and also satisfies (c): a) is not Gainfully Working on the day immediately prior to the Event Date; or b) has not been employed for at least the Minimum Average Hours; 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: (i) is totally and irreversibly unable to perform at least two of the Activities of Daily Living; and (ii) as at the Date of Disablement is unlikely ever to engage in any Gainful Employment for which he or she is reasonably suited by education, training or experience, or would be suited by Reasonable Training. Emplus ChildCare Division Insurance Guide Page 4

5 The definitions of the bolded defined terms in TPD Definition 1 & 2 are listed in the following table: Defined Term Activities of Daily Living Date of Disablement Employer Approved Leave Event Date Gainful Employment Gainfully Working Minimum Average Hours Reasonable Retraining Waiting Period Definition Means: a) Bathing bathing and showering b) Dressing dressing and undressing c) Feeding eating and drinking d) Mobility mobility, to the extent of being able to get in and out of bed or a chair, and move from place to place without using a wheelchair e) Toileting the ability to use a toilet, without the assistance of another adult person or suitable aids. Means: a) For TPD Definition 1, the first day after the expiry of the Waiting Period. b) For TPD Definition 2, the first day that all of the elements of the definition are satisfied. Means a person is: a) Employed for reward or financial benefit, or the hope of reward or financial benefit, in any business, trade, profession, vocation, calling, occupation or employment; and b) On leave that has been approved by the employer prior to the commencement of that leave (except for approved sick leave) Means: a) For TPD Definition 1, the first day of the Waiting Period during which the Insured Member, in the Insurer s opinion, solely because of injury or illness, has not worked, b) For TPD Definition 2, the first day that the Insured Member, in the Insurer s opinion, solely because of injury or illness, is totally unable to perform at least two Activities of Daily Living Means any occupation or work for reward or financial benefit, or the hope of reward of financial benefit, whether on a permanent or temporary basis, and whether or not of a lesser grade, status or level of remuneration or of lesser hours than the Insured Member s occupation or occupations or work. Means a person is: a) Employed or self-employed for reward or financial benefit, or the hope of reward or financial benefit in any business, trade, profession, vocation, calling, occupation or employment; or b) On paid Employer Approved Leave. Means 15 hours per week averaged over the six consecutive months immediately prior to the Event Date. Means any further education, training or experience, the person has capacity to reasonably undertake, based on the skills and knowledge the person has acquired from their education, training or experience obtained prior to the Date of Disablement. Means a 183 consecutive day period. Emplus ChildCare Division Insurance Guide Page 5

6 Income Protection Insurance Benefits A benefit will be payable monthly in arrears to your account if you suffer a disability (total or partial) as defined in the insurance policy while you are an insured member of the Fund, and your claim is accepted by the Insurer. The benefit will in turn be paid to you provided that you satisfy temporary incapacity or some other condition of release under superannuation law. The Insurer will assess claims for total or partial disability in accordance with the terms and conditions of the insurance policy. If your claim is accepted by the Insurer, income protection benefits start to accrue and are payable after the end of the Waiting Period for up to two years, whilst you continue to suffer a disability. The Waiting Period is a specific length of time (either 30 days or 90 days, depending on the Waiting Period chosen by you) that you must remain disabled and starts on the date you become totally disabled. Totally disabled/total disability means solely as a result of injury or illness, the insured member is: medically certified as being incapable of performing one or more duties of his or her usual occupation necessary to produce income; not engaged in any occupation; and following the advice of a medical practitioner. Partial disability/partially disabled means, in relation to an insured member, all the following applies: he or she is no longer totally disabled, but has been totally disabled: o for a period during which a Total Disability Benefit has been paid; or o for at least 7 days out of 12 consecutive days during the waiting period; then returns to work, or is medically certified as being capable of returning to his or her usual occupation, but only in a limited capacity; the salary the member is earning, or is capable of earning, is less than his or her pre-disability salary due to the injury or illness causing total disability; and the insured member must be following the advice of a medical practitioner. Pre-disability salary (for the purpose of the partial disablement benefit calculation only) means the total monthly value of salary received by the insured member from his or her usual occupation, averaged over the most recent 12 month period the insured member was at work prior to becoming disabled, or the actual period of work if less. Salary means where the insured member is employed, the following annual remuneration which the insured member receives from his or her usual occupation, before the deduction of income tax: cash salary; regular overtime (averaged over the previous 3 years, or since the insured member started his or her current occupation, if less); the monetary value of non-cash benefits or fringe benefits provided by the insured member's employer in direct substitution of salary (as long as the fringe benefits continue to be provided to the insured member after disability benefits payments have commenced); and performance related commission, bonuses and other monetary benefits, averaged over the previous 3 years or since the insured member started his or her current occupation, if less. In the case of a self-employed insured member, "salary" means that part of the income of the insured member's business due directly to the personal exertion of the insured member less the part of the business expenses of the business (measured over the same period) reasonably apportionable to the insured member before income tax. Please note: some occupations are not eligible for Income Protection Insurance Benefits. Please contact the Fund Administrator to see if your occupation is eligible. It is important that you advise the Fund Administrator if your usual hours of work change as this affects your eligibility for income protection insurance. WILL I RECEIVE DEFAULT COVER? Upon joining the Fund, yes. You will be provided with the default insurance cover for your employment category. You can opt-out of this cover by notifying the Administrator of the fund on Also, members may apply to increase or alter their cover. As well as the eligibility criteria below, to be eligible for this cover: we must receive an initial contribution from your employer within 120 days of the date you commence employment you must be At Work on the date you join the Fund, and you must not have received nor be entitled to receive a TPD or terminal illness benefit from any insurance policy. If you do not satisfy the above requirements for default cover, you may be eligible to apply for Voluntary Cover if you meet the eligibility requirements set out below. WHO IS ELIGIBLE FOR COVER? You are eligible for insurance cover if: you are aged at least 16 and up to age 64 you are an Australian citizen or permanent resident, residing in Australia you are engaged in an occupation which is not an excluded occupation, and you are working at least 15 hours per week on a permanent basis. What happens if I am not eligible for insurance cover? If you are not eligible for insurance cover under eligibility criteria specified in the insurance policy, the deduction of insurance premiums from your account and the receipt of those insurance premiums by the Insurer will not result in you being insured. Any premiums paid to the Insurer in these circumstances will be treated as having been paid in error and will be refunded. Emplus ChildCare Division Insurance Guide Page 6

7 HOW MUCH INSURANCE BENEFIT IS PROVIDED? Emplus Super ChildCare Default Cover: Category Death Insurance TPD Insurance Income Protection Insurance A 20% x Salary x Years to Age 65, where salary is your Total Remuneration Cost at the previous 1 July, and years is calculated as the period in Years and Months from the last 1 July to your 65th Birthday B 15% x Salary x Years to Age 65, where salary is your Total Remuneration Cost at the previous 1 July, and years is calculated as the period in Years and Months from the last 1 July to your 65th Birthday C Emplus MySuper Default Table of Cover insurance cover. Two age based units of cover ranging from $12,000 to $172,000, depending on age. 20% x Salary x Years to Age 65, where salary is your Total Remuneration Cost at the previous 1 July, and years is calculated as the period in Years and Months from the last 1 July to your 65th Birthday 15% x Salary x Years to Age 65, where salary is your Total Remuneration Cost at the previous 1 July, and years is calculated as the period in Years and Months from the last 1 July to your 65th Birthday. Emplus MySuper Default Table of Cover insurance cover. Two age based units of cover ranging from $0 to $172,000, depending on age. The maximum benefit is the lesser of 75% of salary/income or $20,000 per month, with a 30 day Waiting Period and 2 year Benefit Period The maximum benefit is the lesser of 75% of salary/income or $20,000 per month, with a 30 day Waiting Period and 2 year Benefit Period Premium rates for Category A & B members are available in Table 3 and 4. Premium rates and insurance cover for Category C members are available below. Refer automatic acceptance eligibility in the Insurance Cover Summary Section. Nil Emplus ChildCare Division Insurance Guide Page 7

8 Emplus MySuper Default Table of Cover (Category C Members) Generally, the default cover under the Emplus MySuper Default Table of Cover is two units of Death and TPD insurance cover (see following table). This insurance cover is based on Age based units where the premium remains the same and the sum insured varies. Up to age 64, you receive two units of Death and TPD insurance for $3.20 per week. From age 65 to 69, you will be provided with two units of Death only cover for $1.60 per week. Table 2: Emplus MySuper Default Table of Cover (Category C Members) Age Next Birthday *Death cover only Sum Insured 1 Unit Death & TPD Cover Number of Units Emplus MySuper Default Cover Sum Insured Emplus MySuper Default Death & TPD Cover $50,000 2 $100, $75,000 2 $150, $86,000 2 $172, $60,000 2 $120, $42,000 2 $84, $37,000 2 $74, $34,000 2 $68, $32,000 2 $64, $29,000 2 $58, $27,000 2 $54, $25,000 2 $50, $22,000 2 $44, $20,000 2 $40, $19,000 2 $38, $17,000 2 $34, $16,000 2 $32, $15,000 2 $30, $14,000 2 $28, $13,000 2 $26, $12,000 2 $24, $11,000 2 $22, $10,000 2 $20, $9,000 2 $18, * $6,000 2 $12, * $6,000 2 $12, * $6,000 2 $12, * $6,000 2 $12, * $6,000 2 $12,000 Voluntary Cover You can apply for voluntary insurance or additional insurance cover by completing an insurance application form ( Personal Statement ), available by going to the Forms page of or on request by phoning Your application will be assessed by the Insurer. Your voluntary cover will commence once the Insurer has accepted the application for cover and you have sufficient account balance to cover the monthly insurance premium. Voluntary Cover can be applied for using the Emplus MySuper Default Table of Cover units or the other TPD and Income Protection insurance cover in the Insurance Tables in this Insurance Guide. Emplus ChildCare Division Insurance Guide Page 8

9 Death and TPD Insurance Benefits The amount of insurance benefit is the amount nominated by you at application and accepted by the Insurer. In all cases, the maximum insurance benefit in the case of death insurance is $4,000,000, and the maximum insurance benefit in the case of TPD insurance is $2,000,000. You can decide whether your Death & TPD cover is: Unitised cover this means your insured benefit is made up of units of cover, where each unit equals a specific amount depending on your age (as set out in the table above). Generally, the value of each unit may increase or decrease as you get older but the cost per unit does not change. Fixed cover this means your insured benefit is fixed and does not change as you age. Generally, the cost will increase as you get older. Income Protection Insurance Benefits The insurance benefit is based on your salary / income at the time you apply for the benefit. If your income increases, it is necessary for you to re-apply to have your insurance benefit increased. Total disability benefits: The maximum monthly benefit is 75% of your monthly salary or $20,000 (whichever is less) and is payable for a maximum period of two years. Partial disability benefits: A partial disability benefit is calculated using the following formula; ((A-B)/B) x monthly benefit Where: A is the pre-disability salary (as defined above); and B is the greater of the salary the insured member earns or is capable of earning (based on medical evidence and other relevant information) for the month that the partial disability benefit is payable. If you have been in receipt of a monthly disability benefit, continuously, for 12 months, the monthly benefit may be increased by the less of the annual increase in the Consumer Price Index and an escalation factor determined by the Insurer. Please note: The amount of insurance benefit paid under an Income Protection claim may be reduced by amounts received from other sources including (but not limited to) workers compensation, and other disability income policies. Any lump sum payment received in respect of loss of income is converted to an equivalent monthly amount by dividing the lump sum amount by the number of months in the benefit period. Annual leave, sick leave, long service leave entitlements and investment income received by a member will not reduce the amount of the benefit. Payment of the insurance benefit is also subject to the member being under the regular care and treatment recommended by their medical practitioner and, when required by Insurer, undergoing vocational assessment and/or rehabilitation or other requirements of the Insurer. Death while in receipt of Income Protection benefits In the event of your death while you are receiving Income Protection benefits, the Insurer will pay an additional month s payment based on the benefit amount that was paid immediately prior to the death. When you are applying for Insurance Cover Interim Accident Cover You may be entitled to Interim Accident Cover for death or disability resulting from accidents while your application for cover is processed. Interim Accident Cover commences once your application is received by the Insurer and ceases on the earlier of you being notified of the Insurer s decision or when 90 days lapses. Interim Accident Cover is equal to the amount of cover being applied for (up to the maximum amount under the Policy) and will only apply for events that occur during the period in which Interim Accident Cover applies. For Death and TPD insurance applications: Interim Accident Cover only applies for events that result in Accidental death. Accidental death means death directly resulting from an unforeseen and unintentional accident caused by violent, external and visible means. For Income Protection insurance applications: Interim Accident Cover only applies for events that result in an accidental bodily injury. Accidental bodily injury means an injury which: is caused solely and directly by violent, accidental, external and visible means; occurs independently of any other cause; is not the unintended and unexpected consequence of an intended act such as the application of unintentionally excessive force or the creation of unintended excessive force, pressure or strain. Emplus ChildCare Division Insurance Guide Page 9

10 HOW MUCH DOES THE INSURANCE BENEFIT COST? The premium for insurance benefits will be calculated on a monthly basis and automatically deducted from your superannuation account at the end of each month. If there is not enough money in your superannuation account to pay the insurance premiums, your insurance benefit will cease after 30 days. Voluntary Cover Rates depending upon your Age, gender and amount of cover, as per the following formula: (Annual Benefit / $1,000) x AGE RATE as per Table 3 in the Insurance Guide + Stamp Duty An application for cover will need to be completed for all voluntary cover. This cover will commence on the date your application is assessed and accepted by the Insurer. Premium rates, as detailed in the Insurance Tables that follow, are based on your age next birthday and are determined by other factors, such as your gender, whether you smoke, your occupation, and your income protection waiting period. The Fund Administrator will confirm premium rates upon application or request for a quotation. Note. Premiums may change when your employment changes. Your insurance cover and premiums will be confirmed by the administrator once they have been advised of any change in your employment. Category A and B Members Death and Total & Permanent Disablement Insurance Cover- Rates depend upon your age, gender and amount of cover, as per the following formula; (Benefit / $1,000) x AGE RATE as per Table 3 in the Insurance Guide. Different rates may apply where a participating employer has more than 50 members in the Fund. The rates that apply to your cover will be confirmed on your Welcome Certificate. Income Protection Insurance Cover- Rates depend upon your age, waiting period and amount of cover, as per the following formula; (Annual Benefit / $1,000) x AGE RATE as per Table 4 in the Insurance Guide + Stamp Duty Different rates may apply where a participating employer has more than 50 members in the Fund. The rates that apply to your cover will be confirmed on your Welcome Certificate. Category C Members Emplus MySuper Default Table of Cover: Death and Total & Permanent Disablement Insurance Cover- $1.60 per week per unit of insurance benefit (default cover is $3.20 per week for two units) Emplus ChildCare Division Insurance Guide Page 10

11 Table 3: Rates for Death and Total & Permanent Disablement Cover (rate per $1,000 insurance cover) Next Birthday Male Death Only Female Death Only Male TPD Only Female TPD Only Emplus ChildCare Division Insurance Guide Page 11

12 Table 4: Rates for Income Protection Cover (rate per $1,000 annual benefit) Stamp Duty is to be added to premiums. Stamp Duty is based on the member s state of domicile and ranges from 5% to 11%. Refer to Table 5 for more information. Waiting Period Age Next Birthday 30 Days 60 Days Male Female Male Female Emplus ChildCare Division Insurance Guide Page 12

13 Table 5: Stamp Duty Stamp Duty is based on the member s state of domicile as detailed below: State of Domicile Stamp Duty ACT 10.00% NSW 5.00% NT 10.00% QLD 7.50% SA 11.00% TAS 8.00% VIC 10.00% WA 10.00% CHANGES IN PREMIUMS Changes may be made to the rate of premiums, from time to time. Changes to your risk classification, or Employer Group classification may also impact on your premiums. You will be provided with one month's written notice before any change in the premium rates affecting your cover. DO I NEED TO PROVIDE ANY INFORMATION ABOUT MY HEALTH IN ORDER TO HAVE INSURANCE COVER? Category A and B Members Death and Total & Permanent Disablement Insurance cover: Employer Fund has less than 10 members Employer Fund has between 10 members and 49 members Employer Fund has more than 49 members An application for cover, called a Personal Statement, will need to be completed. Cover will commence on the date your application is assessed and accepted by the Insurer. Cover up to the Insurer s Automatic Acceptance Limit of $400,000 will be provided without an application, subject to meeting the Automatic Cover provisions outlined below. Subject to negotiation Income Protection Insurance cover: Subject to confirmation Category C Members Emplus MySuper Default Table of Cover Insurance Cover: Two units of Emplus MySuper Default Table of Cover insurance cover will be provided without an application, subject to meeting the Automatic Cover provisions outlined below. All other insurance cover is subject to confirmation by the Insurer. An application for cover, called a Personal Statement, will need to be completed. Cover will commence on the date your application is assessed and accepted by the Insurer. Emplus ChildCare Division Insurance Guide Page 13

14 Automatic Cover Provisions Insurance cover under your Insurance Category is provided without the need for you to supply any health evidence, subject to: the amount of benefit is under the Insurer s Automatic Acceptance Limit you meet the Insurer s eligibility requirements each insurable member joins the Fund within 120 days of becoming an employee of the participating employer each insurable member is certified by their participating employer as being actively at work on the day they joined the Fund each insurable member is resident in Australia at work means the member or proposed member is an eligible person actively participating in his or her usual occupation on a full time basis (if engaged full time) or part time basis (if engaged part time) with his or her participating employer, or is on approved leave other than leave which is taken for reasons related to injury or illness and is not in receipt of and/or entitled to claim income support benefits from any source including workers compensation benefits, statutory transport accident benefits and disability income benefits. If the eligible person does not meet these requirements and is not engaged to work at least 15 hours per week, he or she cannot qualify as at work and is correspondingly described as not at work. Your insurance cover will be subject to confirmation by the Insurer, and you will be asked to provide satisfactory evidence of health, if: you do not meet all of the criteria noted above your insurance cover is in excess of the Insurer s Automatic Acceptance limits you have applied for additional insurance cover you have applied for additional units of insurance cover WHEN DOES INSURANCE COVER COMMENCE? Where the Automatic Cover Provisions apply, insurance cover up to the applicable Automatic Acceptance Limit commences when you join the Fund, subject to you actually being actively at work (as defined above) on the day that you joined the Fund. Where the Automatic Cover Provisions DO NOT apply, or if you have applied for Voluntary Cover or additional units of cover, the insurance is subject to the provision of satisfactory Health Evidence and will not commence until the Insurer has confirmed acceptance of your application. The Administrator will write to you once this has occurred. WHEN DOES INSURANCE COVER CEASE? Your death, TPD and income protection insurance will cease on the earliest of the following: You reach the benefit expiry age (usually age 65 or 69 depending on the type insurance cover) The date you commence active duty with the armed forces of any country You die You cease to be a member of the Fund The date the Policy terminates The date on which all premiums due in respect of you (including all arrears) have remained unpaid for 30 days from the date premiums were last payable You cancel your insurance cover effective from the date we receive your request or the date you specify the cancellation to be effective from, whichever is the later The date you have been on unpaid Employer Approved Leave (including paternity leave) for more than 12 months You depart Australia to work overseas and the Insurer has not approved continuation of cover whilst you are overseas A Terminal Illness benefit which is equal to your Death benefit is paid to you You are no longer working 15 hours per week and/or employed on a permanent basis (income protection cover only) A TPD benefit is paid or payable to you under the policy The date the Insurer cancels your cover or policy in accordance with its legal requirements In the case of Income Protection, benefits will cease at the earliest of the following: the end of the two year benefit period you reach the benefit expiry age you die you are no longer totally or partially disabled if you are on a working visa, the date your employment contract and/or visa expires or is terminated, or the date you depart Australia if you are receiving partial disability benefits, when you become capable of earning your pre-disability salary or greater. Please note: it is possible that your insurance cover may vary or cease in the event that you change occupations. Please contact the Administrator if you change occupations to ascertain that your cover will continue. CHANGING EMPLOYERS WITHIN THE CHILDCARE INDUSTRY? Your insurance cover automatically stays with you should you change employers while working in the Childcare industry. The basis for your insurance cover and premiums will remain the same as per the details in this PDS, subject to you continuing to meet the eligibility criteria. LEAVING THE CHILDCARE INDUSTRY? If you are no longer employed in the Childcare industry but wish to remain in the Fund, your insurance cover for Death and Total & Permanent Disablement will remain in place, subject to you continuing to meet the eligibility criteria. However, any Income Protection cover will cease unless you request for your Income Protection cover to continue, by notifying the Administrator within 30 days of ceasing to work in the Childcare Industry. The continuation of any insurance cover is subject to you continuing to meet the eligibility criteria, and your premiums Emplus ChildCare Division Insurance Guide Page 14

15 may change. The administrator will confirm your new details to you. HOW CAN I INCREASE COVER WITHOUT PROVIDING MEDICAL EVIDENCE? You may be entitled to apply for additional insurance as a member of Emplus Super without medical evidence. The following two options are available: Insurance Transfer Cover You may apply to transfer existing insurance cover with another superannuation fund to your Emplus account. By completing an Insurance Transfer Application you can apply to transfer up to $1,000,000 Death and TPD cover and up to $20,000 a month Income Protection insurance cover. The following conditions apply to the transfer of insurance cover: An Insurance Transfer Application must be completed You must provide evidence of the existence of the previous cover. We must receive the evidence within 60 days of the date it is issued. The previous cover must be current at the time you submit the Insurance Transfer Application You will be notified following the acceptance of the Insurance Transfer Application Where the previous cover was subject to any special conditions (e.g. restrictions, exclusions and/or premium loadings) the same special conditions will apply to the transferred cover You are not permitted to transfer cover from an insurance policy owned by the trustee of a self-managed superannuation fund You are not permitted to transfer cover where you have claimed or are entitled to claim on the previous cover Upon being notified of the acceptance of the Insurance Transfer Application; o You must cancel the previous cover o You must not transfer the previous cover to any other policy o You must not reinstate the previous cover or exercise any continuation option on the previous cover If the previous cover is not cancelled and the Insurer accepts an insurance claim, we will reduce any benefit payable by the amount of the previous cover that should have been cancelled Previous Income Protection insurance cover with a waiting period greater than 60 days cannot be transferred A 30 day waiting period will apply where the transferred Income Protection insurance cover has a waiting period of 30 days or less. A 60 day waiting period will apply where the transferred cover has a waiting period greater than 30 days but less than or equal to 60 days The two year benefit period will apply to the transferred Income Protection cover The transferred Income Protection insurance cover will replace any existing cover on your Emplus Super account The transferred Death & TPD insurance cover will be in addition to any existing cover on your Emplus Super account The Insurance Transfer Application form is available at or contact us on Life Events Cover You may apply to increase your Death & TPD cover without supplying medical evidence upon the occurrence of specific life events. The following conditions apply to Life Events cover: A Life Events Application must be submitted within 90 days of the occurrence of a specific life event You will be notified following the acceptance of the Life Events Application Specific life events include; your marriage, your dependent child starting secondary school, birth or adoption of your child and a new mortgage or increased mortgage on your principal place of residence You must be an insured member prior to the occurrence of the specific life event. The increase will only apply to the type of cover the member is insured for either Death only or Death and TPD. You must be less than 55 years of age at the date of the specific life event We will accept a Life Events Application only once in a 12 month period and, a maximum of 3 times during your membership with Emplus Super We will accept a Life Events Application with respect to marriage only once during the period of membership We must not have declined a previous application for insurance cover Any increase in cover cannot exceed the Maximum Benefit Level At the time of submitting your Life Events Application, you must not have made or be entitled to make a claim under any life insurance policy The increase in cover will be on the same terms and conditions that apply to your existing insurance cover Emplus ChildCare Division Insurance Guide Page 15