Flexible Benefits Technical summary

Transcription

1 Flexible Benefits Technical summary

2 An excellent choice Canada Life Limited aims to satisfy your specific requirements for Group Life, Group Income Protection or Group Critical Illness cover. With us you will directly benefit from the full support of a dedicated team of specialist underwriters, administrators and account managers. This summary sets out only the key differences between schemes set up under a flexible benefits basis and our non-flexible benefits basis. This technical summary should be read in conjunction with the relevant technical guide for each product. You should keep this summary, your quotation(s) and technical guide(s) together for future reference. Where the quotation states different terms to this summary, the quotation takes precedence. The full details of the insurance cover provided by Canada Life will be contained in the policy conditions and policy particulars when these are issued. Canada Life can only issue policies to commercial customers under the Insurance Conduct of Business (ICOBS) rules. This means that our contract is with the employer, and not with each individual person in the scheme. 2

3 Specific terms and expressions we use Default benefit : the level of benefit for a new member who has not yet chosen a different level of benefit. Flexible benefits : the employee benefits provided by an employer where an employee can choose their amount of cover within certain parameters. Flex Step : the amount that an employee can choose to increase their benefit. For Group Life Assurance and Group Critical Illness the step could be a multiple of salary, such as 1 x salary, or a fixed unit of benefit such as 25,000. For income protection each step is usually described separately, for example 50% of salary, 66% of salary and 75% of salary. Life event: a specified change in a member s personal circumstance when the member can alter their level of benefit. Partner : a person with whom the member cohabits and includes the member s spouse or civil partner or other person who is financially dependent or financially interdependent on or with the member. It shall not, however, include a relative (other than the member s legal spouse), natural child, adopted child, stepchild or foster child or any person who is also an employee of the employer. Single premium flex rates : the table of rates that are normally used to cost the flexible benefits. The table is specific to the scheme and your quotation will show the table of rates if these apply. 3

4 Your commitment In addition to the specific commitments for each product as detailed in the relevant technical guide, you must ensure that where a 3rd party administrator is involved, they provide us promptly with any data or information that we would ask from you. Risk factors In addition to the specific risk factors for each product, flexible benefits also involve the following risks. If the number of employees eligible for flexible benefits drops below 250 at any time we reserve the right to cancel the policy at the next periodic review date or alter it to a non-flexible benefits basis. If the total periodic premium falls below our minimum premium you must still pay the minimum premium. The minimum premium is 1,000 for annually paid policies and 85 per month for monthly paid policies. This is particularly relevant for policies entirely costed on single premium flex rates where few employees have selected benefit. You must ensure that your employee communications: emphasise the need for employees to review their choices each year as changes to a member s circumstance may make their choice of benefits inappropriate to their needs and outline our requirements for increases. This includes any actively at work requirements and our critical illness pre-existing conditions exclusion. Certain claims will be ineligible. Please see section 1.6 for further details. 4

5 Your questions answered 1.0 What factors should be considered in deciding what benefits to provide? You will need to consider: Whether to flex some risk products but provide adequate benefit levels for other products outside of the flex arrangement. Whether the take up rate for any particular product justifies the additional cost of making it available. If the take up rate is anticipated to be low the cost of administering the benefit may be out of proportion to the amount of benefit covered. In such circumstances we may not wish to provide new cover or to continue with any existing cover. 1.1 What types of cover are available? Group Life Lump Sum Group life assurance enables employers to provide a tax-free lump sum benefit payment, to an employee s dependants if they should die in service. This is a commonly flexed benefit where employees without dependants can choose lower levels of cover than those with dependants. Group Life Dependant s Pension A dependant s pension is payable on the death of an employee to provide ongoing income to an employee s dependant. This product is not commonly flexed as employers often replace dependant s pension with the option to select higher levels of lump sum benefit. Partner Group Life Assurance A tax free lump sum payable on the death of an employee s spouse or partner. Employees may view this as a convenient way of providing cover for their partner, particularly if their partner does not already have employee benefits protection. Group Income Protection Canada Life group income protection provides a continuation of a proportion of salary to an employee during absence due to ill-health or injury after a specified deferred period. Pension and employer s National Insurance contributions can also be insured. Group Critical Illness Our group critical illness solution offers a living benefit to employees, helping them adjust to their new circumstances. Critical illness cover for partners of employees is also available at an additional cost. 5

6 1.2 Product matrix and benefit parameters Minimum no. Minimum Maximum Flex step Product of employees benefit benefit size Employee lump x salary 12 x salary where DIS 1 x salary sum is not insured 1 Employee dependants % of salary 50% of salary 5%, 10% or pension 1/9 th salary Partner None Lower of 250,000 and Fixed amount lump sum 2 4 x employee salary up to 25,000 Income Protection % of salary 75% of salary Between 5% and 20% of salary Critical Illness: None Lower of 500,000 and Fixed benefit Employee 4 x employee salary up to 25,000 Critical Illness: 250 None Lower of 150,000, Fixed benefit up Partner 3 employee benefit and to 25, x employee salary Notes 1 Where DIS pension is payable in addition to the lump sum benefit we will reduce the maximum lump sum payable. 2 Normally only available if Canada Life insures the employee lump sum benefit. 3 Only available in conjunction with critical illness for employees. 4 Partner critical illness cover may not exceed the amount of the employee cover. 5 Where at least 30 employees have selected benefit in an existing flexible benefits scheme we will provide a quotation provided the total eligible number of employees exceeds the minimum number of employees shown in the table 1.3 When can employees change their levels of benefit? Employees can revise their benefit selection levels at the annual revision date and at one of the permitted life events. At the annual revision date Normally employers allow a selection window at the annual revision date where the flex scheme is advertised to the employees. Employees must make any selection for a change in benefits within this window. The window typically lasts for one or two months prior to the anniversary date and we will ask you what dates you wish to use. At a life event At a life event, employees can only make a selection within one month either side of the event. 6

7 What are the life events? Your quotation will show the life events included in the policy. Where you do not specify what life events are required we will just use the ones shown below: Marriage, registration of a civil partnership or gaining a partner (cohabiting for at least 6 months). Birth of a child or start or end of maternity or paternity leave. Adoption of a child or start or end of adoption leave. Moving home (the completed purchase of a property used for the employee's main residence). Change in contract from part-time to full-time or full-time to part-time or change in basic salary exceeding 10% (except where change is due to ill-health or birth/adoption of a child). Ending of partner relationship, permanent separation, divorce or dissolution of civil partnership. Death of the member's partner or dependant child. You can choose alternative or additional life events, subject to our prior agreement, from the table below (where allowed). You may also remove life events if they are not required. Group IP and Alternative/Additional life events Group Life Group CI Birth of a child/adoption of a child or getting pregnant or starting maternity leave or returning from maternity leave Yes Yes Death of a dependant Yes Yes Secondment overseas Yes Yes Return from secondment overseas Yes Yes Redundancy of partner Yes Yes Return from temporary absence No No Commencing temporary absence No No Life event notes Increases are not permitted on the starting or ending of sick leave. Increases are not permitted on return from secondment overseas if return is due to ill-health or the full period of overseas secondment has not been completed. For any partner cover the benefit must cease when the partner dies or the partner relationship ends. 7

8 1.4 What changes in benefit are allowed? At the time of introduction of the scheme, employees can choose any level of cover within the permitted levels. For Partner Group Life Assurance, the member can continue to select any level of cover for the partner at subsequent annual revision dates or life events, subject to the overall maximum benefit shown on the quotation. However for other products, the member can only increase cover by one flex step only at each annual revision date or at a life event, subject to a limit of two flex steps in any one scheme year. Where a member chooses no flex cover, or later reduces to no flex cover, they cannot then select any level of cover. They are limited to only one flex step increase like everyone else. Cover can also be reduced at the annual revision date or on the occurrence of any of the life events detailed in the policy, by any amount. Partner cover for Group Critical Illness and Group Life Assurance can cease immediately on divorce, separation or the death of the partner. 1.5 What are the requirements for increases in benefit? Actively at work requirement for employees The actively at work requirement applies to all increases in benefit, for all types of cover. Any employee must be actively at work on the day the increase in benefits is selected and must not have not been absent from work for more than 15 days due to illness or injury in the 12 months prior to the date of the increase. For Group Life Assurance and Group Critical Illness schemes we may, for an additional cost, reduce the requirement to only being at work on the day the increased selection is made. Partner Group Life Assurance For Partner Group Life Assurance schemes, there is no actively at work requirement. Instead, the initial benefits and any subsequent increases are subject to the employee s partner being able to complete a short health statement and declaration. 8

9 1.6 Are there any exclusions to the payment of benefits? Group Critical Illness for employees and partners The exclusions outlined in section 6 of our Group Critical Illness Technical Guide apply to all increases in benefit. 1.7 Evidence of insurability Members with benefits over the free cover limit will need to be underwritten for these benefits. What happens if a member fails our requirements for increases? Members who are not actively at work at the commencement date or annual revision date of the scheme will not normally be able to increase their cover until their next opportunity. Similarly a partner who cannot satisfactorily complete the short declaration will not normally be able to increase their cover until their next opportunity. However, even if a member fails our requirement, we will allow an increase in cover provided the member can provide satisfactory evidence of health. A Health Declaration (available to download from our website) should be completed and returned to us as soon as possible. The company will need to decide if cover is to be allowed during the underwriting period. If cover is provided during underwriting our temporary cover provisions apply. The member is covered, and a premium is paid, for the higher level of benefit from the day they are first eligible for the increased benefit. If the member is not accepted for the additional cover, the benefit immediately reduces to the previously accepted level of benefit (if any) and the premium will reduce accordingly. If cover is not provided during underwriting, the member is not covered for the higher level of benefit until underwriting has been completed and the member has been accepted. During the underwriting process the member s benefit and premium is based on their previously accepted level of benefit (if any). The flex system needs to be able to handle reductions in benefit if members are declined or postponed or at the end of the temporary cover period if medical underwriting has not been completed. 9

10 1.8 Corporate solution Commercial contract This is a commercial contract between Canada Life and the employer, not individual contracts with the employees. Individual members do not have rights under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of the policy. However for income protection and critical illness schemes, where a claim has been made for a member, the member can pursue that claim as if they were the policyholder. What is the funding method? You must pay for the risk benefits entirely. This may be done either by allocating a flex fund for each individual which they can spend on their chosen benefits or by using salary sacrifice to wholly or partly fund the scheme. We will ask you to confirm that this is the case when you ask us to assume risk. Where a salary sacrifice arrangement is being used, please give us full details so that we can assess whether, or on what basis, we can offer terms. 10

11 2.0 Setting up the policy Setting up a flexible benefits policy is similar to setting up a non-flex policy, however there are different timescales involved which mean that risk needs to be agreed with Canada Life before the selection window opens for the employees to make their choices. The following table compares the steps in setting up a flex policy with a non-flex policy. Flex policy Decision to implement flex scheme Appoint 3rd party flex platform provider or develop in-house flex administration Intermediary carries out market review Decision on insurer for each product Confirm risk with insurer Flex rates input to flex system Flex system tested Selection window opens several weeks before flex implementation date Flex implementation and policy commencement date Non-flex policy n/a n/a Intermediary carries out market review Decision on insurer for each product Confirm risk with insurer n/a n/a n/a Policy commencement date Note that under a non-flex policy the date that the risk is confirmed with the insurer could be the day before the policy commencement date. However for a flex policy, risk needs to be confirmed with the insurer before the flex rates are input into the flex system, in order to give sufficient time for the other steps that must take place. Canada Life requires the completion of a Risk details form for each product, and a form called Flex Schemes Additional Risk Details. These are available on request, or to download from our website. 11

12 3.0 What premiums will be charged for the cover? There are two different methods of costing flex schemes, unit rate and single premium. Some large schemes are unit rated for all their benefits. Some schemes, such as Group Critical Illness with no minimum benefit, and most Partner Group Life Assurance schemes, are costed only with single premium flex rates. However the majority of schemes are costed using a unit rate for some of the benefit and single premium flex rates for the remaining higher levels of benefit. The amount of benefit that is unit rated depends on the costing basis and the amount of employer funding. It is usually either the minimum benefit or the default benefit. Your quotation will show what method has been used and on what part of the benefit. Unit rated benefits Where a unit rate applies, the annual cost of the benefits will be the unit rate multiplied by the benefit insured. Unit rates are usually guaranteed for a two year period. A new rate may apply for the next two year period. Single premium rated benefits Where a table of age specific single premium flex rates applies, the cost for each member will be the relevant age (and gender if shown on the quotation) rate multiplied by their flex benefit. The amount of benefit costed using single premium rates will be the total benefit for the person, less the amount costed for under the unit rate (if applicable). The age of the member used in the flex calculations is their age at the annual revision date, or date of entry if later. For partner benefits, the age used is the partner age, not the age of the employee. The rates are usually guaranteed for a two year period. A new rate table may apply for the following two year period. Single premium flex rate table format The rates are tailored to the scheme profile and benefits and are normally in single year ages. At your request we may be able to quote five year age banded rates. However you should note that using 5 year age bands means that the cost for the employee will increase significantly at the change in age bands, whereas a single year rate table will produce a smoother increase in cost each year. We will normally provide rates based on age attained however we can supply rates based on age next birthday on request. We will use unisex rates unless requested otherwise. If you do not tell us what table format to use, we will make an assumption on the format. We will normally be able to provide an alternative quote on a different format, if requested. 12

13 4.0 How does the policy accounting work? The policy operates on one year accounting periods. Each month we will require individual data in electronic format showing the following: Member name, date of birth, gender, core and flex benefit and the corresponding costs for that month. Where partner cover is included we will require separate details for the partners. The total benefit insured and the total premium due for the month for each product. Joiners and leavers. Benefit changes. Any members with benefits over the free cover limit who require underwriting. Premiums can be paid in a number of ways: A. Monthly by BACS payment to match the monthly cover This is our preferred method of payment. B. Monthly by cheque and invoice to match the monthly cover This is only available where the premium is in excess of 10,000 per month. C. Monthly by Direct Debit 1 D. Annually by cheque or BACS payment 1 1 We make an estimate of the likely premium based on the known selections at the commencement date. This can be paid as a single annual payment or by 12 level monthly payments by Direct Debit. At the end of the year we total the specific flex amounts due during the year and make an adjustment to the end of year account. The premium for the following year can be estimated in the same way. 13

14 5.0 What are the administration requirements? When designing and implementing a flexible benefits administration package, please keep the following points in mind: The flex system must be able to cost members at each flex anniversary and for any changes at mid-year life events using the unit rate/single premium rates provided by Canada Life. The flex system must be able to keep track of changes in benefit levels over time so that an audit trail of all selections can be provided to Canada Life, in the event of a claim. Where monthly premiums are paid to match the monthly cover, the flex system must be able to produce a spreadsheet showing the member s individual selections and costs together with a summary of benefit and cost for the month, that can be sent to Canada Life. We would also expect the flex system or HR records to show that a person satisfied the actively at work requirement for each increase in benefit, in the event of a claim. Canada Life is happy to discuss its administration and data requirements with appropriate parties. 6.0 Claiming benefit The claims process for Canada Life s Flexible Benefit products is the same as for our non-flexible benefits Group products and further information is available in the relevant technical guide and on our website. As part of the flexible benefits claims process Canada Life will check that any benefit increases have been in line with the policy terms and we will require evidence of a life event where applicable. 14

15 7.0 Further information The Company This Group Insurance is issued by Canada Life Limited, an incorporated company limited by shares, whose Head Office is in the United Kingdom. Its address is: Canada Life Limited Canada Life Place Potters Bar Hertfordshire EN6 5BA Surrender value This Group Insurance does not acquire a surrender value. Queries and complaints For further information, or if you wish to complain about any aspect of the service you have received, please contact: Customer Services Canada Life Limited Group Insurance 3 Rivergate Temple Quay Bristol BS1 6ER You can also groupcsc@canadalife.co.uk or ring Lines are open Monday to Friday, 9am to 5pm, (Thursday 9.30am to 5pm). Complaints which we cannot settle can be referred to the Financial Ombudsman Service: The Financial Ombudsman Service South Quay Plaza 183 Marsh Wall London E14 9SR Telephone: or, for mobile phone users: complaint.info@financial-ombudsman.org.uk Website: Making a complaint will not prejudice your right to take legal proceedings. 15

16 Compensation In certain circumstances, if we are unable to meet our liabilities, you may be able to claim compensation in respect of the Policy from the Financial Services Compensation Scheme. Further information is available from the Financial Services Authority and the Financial Services Compensation Scheme. Law The construction, validity and performance of the Policy will be governed by English law. Group Life Assurance including Partner Group Life Assurance Under the Policy, members do not have any rights under the Contracts (Rights of Third Parties) Act Group Income Protection Any person or company who is not a party to this Policy does not and shall not have or acquire any right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this Policy. But after a claim has been made for a member, that member can pursue that claim as if they were the Policyholder. Group Critical Illness Any person or company who is not a party to this Policy does not and shall not have or acquire any right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this Policy. But after a claim has been made for an insured person, the member (if different) can pursue that claim as if they were the Policyholder. This document should be read in conjunction with the quotation. This document does not override the Policy conditions, which contains full details. The proposal and the terms contained in the Policy (and any supplementary proposal) together form the contract. 16

17 Group Insurance Technical summary About us Canada Life Group Insurance is committed to building strong relationships with its customers by providing marketleading products and exemplary service and support. History The Canada Life Assurance Company has grown and prospered since the sale of its first policy in Canada in After commencing operations in the United Kingdom in 1903, it operates in the UK market through its wholly-owned subsidiary, Canada Life Limited. Great-West Lifeco Inc. completed its acquisition of Canada Life in July The Great-West Life Assurance Company, founded in Winnipeg in 1891, is Canada s foremost life and health insurer and a market leader in group insurance and individual segregated funds. The 2003 transaction brought together three leading Canadian life insurers Great-West Life, London Life, and Canada Life to create a strong financial services organisation with global reach. Canada Life in the UK Canada Life Limited has been providing group products for intermediaries and their corporate clients for over 35 years, and is now one of the UK s largest providers of group risk insurance, covering over two million people through its Group Insurance division. Canada Life Group Insurance is recognised as having substantial weight and experience in its three core product sectors Group Life Assurance, Group Income Protection and Group Critical Illness. It is the market leader for Group Life Assurance and a leading provider of Group Income Protection benefits. The value of benefits insured with the Group Division currently exceeds 239 billion. Expertise Group Risk business placed with Canada Life is in the safe hands of specialists who understand your requirements in every way. The dedicated Group Insurance division in Bristol handles every aspect of the management of a scheme, from quotations and customer service support to underwriting and claims. Canada Life also has an ongoing commitment to innovation through the development of administration technology which will further improve service to Group Risk customers. Our forms are available to download from our website: Canada Life Limited, registered in England no Registered Office: Canada Life Place, Potters Bar, Hertfordshire EN6 5BA CLFIS (UK) Limited, registered in England no is an associate company of Canada Life Limited. Registered Office: Canada Life Place, Potters Bar, Hertfordshire EN6 5BA Canada Life group consists of Canada Life Limited, Canada Life Asset Management Limited (both authorised and regulated by the Financial Services Authority), Canada Life International Limited and CLI Institutional Limited (Isle of Man registered companies authorised and regulated by the Isle of Man Insurance and Pensions Authority). All promotional material produced is approved by Canada Life Limited. GRP R Canada Life Limited 3 Rivergate, Temple Quay, Bristol BS1 6ER Telephone