we make it easy for you

Transcription

1 Insurance Guide PDS Supplement we make it easy for you Dated 2 December 2013 CARE Super Pty Ltd (Trustee) ABN AFSL CARE Super (Fund) ABN

2 PDS Supplement The information in this document forms part of the CareSuper Member Guide Product Disclosure Statement dated 2 December Contents Insurance CareSuper has you covered 2 Default insurance cover 4 Personal Plan members 6 Types of insurance 7 How much cover do you need? 12 Insurance what do I need to know? 13 The information in this Insurance Guide applies to Employee Plan members and Personal Plan members. Claiming an insurance benefit 16 Definitions for insurance 19

3 the insurance options available to you will depend on what type of member you are CareSuper offers members access to death, total & permanent disablement and income protection insurance cover at competitive rates. The insurance options available to you will depend on the type of membership you have with us. Which insurance arrangement applies to you? Default... Personal Plan members... Eligible Employee Plan members automatically receive the default level of insurance under CareSuper s Group policy. See page 4 for details on default cover. Need to apply for insurance cover, as it s not automatically provided to you upon joining CareSuper. Refer to page 6 of this Insurance Guide for further information. Note: You may also be able to transfer external insurance cover to CareSuper, subject to conditions. Refer to page 13 for details. Getting advice The advice in this Insurance Guide is of a general nature. It has been prepared without taking into account employers or members particular financial needs, circumstances and objectives. We recommend that members should assess their own financial situation before making a decision about their insurance cover based on the information contained in this document. This may involve seeking the help of a licensed or authorised adviser. CareSuper insurance 1

4 Insurance CareSuper has you covered You wouldn t think twice about insuring your car or your house. But your ability to earn an income is your biggest asset, and it s what really creates financial security. If that was suddenly taken away, insurance cover could help reduce the impact on you or your family. CareSuper insurance premiums are paid from your super contributions before they are taxed, making them even better value for money and you won t feel the impact on your take-home pay. CareSuper offers three types of insurance cover to eligible members: death, total & permanent disablement (TPD) and income protection: Death cover provides a lump sum payment to your beneficiaries if you 1 die (certain restrictions apply). This can help you to ensure the ongoing well-being of family members, even if you are not around to provide for them. Early release of the death benefit may also be available if you are terminally ill (see definition of terminal illness on page 19). You must be aged under 70 and meet other eligibility criteria to obtain death cover. 2 Total 3 Income & permanent disablement (TPD) cover provides a lump sum payment if you are never able to work again (specific definitions apply). This payment could be used to cover medical bills, rehabilitation expenses or medically required home modifications, and to ensure the overall security of your family and your home. You must be aged under 65 and meet other eligibility criteria to obtain TPD cover. If you have previously been paid a TPD payment of any type as a result of a TPD claim, you will only be eligible for death cover with CareSuper, not TPD or income protection cover. protection cover provides a temporary replacement income if you are unable to work due to illness or injury (specific conditions apply). This means you can continue to pay your bills while taking the time to recover and rehabilitate. You must be aged under 65 and on an ongoing basis be earning at least $16,000 p.a. or working 15 hours or more per week to be eligible for income protection cover. Each of these types of cover are explained in detail in the following pages. how much or what type of insurance you need depends on your circumstances 2

5 How it works How much it costs Employee Plan members At CareSuper, each eligible Employee Plan member receives our default insurance cover under CareSuper s Group Policy, however limited default cover ( limited cover ) may apply in certain circumstances. See page 19 for a definition of limited cover. Default cover is provided in units of death and TPD cover. The number of units you receive depends on your age and the amount of cover per unit depends on your age and occupation. With unit-based cover, the same premium per unit applies each year, but your level of cover decreases with each birthday from age 30. If you are an eligible new Employee Plan member, you can also increase this cover up to 10 times your annual salary to a maximum of $1.55 million, and/or add income protection cover, without the need to provide evidence of health if you do so within 90 days of the date on your Welcome letter or . Personal Plan members At CareSuper, Personal Plan members are still eligible for great choices in cover but it must be applied for. For details on tailoring your cover see page 6. It s important to note that units of insurance are not related to units in investment terms. The premium for 1 unit of death cover is $1.05 per week. The premium for 1 unit of TPD cover is $0.85 per week. The premium for 1 unit of death and TPD cover is $1.90 per week. These are the base premiums for all occupational categories. The General occupational category will apply until we are otherwise advised by you. Premiums are subject to change. Different premiums may apply for tailored cover. A portion of the premium is contributed to CareSuper s Group Life Reserve. The Group Life Reserve is used to cover the administration and management of CareSuper s insurance. Tailoring your cover You also have the option to choose fixed death and TPD cover, where your cover is set at a fixed dollar amount. The fixed cover you select must be in multiples of $1000. With fixed cover, the amount you pay will increase with each birthday, but the amount of cover will remain the same. Fixed cover can also be indexed to increase by 5% on 1 July each year, offering added security against the rising cost of living. Further information about tailored cover for Employee Plan members and Personal Plan members is provided on the following pages. Insurance premiums are deducted from your account at the sell unit price. For information about investment unit prices see Fees and other costs available at caresuper.com.au/pds. Did you know? To qualify as an eligible default fund for employers compulsory super contributions (where an employee does not choose their own fund), a super fund has to provide a certain level of death and TPD insurance cover for members. It s important to think about insurance while you re fit and well, as it can be more difficult to obtain if you ve suffered an illness or injury. Insurance cover through your super fund is purchased at group rates which is usually cheaper than getting cover yourself. All insurance cover (including default cover) is subject to the insurer s terms and conditions summarised in the following pages. CareSuper insurance 3

6 Default insurance cover for Employee Plan members Our default cover CareSuper s default insurance cover Age Death cover TPD cover Cost per week unit 4 units $ units 4 units $ units $4.20 Every eligible Employee Plan member gets default cover at the time of joining CareSuper in accordance with CareSuper s Group policy. Your eligibility for default cover depends on your age and other conditions relating to the commencement of cover described on page 13 of this guide. In certain circumstances limited cover only will apply or you may not be eligible for default TPD cover (for example, if you have previously received a TPD payment). Default insurance cover does not include income protection cover. Insurance needs often change over the course of an individual s working life. Before 30, for instance, you might not have a lot of debt or anyone who relies on you financially, but you probably don t have a lot of super to help if you suddenly stopped working. Meanwhile, those over 30 are more likely to have dependants or bigger financial commitments. For this reason, if you are under 30 you receive a default cover amount of 1 unit of death cover, and 4 units of TPD cover. At age 30, death cover increases to 4 units, to match TPD cover. If you are 30 to 64, you will receive a default cover amount of 4 units of death and TPD cover. If you are aged 65 to 69, 4 units of death cover only applies. Default cover is subject to restrictions and exclusions described later in this guide. For example, if you have previously received a TPD payment, you will only be eligible for death cover. Refer to page 8 to see how much cover each unit provides. Refer to page 13 for details on when your cover starts and other important terms and conditions. It also pays to review all your insurance from time to time, to be sure that it changes with your needs. adjust your cover to suit your needs 4

7 Tailoring your insurance cover How much cover you need depends on your individual circumstances. While you ll automatically receive the default level of cover if you are eligible, it s a good idea to assess your actual insurance needs, and adjust your cover accordingly. Your insurance options Available to eligible new Employee Plan members within 90 days of the date on your Welcome letter or Take up a New Member Option with no medical evidence required: 1. Add income protection and/or 2. Increase death and TPD cover up to 10 times your annual salary, to a maximum of $1.55 million To qualify for a New Member Option without providing medical evidence, your application must be received within 90 days of the date on your Welcome letter or by completing the Insurance application form available at caresuper.com.au/forms. If you are not in active employment limited cover may apply. See page 19 for details. Important To qualify for a New Member Option without having to provide medical evidence, you must apply within 90 days of the date on your Welcome letter or . Specific life events cover is applicable only to Employee Plan members. Default cover and cover under a New Member Option may be limited cover in certain circumstances. Refer to page 19 for details. Insurance forms can be found at caresuper.com.au/forms. Available on specific life events Increase your death and TPD cover by one unit or the equivalent amount of fixed cover depending on your age for specific life events, without having to provide medical evidence (subject to eligibility). To qualify for cover available on specific life events, you must be an Employee Plan member and apply within 90 days of the event. See page 10 for more details. Available any time after joining Increasing your cover, either by nominating more units or adding a fixed cover amount, to a maximum of $10 million for death cover and $3 million for TPD Changing your unit-based cover to fixed cover so the amount of cover stays the same Indexing fixed insurance cover Taking up or increasing income protection cover Making sure you re in the right occupational category so you receive the applicable level of cover Applications for varied or increased cover are subject to assessment by CareSuper s insurer. If you would like to apply for further cover, your application will need to be approved by the insurer. To apply, simply complete the Insurance application form available at caresuper.com.au/forms or log on to MemberOnline and go to the Insurance section. Default insurance cover To create a MemberOnline account, go to caresuper.com.au. These options are discussed in more detail in the following pages. Cover subject to medical exclusions may be available if you have an existing condition that prevents you from being eligible for cover. For more information call the CareSuperLine on

8 Personal Plan members If you are not linked to an employer and make your own contributions to your super, you are a Personal Plan member. Personal Plan members do not receive default insurance, but can still apply for great cover. Tailoring your insurance cover How much cover you need depends on your individual circumstances. It s a good idea to assess your actual insurance needs. It also pays to review all your insurance from time to time, to be sure that it changes with your needs. You can apply for cover up to the maximum levels below. Your insurance options (evidence of health required) Death Up to $10,000,000 (unit-based or fixed) TPD Up to $3,000,000 (unit-based or fixed) Income protection Up to $40,000 per month* (unit-based only) * The maximum monthly benefit is 85% of the first $423,530 income per annum, for the entire benefit payment period, plus 60% of the next $200,000 income per annum for the first two years of the benefit payment period. You can apply for death only, TPD only or death and TPD cover. Income protection can be purchased as a stand alone product or combined with death or TPD or death and TPD cover. If you have previously received a payment of any type as a result of a TPD claim, you are only able to apply for death only cover. Refer to page 8 to see how much cover each unit provides for your age and occupational category. Additional choices Changing your unit-based cover to fixed cover so the amount of cover stays the same Indexing fixed insurance cover Applying for income protection cover Making sure you re in the right occupational category so you receive the applicable level of cover. These options are discussed in more detail in the coming pages. Getting started Once you have determined what type and how much cover you need, simply complete the Insurance application form available at caresuper.com.au/forms, including the Personal Statement, or apply online. To apply online log on to MemberOnline and go to the Insurance section. To create a MemberOnline account, go to caresuper.com.au. All applications for cover are subject to assessment by CareSuper s insurer. it pays to review all your insurance from time to time... 6

9 Types of insurance If you have default cover, you can use the information on pages 8 12 to help determine how you can tailor your cover. If you don t have default cover, this information provides a guide to what cover you can apply for, however evidence of health is required. If eligible you will receive insurance at the General occupational category level until you complete and lodge the Changing your occupational category form available at caresuper.com.au/forms. Death and TPD cover How much cover do I need? Once you understand the type and level of cover you require, check out our default cover (if applicable) to see if it meets your needs. First determine your occupational category by answering the three simple questions at right. Then use the tables and examples on pages 8 9 (for death and TPD) and page 11 (for income protection) to calculate the extra cover you can apply for. On page 12 you can calculate how much cover you need, and the cost of this cover per week. To tailor your cover (for example, by increasing your units, or fixing or indexing your cover), simply indicate your choices when filling out the Insurance application form available at caresuper.com.au/forms. Occupational categories To reflect the different levels of risk associated with our members different roles and occupations, CareSuper has three different occupational categories. Each category has a different amount of cover per unit. The three categories are: General Office, and Professional. To determine your occupational category, answer the following questions: 1. Are the duties of your occupation limited to professional, managerial, administrative, clerical, secretarial or similar white collar tasks which do not involve manual work and are undertaken entirely within an office environment (excluding travel time from one office environment to another)? 2. Are you earning in excess of $80,000 from your profession? 3a. Do you hold a tertiary qualification, or are you a member of a professional institute or registered by a government body? or 3b. Are you in a management role? (Please refer to the Manager section in the TPD definition on page 20 for guidance.) Your occupational category will be reviewed each time you complete a new application form or apply to vary your insurance cover, unless medical evidence is not required. You can apply to change your occupational category at any time by completing the relevant insurance form. If you answered no to all of the questions, you qualify for the General occupational category. If you answered yes to Q1 you qualify for the Office occupational category. If you answered yes to Q1 and Q2, and to either Q3a or Q3b, you qualify for the Professional occupational category. Types of insurance Did you know? CareSuper insurance arrangements have been specifically designed to be a simple, tax-effective option. Insurance premiums are paid from your super contributions so you won t feel the impact on your take-home pay. 7

10 Types of insurance (continued) Example John is aged 40 and qualifies for the General occupational category, so one unit equals $73,100 of cover. He has determined that he needs $550,000 of cover. $550,000 = 7.52 units $73,100 Therefore John needs 8 units of death and TPD cover and will have to apply for some or all of this cover depending on whether he has existing cover. how much or what type of insurance you need depends on your circumstances Unit-based cover: benefit for 1 unit death and TPD ($) Age General Office Professional 15 to , , , , , , , , , , , , , , , , , , , , , ,430 96, , ,320 91, , ,200 87, , ,100 85, , ,980 81, , ,870 76, , ,330 73, , ,390 69,380 97, ,860 66,800 93, ,910 63,220 88, ,970 59,750 83, ,230 56,490 78, ,390 53,020 74, ,870 50,070 70, ,820 46,390 64, ,980 43,030 60, ,030 39,450 55, ,510 36,500 51, ,460 32,820 45, ,830 29,670 41, ,990 26,300 36, ,040 22,830 31, ,520 19,780 27, ,570 16,310 22, ,730 12,830 17, ,630 10,310 14, ,630 10,310 14, ,630 10,310 14, to 69* 8,340 9,050 12,690 * Death only cover Note: Your cover will cease when you reach age 70 for death cover and 65 for TPD cover. 8

11 How does fixed cover work? With unit-based cover, the level of cover will decrease with age but your premium will stay the same. With fixed cover, the reverse is true; your amount of cover will stay the same but the premium will increase with age and is determined by your age and occupational category. You can also choose to have your fixed cover indexed meaning that it increases by 5% on 1 July each year to account for inflation. You must apply for a minimum of $10,000 of fixed cover and it must be in multiples of $1,000. To determine what your annual premium would be for fixed cover, divide your required level of cover by $1000, and multiply by the premium that corresponds to your age and occupational category. Example Anna is aged 40, in the General occupational category and has applied for $550,000 of fixed death and TPD cover. Her premiums at intervals over the next 15 years are shown below (without indexation and assuming no other changes in premiums occur). Age 40 $550,000 x 1.36 = $ p.a. $1,000 Age 45 $550,000 x 1.77 = $ p.a. $1,000 Age 50 $550,000 x 2.37 = $ p.a. $1,000 Age 55 $550,000 x 3.61 = $ p.a. $1,000 Premium per year per $1000 sum insured of fixed cover ($) Age General Office Professional Death TPD Death & TPD Death TPD Death & TPD Death TPD Death & TPD 15 to to 69* Types of insurance Note: Fixed cover is available to all members on application to the insurer. * Death only cover Insurance premiums are deducted from your account at the sell unit price. For information about unit prices see Fees and other costs available at caresuper.com.au/pds. 9

12 Types of insurance (continued) Income protection cover Who can apply? Anyone aged under 65 earning on an ongoing basis at least $16,000 p.a. or working 15 hours or more per week is eligible to apply for income protection insurance, including contractors, parttime employees and casual employees. You will not be eligible for income protection cover if you have previously been paid a TPD claim. How much income protection cover do I need? Income protection cover can be tailored to suit your requirements with the following options to choose from: A waiting period of 30, 60 or 90 days, and A benefit period of either 2 or 5 years. The maximum amount of income protection cover you can apply for is determined by your salary. How much you decide you need depends on your estimation of your required income if you are not working. Your cover will automatically increase by 5% on 1 July each year to account for inflation. Premiums will be based on the increased cover. The maximum monthly benefit is 85% of the first $423,530 income per annum, for the entire benefit payment period plus 60% of the next $200,000 income per annum for the first two years of the benefit payment period. Each unit of income protection cover provides a benefit of $425 of which $375 (less appropriate income tax) is payable as a benefit to you and $50 is payable to your CareSuper account as a superannuation contribution. Continued contributions to super help to keep you on track for your retirement goals and help to maintain a sufficient balance in your account to continue covering your insurance premiums. The maximum income protection cover you can apply for with no evidence of health required (if your application is received within 90 days of the date of your Welcome letter or ) depends on your occupational category, as below: General category: a salary of up to $72,000 p.a. (or 12 units) can be covered Office category: a salary of up to $102,000 p.a. (17 units) can be covered Professional category: a salary of up to $144,000 p.a. (24 units) can be covered. If you need more cover, tailored income protection allows you to apply for as many units as you like up to the maximum monthly benefit. This cover will be subject to assessment and acceptance by our insurer. Premium loadings and/or exclusions may apply to some members. How much does income protection cover cost? The cost of income protection cover is based on your age, your occupational category, the waiting period you select (30, 60 or 90 days) and the benefit period you choose (2 or 5 years). The cost decreases if you wait longer to receive your benefit. If you do not make a selection the default waiting period is 30 days. The cost increases if you choose the 5-year benefit period. If you do not indicate a benefit period on your application form, the 2-year (default) benefit period will apply. Using the number of units you have determined you need (see page 12), use the tables on page 11 to calculate your weekly premium. The premiums are deducted from your CareSuper account before contributions tax is deducted. This means you can pay for your insurance using your Super Guarantee contributions, in a tax-effective manner that doesn t impact on your take-home pay. easy upgrade on specific life events As an Employee Plan member you can increase your death and TPD cover by one unit or the equivalent amount of fixed cover depending on your age for specific life events, without having to provide medical evidence. The life events include: Marriage Registration of a de facto relationship Divorce Birth or adoption Taking out a mortgage Your child s first day at primary or secondary school Death of your spouse. The total amount of insured cover which has not been subject to underwriting cannot exceed the automatic acceptance limit of the lesser of 10 times your annual salary and $1.55 million. To qualify for a life event increase without providing medical evidence, your application must be received within 90 days of the event occurring. You can only increase your cover for life events with no medical evidence four times during your membership and you must be in active employment at the time of your application. See page 19 for a definition of active employment. To apply for a life event increase in death and TPD cover, simply complete the Life events cover application form available at caresuper.com.au. 10

13 Waiting period Premium per week per unit of income protection cover (2-year benefit period) General Office Professional 30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days Current age $ $ $ Note: cover will automatically increase by 5% on 1 July each year to account for inflation. Waiting period Premium per week per unit of income protection cover (5-year benefit period) General Office Professional 30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days Current age $ $ $ Types of insurance Note: Income protection cover will automatically increase by 5% on 1 July each year to account for inflation. Insurance premiums are deducted from your account at the sell unit price. For information about investment unit prices see Fees and other costs available at caresuper.com.au/pds. 11

14 How much cover do you need? Death and total & permanent disablement insurance How to calculate your death and TPD benefit and premium If you have default cover you can use the following table to calculate the number of units of cover needed to meet your insurance requirements for death and TPD, as well as the weekly cost of this cover. If you are a Personal Plan member you can also use the following table as a guide, keeping in mind that default cover does not apply. Refer to page 8 for benefits table. Refer to page 3 for premiums applicable to unit-based cover. If you would like fixed cover, refer to page 9 for premiums table. Important questions Example * Your calculation How much insurance cover would you need to meet your commitments in the event of your death or disablement? Consider your current financial needs mortgage repayments, car loans, credit cards, school fees, food, clothing, etc. Keep in mind other assets, such as savings or super, which might be accessed to assist in meeting your commitments. Using the information on page 7, determine your occupational category. Then, using the table on page 8, check whether this changes your benefit per unit. All members are allocated to the General occupational category until you complete and lodge the Insurance application form. In this example the member is aged 40 and qualifies for the Office category. Check what cover you may already have. If you have default cover, see page 4 for the number of units you receive. Refer to the table on page 8 and locate the benefit payable for the cover that applies to your age and occupational category. If the benefit amount (B) is less than the amount of your commitments (A), then you may not have enough insurance cover. This may depend on what other insurance cover you have directly or via another super fund. At this point, you might like to consider applying for tailored cover to meet any shortfall for example, a fixed amount of cover (see page 9), or alternatively, please continue for unit-based cover. Work out the difference between your existing cover and the cover you want. Refer to the table on page 8 and locate the benefit payable for one unit of cover for your age and occupational category (C). To work out the number of units required, calculate A C. Round this figure up if not whole. How many units of death and TPD cover are required? (including the existing cover (A)) How much will it cost? Unit-based cover is $1.90 per week per unit of death and TPD cover. In this example the member has increased their cover by $135,250 for an extra cost of $1.90 per week ($49,720 by correcting their occupational category plus $85,530 for an extra unit). $400,000 (A) Category change from General ($73,100 per unit) to Office ($85,530 per unit) $85,530* x 4 = $342,100 (B) $85,530 (C) A C $400,000 $85,530 = 4.7 units rounds up to 5 units 5 units of cover are required, providing cover of 5 x $85,530 = $427,650 5 x $1.90 = $9.50 per week * In this example the member has default cover, is 40 years old and is covered under the General occupational category (that is, the member has 4 units of death and TPD). Remember, unit-based cover decreases with age, so you should take this into consideration. Income protection insurance How to calculate your income protection benefit and premium You can use the following table to calculate the number of units needed to meet your insurance requirements for income protection, as well as the weekly cost of this cover. Refer to page 11 for premiums Important questions Example* Your calculation On average, how much do you earn before tax each month? $2200 Multiply this by 85%.** The result is the maximum benefit amount you could receive per month if you made a claim. Divide this by $425 and round up to the nearest whole number. The result is the maximum number of units of income protection cover you may apply for. For every $425 benefit, $375 (less your appropriate income tax) will be paid into your nominated bank account and $50 will go into your CareSuper account. How much will it cost? Multiply the number of units of cover by the premium that relates to your age under the General, Office or Professional occupational category after selecting suitable waiting and benefit periods (see the tables on page 11). This is your weekly premium. * In this example the member is aged 35, is covered under the General occupational category and has chosen a 60-day waiting period and a benefit period of two years. ** The benefit amount must not exceed 85% of the first $423,530 income per annum for the entire benefit payment period, plus 60% of the next $200,000 income per annum for the first two years of the benefit payment period. $2200 x 0.85 = $1870 $1870 $425 = rounds up to 5 5 units x $0.48* = $2.40 per week Note: Income protection must be applied for and is subject to acceptance by the insurer. Premium loadings and/or exclusions may apply to some members.

15 Insurance what do I need to know? Transferring your insurance You may be able to transfer your current super or retail insurance arrangement to CareSuper without having to provide medical evidence. To transfer your existing cover, please complete the Transfer your insurance form available at caresuper.com.au/forms and provide the required documentation. This option is available to both Employee Plan members and Personal Plan members. You may transfer up to $2 million death and TPD cover which will be added to any existing cover in the fund (up to the cover maximums). If you want to transfer cover in excess of $2 million, you will need to be assessed and accepted by our insurer. If the transferred income protection cover is higher than the cover held with CareSuper it will replace any existing cover you have. The maximum amount that may be transferred for income protection is $20,000 per month. The waiting period and benefit payment period will be adjusted in line with CareSuper s insurance design. For example, if the income protection cover transferred has a to age 65 benefit period, you will be provided with a 5-year benefit period under CareSuper. The waiting period will be rounded up to the next highest waiting period under CareSuper (for example, a 45-day waiting period will be rounded up to 60 days under CareSuper). Transferred cover will commence in CareSuper on the date the following are satisfied: The date the insurer accepts your application, and You cancel your existing insurance cover under your former fund, and The whole account balance from your former fund has been transferred to CareSuper (for super transfers). If the insurer accepts your application, your existing amount of death/tpd cover as at the transfer date under your former fund/policy will be added to any existing death/tpd cover held with CareSuper by allocation to your CareSuper account of sufficient units rounded up to the next whole unit or sufficient fixed cover rounded up to the nearest $1,000. When does my default insurance cover commence? Provided you are eligible, default cover commences on the later of: The first day of the period for which the first Superannuation Guarantee (SG) employer contribution is paid by your employer (usually the date you commence work with your employer), or The date your employer becomes a participating employer of CareSuper. In some instances, this will be the date on which CareSuper receives the first SG employer contribution on your behalf, or The date 130 days before we receive your first SG employer contribution. Please refer to the Exclusions and restrictions section on pages for further information about commencement of cover. Any tailored or transferred cover which is applied for by a member who has default cover commences on the date we advise you in writing. When does Personal Plan insurance cover commence? For Personal Plan members, cover commences on the date you are advised in writing that cover has been accepted. Personal Plan members are also required to have a minimum balance of $1,500 before cover commences. peace of mind knowing your dependants will be covered What do I need to know? 13

16 Insurance what do I need to know? (continued) Can I change my cover later? Yes. You can apply to change the amount of cover you have at any time. For information about your insurance options, refer to page 5. Employee Plan members can increase death and TPD cover based on specific life events without having to provide medical evidence, provided the request is made within 90 days of the relevant event (see page 10). If you would like to increase your insurance cover at times other than on a specific life event, or re-commence insurance cover, you will need to be approved by the insurer. Your occupational category will be reviewed each time you complete a new application or apply to vary insurance cover, unless medical evidence is not required. Applications may be subject to premium loadings and/or exclusions. To apply for an increase in insurance cover you can complete the Insurance application form at caresuper.com.au/forms, or apply online. To apply online log on to MemberOnline and go to the Insurance section. To create a MemberOnline account, go to caresuper.com.au. If you would like to reduce your level of cover, remove the TPD component so you have death only cover, remove income protection cover, remove the death component so you have TPD only cover, or opt out of insurance altogether, call the CareSuperLine on to request the relevant form. Remember, if you do reduce or opt out of cover and you wish to increase or re-commence cover at a later date you will need to meet the insurer s assessment requirements and you may be required to provide evidence of health. Is there a cooling off period? There is a cooling off period for tailored insurance cover, including life event increases. You have 21 days, from the date you are advised that you have been accepted for insurance, to review the terms and conditions to ensure they meet your needs this is known as the cooling off period. You may cancel your tailored insurance by completing the Request to reduce or opt out of insurance cover form, available by calling CareSuper on All premiums paid during the cooling off period will be refunded to your CareSuper account. If you wish to reduce your level of cover, or opt out of insurance altogether after the cooling off period, you will need to call the CareSuperLine on and request the relevant form. There is no cooling off period for default cover. Tax on death, TPD and income protection benefits For more information about taxation of insured benefits, go to ato.gov.au. When does cover stop? Your insurance cover is designed to continue automatically regardless of any changes in employment subject to the terms of the policy. Death, TPD and income protection cover cease at the earliest of the following events: The date you stop being a member of CareSuper The date you reach the maximum insurable age for a particular benefit (see page 15) The date a terminal illness benefit is paid The date of your death The date a TPD benefit is paid where the amount paid is greater than or equal to your death benefit amount. If your death cover is greater than your TPD cover, your death cover will continue when a TPD benefit is paid. Your death cover will be reduced by the amount of TPD benefit paid to you In the case of income protection cover, the date you commence duty with the armed services of any country, other than the Australian Army Reserve (during scheduled Army Reserve exercises, but not if called up for active service) The date the policy is terminated or cancelled for any reason The date we receive your completed Request to reduce or opt out of insurance cover form If there are insufficient funds in your account to meet premiums, the last Friday for which a premium deduction can be made from your CareSuper account. 14

17 Maximum insurable age Death cover 70 years TPD cover 65 years Income protection cover 65 years You cannot be covered for TPD or income protection if you have previously been paid a TPD benefit. Can I recommence my cover? Employee Plan members If you have previously opted out of cover, you will not be eligible for reinstatement of past levels of cover, and all future applications for cover will need to be assessed and accepted by our insurer. If accepted, insurance cover begins when we confirm acceptance to you in writing. If your account balance reaches $0, you have 28 days from the date of the letter notifying you that cover has ceased to make a contribution or roll-in to allow cover to be reinstated. The contribution can be a personal or employer contribution, or a rolled in amount. Cover will recommence from the date your cover last ceased. The amount of cover will be the higher of the cover you had immediately prior to the lapsing, unless you have previously reduced your level of cover, and the default cover as outlined on page 4. For income protection, the amount of cover will be the same as you had immediately prior to cover ceasing. If your account balance reaches $0 and a contribution is not received within 28 days of the notification letter, your cover may be reinstated if: A SG contribution is received within six months from the end of the month that cover ceased The commencement period of the contribution is within six months from the end of the month that cover ceased, and The SG contribution is paid on time according to legislative requirements. Cover will recommence from the effective date of the SG contribution to the higher of the amount of cover you had immediately prior to the cessation, unless you have previously reduced your level of cover, and default cover. For income protection, the amount of cover will be the same as you had immediately prior to cover ceasing: You are required to be in active employment on the date cover recommences. If you are not in active employment on the date cover recommences you will receive limited cover until you return to active employment for two consecutive months at which point full cover will apply. See page 19 for a definition of active employment. In all other circumstances, cover will be reinstated to the higher of the previous cover you had immediately prior to the cancellation, unless you had previously reduced your level of cover, and default cover. For income protection, the amount of cover will be the same as you had immediately prior to cover ceasing. Cover will recommence from the date the SG contribution is received by the Fund. Personal Plan members If your cover ceases, you must reapply and be accepted by the insurer to receive cover again. Am I covered worldwide? Yes. Generally, there are no restrictions on worldwide cover. However, income protection benefit payments are restricted to 12 months while overseas (unless otherwise agreed in writing). You are not required to advise the Fund or insurer before you travel overseas. What do I need to know? 15

18 Claiming an insurance benefit Did you know? If you are eligible for a TPD or permanent incapacity benefit (for example, as a result of an illness or injury), you can start a CareSuper Pension with your lump sum, and draw a regular income. Call the CareSuper PensionLine on to find out more. How do I qualify for a death or TPD benefit? A death benefit will be paid if you die (while insured) before reaching the maximum insurable age, unless the circumstances of your death are subject to the conditions set out on pages If you become terminally ill, you may apply for early release of your death benefit (see page 19 for the policy definition of terminal illness). You may qualify for a TPD benefit if you suffer (while insured) an illness or injury that meets the definition of total and permanent disablement in the insurer s opinion (see page 19). If you have submitted a TPD claim and you die before the claim is finalised, your TPD claim may continue to be assessed as a posthumous TPD claim. A posthumous TPD claim is a TPD benefit that is paid to your beneficiaries after your death. In the event that your death benefit is higher than your TPD benefit, the death benefit will be paid subject to eligibility. How do I qualify for an income protection benefit? To qualify for an income protection benefit, you must suffer (while insured) an illness or injury that meets the definition of total disability (see page 20) and have been unable to work for the applicable waiting period. If you qualify for a benefit, it will remain payable for up to two or five years (depending on the applicable benefit period) from the date payments commence, provided you continue to meet the benefit conditions. At the time of claim, members will receive the lesser of the following amounts: a) The number of units in place b) 85% of the first $423,530 p.a. of income, to a maximum benefit of $30,000 per month for the entire benefit payment period, plus 60% of the next $200,000 p.a. income, to a maximum additional benefit of $10,000 per month, for the first two years of the benefit payment period. No benefits are payable during the waiting period. After this, benefits will begin to accrue and will be payable monthly in arrears if you have met the requirements. The waiting period commences on the first day you are unable to work due to your total disability, and your condition is certified by a medical practitioner. If you are entitled to a benefit for part of a month, you will be paid 1/365th of the benefit for each day you are entitled to a payment. What if I am receiving income from other sources? Your income protection benefit will be reduced by the amount of income you receive from any one of the following sources: a) Any income (other than benefits received under the policy) or commutation (lump sum payment) of income, paid or payable to you as a result of your sickness or injury including: Sick leave payments Any amounts payable under legislation such as workers compensation or motor accident compensation, and Any benefits payable under other income protection insurance policies, and b) Any super contributions from your employer while disabled 16

19 c) Any income that, in the opinion of the insurer, you could reasonably be expected to earn in your occupation while disabled. However, where you are fit to return to work on a reduced capacity but such work is not available with the existing employer, the insurer will not offset any income you should be able to earn from this employer. Any income described in paragraph (a) which is in the form of a lump sum (or is exchanged for a lump sum) is treated as a monthly amount equivalent to 1/60th of the lump sum over a period of 60 months. What happens if I die while receiving a benefit? Your income protection benefits will cease upon your death, with a final payment equal to three times the monthly benefit. What happens if my disablement reoccurs? If you have been receiving income protection benefits, subsequently recover and therefore cease benefits, then within six months of your recovery become totally disabled again due to the same cause or a related cause, this period of total disability will be treated as a continuation of the previous claim and there will be no further waiting period, provided you are still a member. After six months back at work, normal waiting periods apply. The period in which benefits were paid previously will form part of the maximum benefit period for the relevant condition. What happens if I return to work and earn less? If you return to work and are earning an income that is less than your pre-disability income, as a result of being recently totally disabled, you may be eligible for a partial disability benefit. You must have satisfied the definition of total disability for 14 days and still have a reduced income at the end of the waiting period. Are there any exclusions or restrictions? All cover types (death, TPD and income protection cover) If you have two or more accounts with CareSuper, you will not be entitled to insurance cover from more than one account. In this instance, the account with the highest insured benefit will be used in determining any claim. The insurer will not pay a benefit caused directly or indirectly by an act of war. If you have previously been paid a TPD payment of any type as a result of a TPD claim, you will only be eligible for death cover with CareSuper; not TPD or income protection. For exclusions or restrictions applicable to specific types of cover, see the following page. The following exclusions and restrictions also apply to Employee Plan members: Default cover is automatically accepted by the insurer (subject to eligibility). However, automatic acceptance of cover may only occur once while you are a member of CareSuper. If you have received automatic acceptance on more than one occasion, the insurer may adjust the cover accordingly. If you do not become an insured member, and/or do not receive a SG employer contribution to CareSuper, within six months of becoming an employee of the employer making SG contributions to CareSuper, you will receive limited cover for 12 consecutive months. Full cover will then apply after 12 months, provided you were in active employment on the date your cover commenced. However, if you were not in active employment on the date cover commenced, limited cover may continue for more than 12 months until you have returned to active employment for two consecutive months. If you have not returned to active employment for two consecutive months, you will continue to receive limited cover until this requirement is met, at which point full cover will be provided. If you are covered under limited cover (because you did not become an insured member and/or a SG employer contribution was not received by CareSuper within six months from the date you commenced employment with your employer), intentional self-inflicted injury or infection, and suicide (whether it is determined that you were or were not sane at the time) will not be covered for the first 12 months. You are able to apply to have limited cover removed at any time subject to the insurer s assessment requirements. Premium loadings and/or exclusions may apply to some members. Important Restrictions or exclusions may be determined or assessed at the time a claim is made. Claiming an insurance benefit 17

20 Exclusions or restrictions (continued) Death and TPD cover specific In addition to the all cover exclusions and restrictions outlined on the previous page, the following also apply to death, terminal illness and TPD cover. In the event of pandemic outbreak, the insurer reserves the right to alter when cover commences for new members, in order to exclude any pandemic illness that could cause the member to die within 30 days of the date his or her cover commenced, provided the condition was present at the date the cover commenced. Except for default cover (other than limited cover), no benefit will be payable where a claim is directly or indirectly caused by or attributed to suicide within the first 12 months of issue or reinstatement of cover. The insurer will not pay a benefit for you if your death, terminal illness or TPD is caused directly or indirectly by act of war. However, this condition will not disentitle you to a benefit should you die on war service. The war exclusion is only applicable to wars occurring during the policy period. Income protection cover specific In addition to the all cover exclusions and restrictions outlined on the previous page, the following also apply to income protection cover. Income protection must be applied for and is subject to acceptance by the insurer. No benefit is payable under CareSuper s income protection insurance policy if your illness or injury is directly or indirectly caused by: Intentional self-inflicted injury or infection, or attempt at suicide (whether it is determined that you were or were not sane at the time) Your service in the armed forces of any country Normal pregnancy or childbirth, or War. CareSuper s insurer will not make a payment under the policy if the payment would cause them to infringe the Health Insurance Act 1973 (Cth) or the National Health Act 1953 (Cth) or any succeeding legislation in connection with health insurance. Benefits will only be paid for you for one disability at a time. The maximum length of time a benefit for disability resulting from any one or related cause will be paid is the number of months in the benefit payment period. The number of months in the benefit payment period will include any months in which the benefit is reduced or is calculated to be zero. The maximum time in total a benefit will be paid for while you are outside Australia is 12 months, unless otherwise agreed in writing. Premium loadings and/or exclusions may apply to any underwritten cover. about our insurer Group insurance cover for CareSuper members is provided by our insurer, CommInsure. CommInsure is the specialist insurance arm of the Commonwealth Bank and a leading provider of group insurance to corporate and super funds in Australia. They help protect the lifestyles of over 3 million Australians through a wide range of award winning insurance solutions. With a strong history as one of the largest life insurers, they have provided Australians with professional, responsive and supportive service for over 140 years. CommInsure is committed to providing protection and understanding through prompt and efficient payment of all genuine claims during your time of need. 18

21 Definitions for insurance Active employment Active employment means the person is employed to carry out identifiable duties, is actually performing those duties and, in the insurer s opinion, is not restricted by sickness or injury from carrying out those duties on a full time (where full time means 35 hours per week) basis or the duties of his or her usual occupation on a full time basis (even if not then working on a full time basis). Dependant or Interdependency relationship For the definition of dependant or interdependency relationship, see Nominating your beneficiaries at caresuper.com.au/pds. Note: a different definition of dependant applies for taxation purposes. Income (for the calculation of income protection benefits) Means: a) The total salary package value of remuneration received by the insured member from his or her employer averaged over the most recent 12 months immediately prior to becoming disabled (including overtime, bonuses and shift allowances). b) If the insured member has been working with their employer for a period of less than 12 months immediately prior to becoming disabled, then the total monthly value of remuneration will be averaged over the period since the insured member last commenced employment with their employer. c) If the insured member is unemployed immediately prior to becoming disabled, the total value of remuneration will be averaged over the lesser of the most recent 12 month period immediately prior to becoming disabled or the period since they last commenced employment with their most recent employer. d) If the insured member is self employed then the total monthly value of remuneration means the pre-tax income that is generated by the insured member or the business as a result of the insured member s personal exertion, and: (i) includes any allowances or fringe benefits paid to the insured member which he or she may convert into cash salary at her or his option, or which the insurer agrees to treat as part of the insured member s income, but (ii) does not include any necessary business expenses incurred in producing that income. Paragraphs b) and c) above will be subject to a minimum averaging period of three months for casual employees. No minimum averaging period applies to permanent employees. Limited cover Limited cover means the insured member is only covered for claims arising from: a sickness which first became apparent, or an injury which first occurred on or after the date the cover last commenced, recommenced or increased for the member in CareSuper. Salary (for the calculation of 10 times salary for New Member Option) Salary for permanent employees will be the gross annual salary (including overtime, commission, bonuses and shift allowances but excluding mandated SG contributions). Salary for casuals/contractors will be annualised based on the total gross salary earned within the last three months immediately prior to application Where a member has multiple employment arrangements the salaries (which may be either permanent or casual) will be combined to provide a total gross annual salary figure. Terminal illness An insured member with a terminal illness will be able to apply for early release of their insured death benefit if the insured member suffers from an illness which: a) Two medical practitioners, with at least one specialising in the person s terminal illness, certifies in writing that despite reasonable medical treatment the illness will lead to the person s death within 12 months of the date of certification, and b) CareSuper s insurer is satisfied on medical or other evidence that despite reasonable medical treatment the illness will lead to the person s death within 12 months of the date of certification. The illness from which the person suffers must occur, and the date of the certification referred to in (a) must take place, while the person is insured under the policy. Total and permanent disablement Total and permanent disablement means: For persons who are or have been employed or self-employed within the 12 months prior to the onset of an injury or illness leading to permanent incapacity, an insured member is totally and permanently disabled if the insured member: Has suffered: The permanent loss of two or more limbs a limb being the whole hand or foot, or The complete and irrecoverable loss of sight in both eyes, or The loss of one limb and the complete and irrecoverable loss of sight in one eye. Or As a result of sickness or injury, has been absent from all employment for three consecutive months from the date of disablement, and the insurer is satisfied on the basis of medical and other evidence that the insured member is unlikely ever to be able to engage in any occupation, whether or not for reward. Definitions for insurance 19

22 Definitions for insurance (continued) Or All of points following (i iv) apply to the insured person: (i) The person was, on the date of disablement, age 65 years or less (ii) The person was absent from all work as a result of suffering cardiomyopathy, primary pulmonary hypertension, major head trauma, motor neurone disease, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia, hemiplegia, diplegia, tetraplegia, dementia and Alzheimer s disease, Parkinson s disease, blindness, loss of speech, loss of hearing, chronic lung disease or severe rheumatoid arthritis (specific definitions apply) (iii) CareSuper s insurer is satisfied that on the basis of medical and other evidence the person is unlikely ever to be able to engage in any occupation, whether or not for reward (iv) The person is likely to be so disabled for life. Where: Occupation means: For a professional or manager, the person s occupation based on the general area of expertise of the person For all other staff either, (i) an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience over the past five years where the member has remained in the same occupation (i.e. the general area of expertise), or (ii) an occupation that the person can perform, on a full-time or part-time basis, based on the skills and knowledge the person has acquired through previous education, training or experience over the past 10 years where the member has changed occupation in the last five years. Professional means a person who: Has a tertiary qualification or is eligible to belong to a professional body Earns a salary greater than $80,000 per year, and Only works in an office environment and in a sedentary capacity. Manager means a person who: Is part of the management of the employer Earns a salary greater than $80,000 per year, and Only works in an office building and in a sedentary capacity. Or For persons unemployed for a continuous period of 12 months before the onset of total disability leading to the permanent incapacity: The insured member has, in the opinion of the insurer, after consideration of medical and/or other evidence become permanently incapacitated to such an extent as to prevent him/her from engaging in any gainful occupation, or The insurer is satisfied that the insured member has become so disabled by bodily injury or illness that he/she will never be able to perform at least two of the following activities of daily living: Dressing the ability to put on and take off clothing without assistance Bathing the ability to wash or shower without assistance Toileting the ability to use the toilet, including getting on and off without assistance Mobility the ability to get in and out of bed and a chair without assistance. Feeding the ability to get food from a plate into the mouth without assistance. Where: Assistance means the help of another person. Or For persons who perform full-time unpaid domestic duties, the insured member: has been unable to perform their unpaid domestic duties for three consecutive months and in the opinion of the insurer, after consideration of medical and/or other evidence, is incapacitated to such an extent that it is unlikely that he or she will again be able to engage in their unpaid domestic duties, or in any other occupation for which they are reasonably suited by education, training or experience, and is so incapacitated that they are unable to leave their place of residence without the assistance of another person. Where: Assistance means the help of another person. Total disability/disablement (income protection) An insured member is totally disabled if, because of sickness or injury, he or she is: Unable to perform at least one income producing duty of his or her own occupation Under the regular care of, and following the advice of, a medical practitioner, and Not working in any occupation, whether or not for reward. Income producing duty means a duty of the member s occupation immediately before they became totally disabled which generates 20% or more of the member s income. Own occupation means the normal occupation of work carried out by the insured member before becoming disabled. The insurance information contained in this Insurance Guide is a summary only. There are other defined terms in the insurance policies. The insurance terms and conditions, including payment of benefits are applied in line with the policies. In the event of any inconsistency between this summary and the policies, the policies will prevail. 20

23 Page 1 of 12 applying for, or increasing your insurance cover online is easy! Simply log on to MemberOnline, go to the Insurance section and click on InsuranceOnline. InsuranceOnline is a secure, convenient way to alter your cover and also provides a calculator to assess your insurance requirements. To create a MemberOnline account, go to caresuper.com.au. You can also complete the Insurance application form available on the Forms and publications page at caresuper.com.au. Do NOT detach form Please complete the form in blue or black pen and block letters. Determine the category that applies to you. This will determine your premiums and the unit-based cover amount that will apply to you. insurance application form Apply online Please choose a New Member Option by ticking ( ) your choice(s) if desired. You can complete the insurance application process online via the Insurance section of MemberOnline at caresuper.com.au Instructions To apply to change your occupational category, complete sections 1, 2 and 9e, and ensure you read sections 9a and 9b. Option (Employee Plan members only), complete sections 1, 2, 3, 4 and 9. complete sections 1, 2, 5, 6 and 9. reduce your level of default cover, please call the CareSuperLine on Please do not complete this form. To apply for a New Member To apply for tailored cover, If you wish to opt out or You are an Employee Plan member if your employer pays super guarantee contributions on your behalf. You are a Personal Plan member if you are responsible for paying your own super. Personal Plan members do not need to complete section 3 of this form. 1. Your personal details / / CareSuper member number Surname Date of birth (DD/MM/YYYY) Mr/Mrs/Ms/Miss/Dr Given names Address Suburb/town State Postcode Telephone (home) Telephone (work) Mobile number address Employer name Occupation Duties performed Gross annual salary or yearly remuneration 2. Occupational categories CareSuper offers three different categories of cover to refl ect the different levels of risk associated with our members occupations. Please complete the following questions to determine the scale that applies to you: 1. Are the duties of your occupation limited to professional, managerial, administrative, clerical, secretarial or similar white collar tasks that do not involve manual work and are undertaken entirely within an offi ce environment (excluding travel time from one offi ce environment to another)? Yes No 2. Are you earning in excess of $80,000 per year from your profession? Yes No 3. a) Do you hold a tertiary qualifi cation or are you a member of a professional institute or registered government body? Yes No or b) Are you in a management role? Please refer to manager under the TPD defi nition of the Insurance Guide for guidance when answering question 3b. Yes No If you answer No to Q1, you qualify as General. If you answer Yes to at least Q1, you qualify as Offi ce. If you answer Yes to Q1 and Q2 and either Q3a or 3b, you qualify as Professional. Your level of cover will be reviewed each time you complete a new application form or apply to vary your insurance cover. If you are a new member and you do not complete this section 2, the General category will apply to your cover. 3. New Member Options available in your first 90 days (for Employee Plan members only) Increase your death and TPD cover or add income protection cover with no health assessment, provided your application is received within 90 days of the date on your Welcome letter or . Please choose your option by ticking ( ) your choice(s). I would like to increase my total death and TPD cover up to 10 times my salary (maximum limit of $1.55 million). Refer to the Insurance Guide for the full defi nition of salary. My annual gross salary (including overtime, commission, bonuses and shift allowances but excluding mandated SG contributions) is: $ The amount of cover I wish to apply for is: Death $ TPD* $ I would like this cover to be: Unit-based OR Fixed cover I would like to index my fi xed cover annually by 5% I would like to add income protection cover. Please complete section 4 on page 2. * Under New Member Options, TPD cover must be less than or equal to death cover. $ Keeping in touch call us visit us CareSuperLine caresuper.com.au For easy access to your CareSuper account information, just call and talk to one of our friendly staff 8am to 8pm Monday to Friday AEST. Simply visit caresuper.com.au to access the latest news and information, check out how CareSuper is performing and to download the latest member publications and forms. CARE Super Pty Ltd (Trustee) ABN AFSL CARE Super (Fund) ABN See over > CR/SUP/INS/APP/ /12 ISS4 log on MemberOnline Manage your super through MemberOnline. Simply log on to view your account balance, change your details or change your investment options. Register for your password directly via caresuper.com.au/register. You can write to: CareSuper Locked Bag 5087 Parramatta NSW admin@caresuper.com.au Make sure we can find you too! If you have changed your address or if you are about to, don t forget to let CareSuper know. This way, you ll be sure to receive your important superannuation statements and other valuable information. Call the CareSuperLine, or log on to caresuper.com.au to advise your new details. CareSuper s offices CareSuper VIC, SA, TAS & WA (Registered office) Level 18, 31 Queen St Melbourne VIC 3000 Tel (03) CareSuper QLD & NT Tel (07) CareSuper NSW & ACT Tel (02) Contact us CareSuper has mentioned the names, products and/or services of third party companies with their consent. This consent had not been withdrawn at the date of publication. 21

24 we make it easy for you CareSuperLine This publication is printed on Nordset Offset. Manufactured under the strict ISO14001 & EU EMAS Environmental Management Systems using FSC certified Mixed Source pulp from Well Managed and Legally Harvested forests, and carries the internationally recognised EU Flower eco-label. caresuper.com.au CR/INS/GDE/PDSIBR /13 ISS5