Insurance Regulations

Transcription

1 Insurance Regulations Liberty Foundation for Vested Pension Benefits

2 Table of contents Art. 1 Eligible persons Art. 2 Insurance coverage Art. 3 Admission to insurance Art. 4 Special risk countries Art. 5 Start and end of insurance coverage Art. 6 Account-holder s obligation to inform Art. 7 Risk premiums Art. 8 Claims Art. 9 Requisite documentation Art. 10 Additional information and verification of pension entitlement Art. 11 Account-holder s obligation to cooperate Art. 12 Limits to insurance coverage Art. 13 Payments Art. 14 Disability pension Art. 15 Supplementary lump-sum death benefit Art. 16 Omissions in the Regulations Art. 17 Authoritative language Art. 18 Amendment of Regulations Art. 19 Jurisdiction and governing law Art. 20 Effective date

3 Insurance Regulations Pursuant to Article 1(2) of the Pension Scheme Regulations of Liberty Foundation for Vested Pension Benefits (hereafter referred to as the Foundation ), the Foundation Board has adopted the following Insurance Regulations: (for greater clarity, references to the masculine gender include the feminine gender.) Art. 1 Eligible persons (hereafter referred to as Account-holders ) The following Account-holders are eligible for insurance coverage through the Foundation: 1 Swiss residents gainfully employed in Switzerland 2 Swiss residents gainfully employed in a foreign country 3 Non-active Swiss residents 4 Foreign residents gainfully employed in Switzerland 5 Foreign residents gainfully employed in a foreign country 6 Non-active foreign residents Art. 2 Insurance coverage 1 General insurance coverage Gainfully-employed Account-holders must have paid AHV/ IV//AVS/AI contributions for at least one year if they are Swiss residents and at least three years if they are foreign residents. Death and disability risks can be insured until the Account-holder reaches normal AHV/AVS retirement age at the latest. Insurance benefits automatically include sickness and accidents. Disability risk covers the following benefits: For gainfully-employed persons who are subject to Swiss social security: maximum 60% of the AHV/AVS contributory salary incl. 50% of the variable salary or bonus, maximum 60% of ALV/AC daily unemployment benefits or maximum 60% of the average AHV/AVS salary of the last three years, including 100% of the variable salary or bonus, subject to a maximum ceiling of CHF 300,000 p.a. For gainfully-employed persons who are not subject to Swiss social security: maximum 60% of the last AHV/AVS contributory salary incl. 50% of the variable salary or bonus, maximum 60% of the last ALV/AC daily unemployment benefits or maximum 60% of the average AHV/AVS salary of the last three years, including 100% of the variable salary or bonus, subject to a maximum ceiling of CHF 300,000 p.a. For non-actives (no AHV/AVS salary or ALV/AC benefits), the maximum disability pension is CHF 36,000 p.a. In the event of death, the following benefits are covered: For gainfully-employed persons who are subject to Swiss social security: maximum 600% of the AHV/AVS contributory salary incl. 50% of the variable salary or bonus, maximum 600% of ALV/AC daily unemployment benefits or maximum 600% of the average AHV/AVS salary of the last three years, including 100% of the variable salary or bonus, subject to a maximum ceiling of CHF 5,000,000 For gainfully-employed persons who are not subject to Swiss social security: maximum 600% of the last AHV/AVS contributory salary incl. 50% of the variable salary or bonus, maximum 600% of the last ALV/AC daily unemployment benefits or maximum 600% of the average AHV/AVS salary of the last three years, including 100% of the variable salary or bonus, subject to a maximum ceiling of CHF 5,000,000. For non-actives (no AHV/AVS salary or ALV/AC benefits), the maximum lump-sum death benefit is CHF 500, Additional requirements and exceptions to general insurance coverage a. Swiss residents gainfully employed in a foreign country Disability risk Account-holders gainfully employed under a local employment contract and Account-holders on a foreign posting must have been insured with the AHV/IV//AVS/AI for at least one year immediately before taking up their main occupation abroad. Disability risks can be insured at the latest until the Account-holder reaches normal AHV/AVS retirement age. b. Foreign residents gainfully employed in a foreign country Disability risk Account-holders gainfully employed under a local employment contract must have been insured with the AHV/IV// AVS/AI for at least three years immediately before giving up their Swiss residence; Account-holders on foreign posting must have been insured with the AHV/IV//AVS/AI for at least three years at the end of their term of posting. Disability risks can be insured at the latest until the Account-holder reaches normal AHV/AVS retirement age. c. Non-active foreign residents Death and disability risks Account-holders who are not gainfully employed as a main occupation must have been insured with the AHV/IV//AVS/ AI for at least three years immediately before permanently

4 giving up their Swiss residence or their main gainful employment abroad. Death and disability insurance coverage is limited to CHF 36,000 for disability benefits and CHF 500,000 for lump-sum death benefits and cannot be insured beyond the normal AHV/AVS retirement age. d. All insurable benefits are insured on a fixed-sum basis only. 3 The Foundation shall conclude reinsurance contracts with an insurance company that is subject to regulatory oversight to cover the offered risk benefits. The Foundation shall not be liable for any benefits beyond those covered by such reinsurance contracts. Art. 3 Admission to insurance 1 Risk insurance may only be contracted by Account-holders with full capacity for work. Account-holders shall submit the insurance certificate of the prior year or those of the last three years to evidence their declared AHV/AVS salary. 2 Account-holders must have a credit balance of at least CHF 1. on their vested benefits account with the Foundation. 3 Account-holders applying for insurance must complete a personal health questionnaire. They are also required to complete a health questionnaire if coverage is increased during the term of insurance. In both cases, the Foundation may request additional information and require the Account-holder to undergo a medical examination with its medical advisor. A medical examination is mandatory in the following cases: a. up to the age of 50: if insurance is contracted for a disability pension exceeding CHF 48,000 and/or a lump-sum death benefit exceeding CHF 500,000. b. as of age 50: if insurance is contracted for a disability pension exceeding CHF 36,000 and/or lump-sum death benefit exceeding CHF 500, If the information or medical examinations required to establish the Account-holder s health are not provided or undertaken in good time, the Foundation may deny risk benefits. 5 The Foundation may make reservations or deny the requested coverage. 6 Reservations cannot be made for durations exceeding 5 years. If the Account-holder s previous insurer had imposed medical exclusions for any given risk, the Foundation may take over such exclusions for the residual term of exclusion. 7 If an exclusion is imposed for a limited duration, no benefits will be granted during the vested benefit relationship in respect of the excluded risk if such risk occurs while the exclusion is still in effect. Art. 4 Special risk countries The Foundation may also restrict or deny coverage of death and disability risks in higher-risk countries. In this regard, see the countries list in Annex I and the Fact Sheet Entitlement to a Disability Pension & Benefit Limits. Art. 5 Start and end of insurance coverage 1 Coverage starts when the Insurer issues its definitive confirmation of coverage but not before the funds have been received on the Account-holder s vested benefits account. 2 From the start of the insurance until the definitive confirmation of coverage by the Insurer, but for no more than 60 days, temporary coverage shall be granted as follows for the benefits requested in the application form: Lump-sum death benefit up to a ceiling of CHF 100,000 Disability pension up to a ceiling of CHF 36,000 per year No benefits are granted for claims resulting from a disease, disability or the sequels of an accident which existed prior to the start of temporary coverage. 3 Insurance coverage may be changed, canceled or terminated for the end of any calendar month subject to 90 days notice. 4 If the vested benefits account is cashed in or transferred, the insurance protection shall expire when (value date) the pension assets are credited to the Account-holder s account or transferred to his new pension institution. 5 If the vested benefit account relationship with the Foundation is terminated, insurance coverage shall cease on expiry of the notice period but at the latest when the vested benefits account is liquidated. However, insurance coverage ends for all Account-holders when they reach the normal AHV/AVS retirement date. Art. 6 Account-holder s obligation to inform 1 Account-holders who are gainfully employed abroad are required to notify the Foundation of any changes affecting their mandatory or voluntary AHV/IV//AVS/AI insurance. 2 This obligation to inform also applies to insured gainfully employed foreign residents who give up their principal gainful employment. Art. 7 Risk premiums 1 Risk premiums for the agreed coverage are either debited to the Account-holder s vested benefits account or invoiced to him. 2 In special cases, premiums may be paid by the employer.

5 3 Premium waivers are also insured with the disability risk. In case of an insured event, the agreed insurance coverage (disability pension and lump-sum death benefit) will be maintained free of premium subject to a waiting period of 3 months. In the case of a pure life insurance, premiums remain due. 4 The risk premium applied at the start of the insurance is a one-year rate valid for the current calendar year. If coverage is extended for a further year, the premium shall be adjusted accordingly. Premium tariffs are not guaranteed. Art. 8 Claims 1 Claims shall be submitted to the Foundation without delay. 2 The Foundation must be notified immediately of any events and circumstances liable to affect the nature and scope of coverage. 3 If an insured event is declared belatedly through gross negligence, the Foundation may deny benefits. Art. 9 Requisite documentation The Account-holder and his survivors shall submit the following requisite documentation inter alia at their own expense: Disability claims a. duly completed questionnaire concerning the earning incapacity b. medical report c. all relevant social insurance decisions, especially those of the Federal Disability Insurance, accident insurance, military insurance, daily sickness benefits insurance as well as any decisions of foreign social insurance entities. Death claims a. official death certificate b. medical certificate indicating the cause of death c. family record book/certificate Art. 10 Additional information and verification of pension entitlement 1 In order to determine the scope of benefits, the Foundation may ask for additional documents and information. 2 The Foundation is entitled to verify pension entitlements at any time and to subordinate the continued payment of a pension to a confirmation that the recipient is still alive. Art. 11 Account-holder s obligation to cooperate 1 Account-holders claiming or drawing disability benefits are required to cooperative actively with all health inquiries, medical examinations and any reasonable rehabilitation measures. If cooperation is refused, the Foundation may reduce benefits or deny further payments. 2 The Foundation may require the Account-holder to assign to it his claims against any liable third-parties or liability insurance up to the amount of the contractual benefits. 3 If the Account-holder does not satisfy this requirement within four weeks of the relevant reminder, the Foundation may refuse to pay benefits. Art. 12 Limitation of insurance coverage 1 Reduction in accordance with other social insurance decisions If the AHV/AVS, the IV/AI or the accident insurance reduces, withdraws, or denies benefits on the grounds that the death or disability was caused by gross negligence on the part of the beneficiary or the Account-holder, or if the latter refuses rehabilitation measures, the Foundation may reduce its benefits accordingly. 2 Fault If an event is the result of serious (deliberate) fault on the part of the Account-holder or a beneficiary, the Foundation shall not be obligated to pay benefits. In case of gross negligence on the part of the Account-holder or the beneficiary, the Foundation may reduce its benefits proportionately to the degree of fault. If the Account-holder commits (or attempts to commit) suicide, the Foundation has no obligation to pay benefits in the first three years of insurance coverage. This also applies if the Account-holder acted when he was of unsound mind or in a state of diminished responsibility. 3 Breach of the duty to disclose If the Account-holder inaccurately discloses or fails to disclose any circumstance of which he is aware or should be aware which is liable to seriously affect his personal health, the Foundation may reduce its benefits in case of an insured event provided those circumstances actually caused the subsequent death or disability. The failure to disclose smoking in his insurance application, or during the term of insurance if the Account-holder takes up smoking later, constitutes a breach of the duty to disclose. 4 Acts of war Events caused directly or indirectly by a war waged by Switzerland or by acts of war in which Switzerland is involved are not insured regardless whether the Account-holder participated in the war and is staying in Switzerland or abroad. This exclusion also applies to Account-holders who participate in a war or acts of war, even if Switzerland is not waging the war and is not involved in the acts of war, or if the Accountholder takes part in a civil war. The Foundation is also released from its obligation to pay benefits if the Account-holder becomes incapacitated during or as

6 a result of a stay in a country at war or in war-like circumstances. In that case, the Foundation is only required to pay benefits if it is proven that the earning incapacity has no direct or indirect connection with the war or the war-like circumstances. 5 Radioactivity Events which are the direct result of nuclear reactions such as splitting or melting are not insured. Notwithstanding, if such events are the result of medical treatment or fall within the scope of professional activities, they are covered. Art. 13 Payments 1 Disability benefits are paid monthly in advance in the form of a pension. 6 Definition of disability according to the Federal Law on General Social Insurance Law (ATSG/LPGA): Disability is understood to mean full or partial earning incapacity which is presumed to be permanent or long-term. 7 The obligation to pay disability benefits is established based on a final decision of the Federal Disability Insurance (IV/AI) recognising a disability. The amount of the pension is based on the degree of disability recognised by the Federal Disability Insurance. Where necessary, an opinion from the medical advisor may be obtained. 8 In cases of partial disability, benefits shall be adapted to the degree of earning incapacity. Pensions are calculated in accordance with the following table: 2 Death benefits are paid out in the form of lump-sum capital. 3 Payments to foreign residents are subject to withholding tax. Art. 14 Disability pension 1 The Account-holder s personal insurance certificate specifies the nature and amount of the insured disability benefits. 2 Disability claims are determined in accordance with Swiss law. The provisions of the Federal Law on General Social Insurance Law (ATSG/LPGA) and Federal Law on Disability Insurance are applicable (IVG/LAI). 3 Insured disability events start from the beginning of the relevant incapacity for work, the cause of which led to the subsequent death or disability. 4 Definition of incapacity for work according to the Federal Law on General Social Insurance Law (ATSG/LPGA): incapacity for work means a full or partial incapacity, caused by an impairment of physical, mental or psychological health, to undertake work which could be reasonably required of the insured s in his current profession or functions. In case of longer-term incapacity, the ability to perform work which could be reasonably expected in another profession or other functions is taken into account. 5 Definition of earning incapacity according to the Federal Law on General Social Insurance Law (ATSG/LPGA): Earning incapacity means a full or partial loss of earning capacity on a balanced labour market caused by an impairment of physical, mental or psychological health, and which persists after reasonable treatment and rehabilitation measures. In establishing earning incapacity, only the consequences of the health impairment shall be considered. Moreover, earning incapacity only exists if it cannot objectively be overcome. Degree of earning Pension incapacity 40 % 49,9 % One quarter of a pension 50 % 59,9 % One half of a pension 60 % 69,9 % Three-quarters of a pension As of 70 % Full pension There is no entitlement to benefits when the partial earning incapacity is less than 40%. 9 The obligation to pay benefits begins in the month when the obligation is notified, but not before the expiry of the waiting period. The waiting period for a disability pension is 24 months and for a premium waiver 3 months. 10 If a renewed incapacity for work or earning incapacity arises within one year owing to the same cause (relapse), the waiting period shall not start to run anew. 11 The entitlement to benefits expires at the death of the Account-holder, when his earning incapacity falls below 40% and in any event on reaching the normal AHV/AVS retirement age valid at the start of the IV/AI pension. Art. 15 Supplementary lump-sum death benefit 1 The Account-holder s personal insurance certificate specifies the nature and amount of the insured supplemental lump-sum death benefit. 2 If the Account-holder dies before reaching the normal AHV/ AVS retirement age, the accrued pension assets will be paid to the beneficiaries together with the insured supplementary lump-sum death benefit, if any, in the order provided in Article 15 FZV/OLP or as provided in the Notice of Beneficiaries filed with the Foundation. If death occurs after the normal AHV/AVS retirement age, only the accrued pension assets are paid out.

7 Art. 16 Omissions in the Regulations If any provision has been omitted from these Regulations on any specific point, the Foundation Board shall adopt an appropriate rule. Art. 17 Authoritative language All Regulations shall be construed and interpreted in the German-language version. Art. 18 Amendments The Foundation Board may decide to amend these Regulations at any time: these Regulations are freely available at or may be obtained from the Foundation. Art. 19 Jurisdiction and governing law All Regulations are governed by Swiss law. Disputes between the Account-holder and the Foundation are subject to the jurisdiction of the courts in accordance with Article 73 BVG/ LPP. In all other respects, the place of jurisdiction is Schwyz. Art. 20 Effective date These Regulations are effective from 1 September 2015 and replace the previous regulations of 1 August Schwyz, 24 September 2015 Foundation Board of Liberty Foundation for Vested Pension Benefits Annex 1 Reinsurance cover High risk countries

8 Annex I Reinsurance cover High risk countries The simplified form of the determination of premiums and contributions depend on certain restrictions regarding domicile (abroad) of the insured persons. This list distinguishes between countries where no coverage (Risk Level 1) or only limited cover (Risk Level 2) may be granted. All countries not listed here can be insured without restrictions. In case of doubt, we recommend submission of the cases of PartnerRe. The reinsurer s current list shall be authoritative. Date of review: July 15, 2015