Insurance changes 1 July 2017

Transcription

1 Insurance changes 1 July 2017 We are making a number of insurance changes and enhancements from 1 July Key elements of this package of changes include improved access to cover, the introduction of a more meaningful definition of disablement and a focus on supporting members in their return to work. Inside 1 Changes to total and permanent disablement (TPD) cover 2 Changes to death cover 3 Changes to income protection cover 4 Changes to all types of insurance cover 5 Appendices Changes to total and permanent disablement (TPD) cover Benefit claims a new definition that s easier to meet Changes to death cover Terminal illness claims life expectancy period lifts to 24 months Changes to income protection cover Helping members in their return to work No loss of cover on reduced working hours Changes to all types of insurance cover Changes in individual transfer terms Worldwide cover a simpler approach New premium rates Appendices Appendix A: TPD Activities of Daily Working definition Appendix B: Income protection disability definitions Appendix C: Premium rates Corporate Super Appendix D: Premium rates Personal Super

2 Changes to TPD cover Benefit claims a new definition that s easier to meet If a member claims a TPD benefit, the insurer will assess their claim against the most appropriate of a number of TPD definitions. The current TPD definition contains 3 parts (A,B,C) for smartmonday PRIME or 4 parts (A,B,C,D) for smartmonday DIRECT. Part C is changing from Activities of Daily Living to Activities of Daily Working (ADW) for claims arising on or after 1 July For more information on when ADW applies and its relationship with the other TPD definitions see the Insurance reference guide of your Product Disclosure Statement. We expect this change will make more members eligible to make a claim. To satisfy the ADW definition, a member must be unable to perform at least three of these five activities of daily working mobility, vision, lifting, communicating or manual dexterity. See Appendix A for more information. Changes to death cover Terminal illness claims life expectancy period lifts to 24 months From 1 July 2017, the life expectancy period for terminal illness claims will lift from 12 to 24 months. Changes to income protection cover Helping members in their return to work Returning to work during the waiting period A new provision will support a member s attempts to return to work without compromising their ability to make a claim if those attempts do not succeed. If a member returns to work for up to 10 days during a 60 or 90-day waiting period or for up to 5 days during a 30-day waiting period they will not have to re-start the waiting period if they are subsequently unable to work. Rehabilitation programs no cost to the member From 1 July 2017, the insurer will meet the full cost of rehabilitation programs attended by members receiving income protections benefit payments, provided the program includes an approved return to work plan. Currently, the insurer meets the cost up to an amount equal to six months of benefit payments. No loss of cover on reduced working hours From 1 July 2017, a member who moves to working less than 15 hours a week will keep their income protection cover. If they subsequently make a claim, they will be assessed against an alternative definition of total disability as laid out in Appendix B. Currently, a member would lose their cover if they move to less than 15 hours. Page 2 of 19

3 Changes to all types of insurance cover Changes in individual transfer terms Members can transfer in any insurance cover that they have with other insurers or super funds into the Fund. Under current eligibility rules, a member must be under age 55 to make a transfer. From 1 July 2017, we re making the transfer option available to more members by lifting the eligibility age to 65. Worldwide cover a simpler approach Our new, straightforward rules around worldwide cover offer a clearer explanation to members who are heading overseas. From 1 July 2017, any member who is out of Australia will have cover as long as they have not moved overseas permanently. New premium rates A premium rate is the annual cost of each $1,000 of death or TPD cover, and each $100 of a monthly income protection benefit. The rate varies with change in age. We have successfully negotiated a change in premium rates to apply from 1 July 2017 to 28 February In the face of the continuing rise in claims across the industry that has caused many funds to increase their TPD and income protection premium rates, we believe that the premium rate changes are a good outcome for our members. There has been a small reduction in TPD rates (an average of -3.8%) and a small increase in death rates (an average of 2.9%), and income protection premium rates will increase by 10% on average. The overall effect of this for most members will be very small. The new rates reflect the availability of the less stringent Activities of Daily Working definition for TPD claims, the changes to the terminal illness period, and the other enhancements to terms and conditions. We have worked with our insurer to minimise the impact of these changes on members and to ensure that our premiums remain competitive. See Appendix C for the new premium rates for smartmonday PRIME members and Appendix D for smartmonday DIRECT members. Page 3 of 19

4 Appendix A: TPD Activities of Daily Working definition Activities of daily working (ADW) For a period of 6 consecutive months after the occurrence of the injury or sickness, you have been continuously unable to perform (with or without aids and adaptations*) at least 3 of the following activities, as certified by a medical practitioner: Mobility: the ability to: bend, kneel or squat to pick something up from the floor and straighten up again, and get into and out of a standard sedan car; or walk more than 200 metres at a normal pace on a level surface without stopping due to breathlessness as a result of a medical condition or angina, Vision: the ability to see, such that an ophthalmologist can certify that your visual acuity is better than 6/60 in the better eye or a visual field of greater than 10 degrees (ie not legally blind), Lifting: the ability to lift (from bench height) and carry a 5 kg weight a distance of 10 metres and place the item back down at bench height, Communicating: the ability to: speak with sufficient clarity such that you can hold a conversation with another person in a quiet room in your first language. This involves understanding a simple message and relaying that message to another person, or hear such that an audiologist can certify that you have a hearing ability of less than or equal to 40db in the better ear (averaged over the frequencies 0.5, 1, 2 and 3 KHz) in an audiometry test, Manual dexterity: the ability to use: at least 1 hand to pick up and/or manipulate small objects such as picking up a coin from desk height, using cutlery or fastening buttons; or a pen, pencil or keyboard to write a short note that can be understood by another person in your first language, and after consideration of all the medical evidence and such other evidence as the insurer may require, you have become, in the opinion of the insurer, incapacitated to such an extent as to render you unlikely ever to be able to perform any 3 of the above activities. In addition to the above, the insurer, after considering all relevant evidence which is reasonably available, then determines that you will be unlikely ever to be gainfully employed in any occupation for which you are reasonably suited by education, training or experience. Where you are unable to perform one or more of the above activities upon the date cover commenced, that activity shall not be taken into consideration during the TPD assessment. * Aids and adaptations refers to equipment or fixtures to assist you without the assistance of another person to carry out the activities. Page 4 of 19

5 Appendix B: Income protection alternative definition of total disability Total disability Alternative Definition Applies where you ve been working less than 15 hours (on average) in the 3 months (or less, if you ve been employed for less) immediately prior to disablement. You are totally disabled if you ve been off work due to injury or sickness for at least 7 out of 12 consecutive days during the waiting period and, solely by sickness or injury in the insurer s opinion after considering all medical evidence, you are continuously and totally unable to perform (with or without aids and adaptations 1 ) at least 3 of the following activities of daily working as certified by a medical practitioner: Mobility: the ability to: bend, kneel or squat to pick something up from the floor and straighten up again, and get into and out of a standard sedan car; or walk more than 200 metres at a normal pace on a level surface without stopping due to breathlessness as a result of a medical condition or angina, Vision: the ability to see, such that an ophthalmologist can certify that your visual acuity is better than 6/60 in the better eye or a visual field of greater than 10 degrees (ie not legally blind), Lifting: the ability to lift (from bench height) and carry a 5kg weight a distance of 10 metres and place the item back down at bench height, Communicating: the ability to: speak with sufficient clarity such that you can hold a conversation with another person in a quiet room in your first language. This involves understanding a simple message and relaying that message to another person; or hear such that an audiologist can certify that you have a hearing ability of less than or equal to 40db in the better ear (averaged over the frequencies 0.5, 1, 2 and 3 KHz) in an audiometry test, Manual dexterity: the ability to use: at least 1 hand to pick up and/or manipulate small objects such as picking up a coin from desk height, using cutlery or fastening buttons; or a pen, pencil or keyboard to write a short note that can be understood by another person in your first language. Where you are unable to perform one or more of the listed activities on the commencement date of your cover, that activity won t be taken into consideration during the assessment. Where the Alternative Definition is no longer supported, and medical evidence, in the insurer s opinion, confirms that you are still unable to perform at least one Important Duty 2 of your usual occupation, benefit payments will continue where you attend a rehabilitation program with a goal of returning to work. Benefit payments will continue until the earlier of the date that: you return to work in a partial capacity, you return to full-time work, you refuse to continue to participate in the rehabilitation program, or the rehabilitation program ceases. 1 Aids and adaptations refers to equipment or fixtures to assist you without the assistance of another person to carry out the activities. 2 Important Duty means a duty involving at least 20% of overall occupational tasks responsible for generating at least 20% of your pre-disability income. Page 5 of 19

6 Appendix C: Premium rates smartmonday PRIME Premium rates for death and TPD The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age and the type of cover you have, the amount of cover, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost per $1,000 of cover are inclusive of a 10% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the insurance premium payable to the insurer do not reflect any occupational factor. If we are not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Age next Death TPD Age next Death TPD Page 6 of 19

7 smartmonday PRIME Premium rates for income protection: benefit payment period up to 2 years The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 10% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to 2 years Page 7 of 19

8 smartmonday PRIME * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Premium rates: professional and white collar 2 year benefit payment period Page 8 of 19

9 smartmonday PRIME Premium rates for income protection: benefit payment period up to 5 years The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 10% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to 5 years Page 9 of 19

10 smartmonday PRIME * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Page 10 of 19

11 smartmonday PRIME Premium rates for income protection: benefit payment period up to age 65 The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 10% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to age Page 11 of 19

12 smartmonday PRIME * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Page 12 of 19

13 Appendix D: Premium rates smartmonday DIRECT Premium rates for death and TPD The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age and the type of cover you have, the amount of cover, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost per $1,000 of cover are inclusive of a 15% administration fee (plus GST) which is payable by you to Aon Hewitt Limted for insurance administration services provided directly by it. The fee does not form part of the insurance premium payable to the insurer do not reflect any occupational factor. If we are not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Age next Death TPD Age next Death TPD Page 13 of 19

14 smartmonday DIRECT Premium rates for income protection: benefit payment period up to 2 years The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 15% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to 2 years Page 14 of 19

15 smartmonday DIRECT * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Premium rates: professional and white collar 2 year benefit payment period Page 15 of 19

16 smartmonday DIRECT Premium rates for income protection: benefit payment period up to 5 years The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 15% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to 5 years Page 16 of 19

17 smartmonday DIRECT * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Page 17 of 19

18 smartmonday DIRECT Premium rates for income protection: benefit payment period up to age 65 The cost of your insurance is deducted monthly from your account. Costs depend on the annual premium rate for your age, the amount of the benefit, the benefit period and waiting period you have chosen, your gender, your occupation factor, and any additional loadings. See the Insurance reference guide at smartmonday.com.au The annual premium rates shown here: represent the cost of your insurance (per $100 of monthly benefit) are inclusive of a 15% administration fee (plus GST) which is payable by you to Aon Hewitt Limited for insurance administration services provided directly by it. The fee does not form part of the premium payable to the insurer do not reflect any occupational factor. If we re not notified of your occupation category, we will apply a blue collar occupation factor to the calculation of your premium. See the Insurance reference guide at smartmonday.com.au for occupation factors. Premium rates: benefit payment period up to age Page 18 of 19

19 smartmonday DIRECT * * * Available only to professional and white collar categories. See the Insurance reference guide at smartmonday.com.au Page 19 of 19

20 E. P F W. smartmonday.com.au M. Reply Paid 1949 Wollongong DC, NSW 2500 It all adds up Done today Smart easy actions Positive actions Grow your wealth Brighter futures Someday starts today smartmonday is the business name of the Aon Master Trust ABN (the Fund) which has been registered by Aon Hewitt Limited ABN AFSL (AHL) as sponsor of the Fund. The trustee of the Fund is Equity Trustees Superannuation Limited ABN AFSL RSE Licence L This document has been prepared by AHL as sponsor and administrator of the Fund. smartmonday PRIME, smartmonday DIRECT and smartmonday PENSION products are part of the Fund. AHL has taken care in the production of this document, the contents of which has been obtained from sources that it believes to be reliable. AHL does not warrant, represent or guarantee the accuracy, adequacy, completeness or fitness for any purpose that this document may be used and accepts no liability for any loss incurred by anyone who relies on it. The information in this document is general in nature and should not be relied upon as advice (personal or otherwise) as your personal needs, objectives and financial situation have not been considered. Before deciding whether a particular product is right for you, please consider the relevant Product Disclosure Statement or speak with your financial adviser. If you do not have a financial adviser, call or enquiries@smartmonday.com.au to ask about the advice services you can access through your membership Aon Hewitt Limited SM001_B_ DATE ISSUED: NOV 2017