SA Open Pension / Provident Fund

Transcription

1 SA Open Pension / Provident Fund (12/8/36967 / 12/8/21498) Particulars of new participating Employer Employer Name: Inception Date: Page 1 of 8

2 1 Participating Employer Information 1.1 Name of employer (Please provide documentation confirming registration and proof of physical address for FICA purposes ) 1.2 Telephone number Fax number 1.3 Physical address Postal address 1.4 Contact person at the business 1.5 address of contact person 1.6 Telephone number of contact person 1.7 Number of pay points (if more than one paypoint, please provide schedule with contact persons per paypoint) 2 Sub-Fund Information 2.1 Pension / Provident fund 2.2 Inception (participation) date: 2.3 Are all employees eligible to join the Sub-Fund? 2.4 Number of employees stationed outside RSA borders 2.5 Number of pay points: (if multiple paypoints applicable provide a schedule with breakdown of members per paypoint) 2.6 Will the Sub-Fund have pensionable and risk salaries? 2.7 Does bonus payments form part of a member s pensionable salary? 2.8 How are contributions paid on bonuses? (once per annum / monthly) 2.9 In which month are bonuses paid? Page 2 of 8

3 2.10 Contribution rates Category 1 Category 2 Category 3 Category 4 (Specify category names) Member contributions Employer contributions 2.11 Normal Retirement age: 2.12 Are additional voluntary contributions allowed? 2.13 Are all costs in / excluded in the employer contribution rate (risk premiums / consulting fee / administration fee): Yes No 3 Investment options: 3.1 Trustee / Employer choice only?: Yes No 3.2 Do members have investment choice?: Yes No 3.3 Portfolios selected for investments: - Inflation plus 3% target portfolio Yes No - Inflation plus 5% target portfolio Yes No - Inflation plus 7% target portfolio Yes No Default investment portfolio (where a portfolio selection form is not received for new members, or where members do make make selections) Other portfolios not listed above: If member investment choice is required, complete separate selection forms for each member (the first months contributions will be placed in the chosen default portfolio until such time members selection forms are received) 3.7 How often and when will members be able to switch between portfolios? 3.8 How many switches are allowed per annum? 3.9 Switch Fee amount? 3.10 Any free switches applicable? Page 3 of 8

4 4 Risk Benefit Structure 4.1 Please indicate whether the following risk benefits are applicable to the fund: Group Life Assurance Personal Health Insurance Funeral benefits Lump sum disability Any Other? Please provide details Please provide the following information on the applicable policies: Risk benefit 1: Underwriter (Company): Policy number: Contact person: Contact Tel No: Contact Fax No: address: Risk benefit 2: Underwriter (Company): Policy number: Contact person: Contact Tel No: Contact Fax No: address: Risk benefit 3: Underwriter (Company): Policy number: Contact person: Contact Tel No: Contact Fax No: address: Page 4 of 8

5 5 Previous Fund Information (complete for all sub-funds transferring from another fund) 5.1 Name of fund 5.2 Section 14 (1) transfer 5.3 Type of fund Scheme No 5.4 Name of previous administrator 5.5 Contact person (at previous administrator) 5.6 Telephone number 5.7 Number of existing disability claimants 5.8 Number of fully paid-up members 5.9 Have all contributions been paid up to transfer date 5.10 Are pension backed loans being transferred? 6 Broker Information 6.1 First Name & Surname 6.2 ID number 6.3 address 6.4 Brokerage name 6.5 Postal address Postal code: 6.6 Office tel number Fax number 6.7 Commission code (if applicable) Cell number 6.8 VAT Reg. number FAIS number 6.9 Contact person at broker office (who will be dealing with day to day admin matters) address of contact person 6.11 Telephone number of contact person 6.12 Name of bank 6.13 Name of branch Branch code 6.14 Account name 6.15 Bank account number Page 5 of 8

6 Summary of risk benefits Risk benefit 1: Benefit calculated as follows: Multiple of pensionable / risk salary: or Fixed amount cover: or Other: If benefit based on sliding scale per age group, please provide separate schedule Maksimum Benefit Allowed: Free Cover Limit: Cessation Age of benefit: If cessation age is not NRA, can cover continue until late retirement age? Premium based on: Salary (percentage):or Benefit (unit rate per R100 /R1000):or Fixed amount (per month) Is the premium included in the monthly employer contribution? Is this an approved benefit? Is this benefit mandatory for all members (for the specific PE)? Risk benefit 2: Benefit calculated as follows: Multiple of pensionable / risk salary: or Fixed amount cover: or Other: If benefit based on sliding scale per age group, please provide separate schedule Maksimum Benefit Allowed: Free Cover Limit: Cessation Age of benefit: If cessation age is not NRA, can cover continue until late retirement age? Premium based on: Salary (percentage):or Benefit (unit rate per R100 /R1000):or Fixed amount (per month) Is the premium included in the monthly employer contribution? Is this an approved benefit? Is this benefit mandatory for all members (for the specific PE)? Page 6 of 8

7 Risk benefit 3: Benefit calculated as follows: Multiple of pensionable / risk salary: or Fixed amount cover: or Other: If benefit based on sliding scale per age group, please provide separate schedule Maksimum Benefit Allowed: Free Cover Limit: Cessation Age of benefit: If cessation age is not NRA, can cover continue until late retirement age? Premium based on: Salary (percentage):or Benefit (unit rate per R100 /R1000):or Fixed amount (per month) Is the premium included in the monthly employer contribution? Is this an approved benefit? Is this benefit mandatory for all members (for the specific PE)? Risk benefit 4: Benefit calculated as follows: Multiple of pensionable / risk salary: or Fixed amount cover: or Other: If benefit based on sliding scale per age group, please provide separate schedule Maksimum Benefit Allowed: Free Cover Limit: Cessation Age of benefit: If cessation age is not NRA, can cover continue until late retirement age? Premium based on: Salary (percentage):or Benefit (unit rate per R100 /R1000):or Fixed amount (per month) Is the premium included in the monthly employer contribution? Is this an approved benefit? Is this benefit mandatory for all members (for the specific PE)? Page 7 of 8

8 Costs Administration fee (VAT Inclusive) Is the administration fee included in the monthly employer contribution? Consultancy Fee (VAT Inclusive) Is the consultancy fee included in the monthly employer contribution? Contingency Reserve Is the above included in the monthly employer contribution? Other 1: Is the above included in the monthly employer contribution? Other 2: Is the above included in the monthly employer contribution? Confirmation: Hereby is confirmed that the benefits received will be according to this application form; the same of which will be incorporated in the Special Rules. Signed Date Name Page 8 of 8