Please print and/or save this booklet for your records. Income Continuance Plan. for members of the Veterinary Officers Association (VOA)

Transcription

1 Please print /or save this booklet for your records. Income Continuance Plan for members of the Veterinary Officers Association (VOA)

2 Contents Summary of main benefits... 3 Why you need the VOA Income Continuance Plan... 4 Death Benefit... 5 Affordable for every member... 5 Who is eligible to join?... 5 Frequently asked Questions...6 Joining the Plan... 7 Terms of employment...9 Calculation of Benefit Tax Relief...12 Claiming from the Plan...12 Other common questions Introduction Dear Member, Over 20 years ago, the VOA introduced an extremely attractive arrangement for members of the VOA who wish to protect themselves from loss of salary in the event of long-term illness. Over the years the Plan has grown to become an essential element in veterinary officers financial security has proven its worth many times over. Although many veterinary officers feel they will never need the protection the Plan provides, sadly our experience has been that even the healthiest veterinary officers can suffer unexpected illness or have a serious accident. For veterinary officers the financial effects of long-term disability are particularly grim. This is why membership of the Income Continuance Plan is so vital. Please don t risk your financial security. The VOA believes membership of the Plan makes sound financial sense for every member. If you haven t already joined the Plan I would urge you to consider doing so now. Yours sincerely, Alan Johnson, Treasurer, Veterinary Officers Association (VOA). 2 VOA ICP Policy

3 Summary of main benefits Following on from the review of the VOA Income Continuance Plan in 2009, new benefits/enhancements have been added to the Plan which makes it even better value for money. Just some of the benefits the Plan now includes: An income of up to 75% of salary less any Early Retirement Pension/State Illness Benefit Preferential contribution rate of 0.94% of salary (0.51% after tax relief) Payment of benefit up until age 65 Accidental Death Benefit of 15,000 Children s Death Benefit of 4,000 Special arrangements for Unpaid Maternity, Parental & Carer s Leave All general policy exclusions removed (see page 16, Q4: Are there any exclusions under the VOA Plan? for details). Enhancements for beneficiaries include: No further medical evidence required for claims in payment for more than 10 years No contributions will be collected while claims are being assessed/in appeal. Here s what just two of the people who have already benefited from Cornmarket s Income Continuance Plans have to say The proof is in the pudding! Through its various Income Continuance Plans, Cornmarket has helped protect the financial security of more members of public sector unions/associations than any other company in Irel. But the real testament to the quality of these plans is the amount being paid out to beneficiaries, which is now counted in hundreds of millions of Euro. Mary McMahon, Plan Beneficiary, Co. Kildare. The reality is if you have no money, you are then dependent on the state I think everybody in this country knows what it is like to depend on the state. It s very difficult. That was very important because with a young family, in terms of the Income Continuance Plan, I knew I would have my salary (75% of salary covered). In terms of my life assurance, it would get my children through school college. It sounds very cold but I can guarantee you the first thing I thought of was my children... It s going to cost you very little the benefits far outweigh the cost you have to pay out of your salary I genuinely mean that. At the end of the day we all need money to survive. I was in the Plan for over 20 years... At the time I expected to get better when I didn t I have to say reality came home to me, because I have a wife 3 children... Then the Plan kicked in, certainly we wouldn t have been able to manage without it. That s the bottom line... I certainly didn t want to leave the job, if I could have had a way around it at the time I certainly would have stayed... I know the Plan works I wouldn t like to see anybody in the situation I was in... There is no reason, no logical reason why any member of staff shouldn t join the Plan at any stage along the way because it is a benefit, a huge benefit. Pat Ryan, Plan Beneficiary, Co. Laois. VOA ICP Policy 3

4 Why you need the VOA Income Continuance Plan Although many members feel that they will never need the protection the Plan provides, sadly our experience has been that even the healthiest person can suffer unexpected illness or, of course, have a serious accident. This is why membership of the Plan is so vital for every VOA member. What are your sick pay entitlements? Typically if you are a permanent superannuated member are absent from work due to ill health for more than 26 weeks during any period of 12 months your pay is cut by half. 100% salary/ sick pay Early Retirement Pension/pension rate of pay/state Illness Benefit Plan Benefit Once you have been ill for a full 52 weeks over a period of 4 consecutive years, you are taken off the payroll altogether! An example of what happens when sick pay runs out 75% What happens when your sick pay runs out? If you have been contributing to the Superannuation Scheme for more than 5 years there is a reasonable expectation that you will return to work, pension rate of pay may be paid for a limited period. Alternatively if you are forced to retire on grounds of ill health you may be entitled to an Ill Health Early Retirement Pension (ERP) at this point. 50% 25% 960 p.w. 480 p.w. Either way, even if you have many years of service, your Early Retirement Pension/pension rate of pay will only be a fraction of your pre-disability salary. In addition, those paying PRSI at the A1 rate may be entitled to a State Illness Benefit but, at 10,660 a year (2009 level), this provides a subsistence income only. The reality is that long-term illness inevitably means a severe drop in living stards. 0% 100% First 26 weeks of illness Sick pay totals 100% of salary Second 26 weeks of illness Sick pay totals 50% of salary An example of how the Plan helps 260 p.w. After 52 weeks of illness 27% of pre-disability salary if entitled to Early Retirement Pension/ pension rate of pay How the Plan works Once you have been ill for a full 52 weeks in total over a four year period you are taken off the payroll. At this point the Plan pays you a benefit of up to 75% of the salary you were earning before you fell ill, less any Early Retirement Pension/ Pension Rate of Pay* /or State Illness Benefit to which you are entitled. What s more, if within this period you are ill for more than 6 months in any one year your pay is cut by half. In this instance, the Plan will pay you an income of 25% of the salary you were earning before you fell ill, topping up your sick pay from 50% to 75%. 75% 50% 25% 0% 960 p.w. 240 p.w. 480 p.w. 460 p.w. 260 p.w. The Plan will continue to pay you benefit until you recover, go back to work, reach age 65, or die. *It should be noted that if an individual is receiving Pension rate of pay, they are not in a position to accrue Pensionable service as they are availing of the pension facility. First 26 weeks of illness Sick pay totals 100% of salary Second 26 weeks of illness Sick pay plus Plan benefit totals 75% of pre-disability salary After 52 weeks of illness Plan benefit totals 75% of pre-disability Plan salary less Early Retirement Pension/ pension rate of pay Example is based on a full time VOA member earning 50,000 p.a. ( 960 p.w.) with 15 years of service paying PRSI at the lower D1 rate, who is now unable to work due to a long-term illness. 4 VOA ICP Policy

5 Death Benefit (Life Cover) Members will now benefit from a Death Benefit in the form of: Accidental Death Benefit In the event of accidental death. Benefit of 15,000 is now payable to the member s estate. Accidental Death is defined as death as a direct result of a bodily injury arising from an external accidental cause which leaves a visible bruise or wounds. Children s Death Benefit In the event that a member s child (under the age of 18, or 21 if in full-time education) dies, a Death Benefit of 4,000 will be paid. Affordable for every member How much does it cost Very little! As membership is so vital, the Plan is designed to be affordable for every member. It s remarkably good value because it s negotiated on a special group basis for members of the VOA. The contribution rate is currently set at just 0.94% of pensionable salary (guaranteed until July 2014) is conveniently deducted from your salary by your employer. Please bear in mind that it is your responsibility to ensure that the correct deductions have in fact been made by your employer that deductions are cancelled where appropriate. Income Weekly Real Contribution Contribution after tax relief e70,000 e12.61 e6.82 e80,000 e14.41 e7.80 e90,000 e16.21 e8.77 Contribution for a full-time VOA member of the Superannuation Scheme, paying PRSI on the lower D1 rate. A helping h from the Revenue! You are eligible for tax relief at your highest rate of tax on your contribution to the Plan. This means for most members the cost of membership is only 6 to 9 a week after tax PRSI relief a small price to pay for peace of mind. Who is eligible to join? To be eligible to apply for membership of the Veterinary Officers Association Income Continuance Plan you must be: Under age 65 A member of the Veterinary Officers Association (VOA) Employed on a permanent full-time basis or on a contract of definite duration (if you are in a temporary position, your contract must be of at least 12 months duration) Working more than 8 hours per week. How do you join? If you haven t already joined the Plan, don t put it on the long finger! Apply to join now by calling Cornmarket on (01) Cover begins when New Irel accepts you as a member of the VOA Income Continuance Plan. Job sharing members of the VOA who satisfy the eligibility conditions above, may also apply to join the VOA Plan. The benefits which apply for them may differ from those relevant for permanent full-time members. VOA ICP Policy 5

6 Frequently asked questions Joining the Plan What medical details must be confirmed when applying to join? Who is eligible to join? When does my membership begin? When does my membership end? Are all applications accepted? What does it mean if my application is subject to exclusions, extra premium or even refused? Terms of employment What if I have a second job?...9 What if I have unearned income?...9 What if I take a career break?...9 What if I am not in the Superannuation Scheme?...9 What if I leave the Veterinary Officers Association?...9 Is my benefit affected by the PRSI contribution I pay?...9 What happens if I change my terms of employment or my normal occupation? What benefits does this Plan provide for job sharers work sharers? What if I take unpaid parental, maternity, or adoptive leave? What if I take unpaid leave to take care of a dependant relative? What if I travel abroad? Calculation of benefit On what salary is my cover based? Does it affect my benefit under the Plan if my disability is due to an injury at work? What if I take out a critical illness policy? What if I take out a Specified Injury/ Accident policy? What if I already have some form of Income Protection? Will I receive money back if I never claim under the Plan? What are the maximum benefits paid under the Plan? Tax Relief Do I have to pay tax on benefits from the Plan?...12 How do I claim my tax relief on contributions?...12 Claiming from the Plan How do I claim from the Plan?...12 How disabled do I have to be to qualify for benefit under the Plan? Who decides whether or not I am fit to work? Are there any exclusions under the VOA Plan? Are claims ever turned down by the insurer? When does benefit payment under the Plan begin? For how long will I be paid benefit under the Plan?...17 Do I have to pay my contributions if I am claiming from the Plan?...17 What happens if my claim is rejected?...17 What happens if I return to work only to find that I become ill again a few months later?...17 What happens if I return to work but at a reduced salary or take up a different less well paid job?...17 Other common questions What happens if I cancel my membership?...18 Under what circumstances can the Plan be amended?...18 Who administers insures the VOA Income Continuance Plan?...18 Does my cover increase in line with my rising salary? If I am claiming from the Plan, does the amount I receive increase each year? VOA ICP Policy

7 Joining the Plan 1 What medical details must be confirmed when applying to join? When completing your application form you must answer the following questions: 1 Have you been absent from work through illness or injury for more than 10 consecutive working days in the last 12 months? Yes No 2 Are you currently under medical care of any kind, taking prescribed drugs, medicines or tablets or have you done so in the last six months? Yes No 3 Have you attended or been advised by your doctor to attend any specialist or consultant, hospital or clinic for any medical check-up, blood, saliva or urine test, treatment, investigation or operation in the last three years? Yes No 4 Have you ever suffered from or had treatment for: Anxiety, depression, nervous breakdown or mental disorder? Yes No 5 Have you ever suffered from or had treatment for: slipped disc, whiplash, or other neck or back problems? Yes No 6 Has any application for life, critical illness or disability insurance on your life to any insurer ever been declined, postponed or accepted at an increased premium or with an exclusion imposed? Yes No In addition you must sign your application form to confirm your acceptance of the following conditions: You declare that the statements including any statements written at your requests or to be completed by a medical examiner in connection with this proposal signed by you are true complete shall be the basis of the proposed Plan. You underst that failure to disclose all material facts could result in a claim not being paid. You hereby consent to New Irel seeking information from any doctor who at any time has attended you from any insurance office to which at any time a proposal for insurance of any kind on your life or health has been made you authorise the giving of such information. You underst that cover will not begin until this application has been accepted by New Irel. You underst that any changes to this proposal before the proposed contract comes into force must be notified, in writing, to New Irel. You underst that in the event of your application not proceeding, information provided in connection with your application will be retained by New Irel for a period of six years to facilitate any future application by you as a protection against non-disclosure of material facts. You underst that if your application for insurance is declined or if New Irel offers you insurance on special terms then whether or not your application proceeds, New Irel will note this fact on a registry administered by the Irish Insurance Federation may be shared with other insurance companies as a protection against non-disclosure of material facts. You confirm that you have received an explanatory leaflet about the Plan have received understood the contents of the Cornmarket Terms of Business document. You declare that you are a member of the Veterinary Officers Association (VOA) are eligible to join the VOA Income Continuance Plan. You are actively at work on the date of signing the proposal. VOA ICP Policy 7

8 2 3 Who is eligible to join? To be eligible to apply for membership of the Veterinary Officers Association Income Continuance Plan you must be: Under age 65 A member of Veterinary Officers Association (VOA) Employed on a permanent full-time basis or on a contract of definite duration (if you are in a temporary position your contract must be of at least 12 months duration) Working more than 8 hours per week. Job sharing members of the VOA who satisfy the eligibility conditions above, may also apply to join the VOA Plan. The benefits which apply for them may differ from those relevant for permanent full-time members. When does my membership begin? Your cover begins from the date New Irel accepts your application to the Plan. Members receive a formal acceptance letter confirming they have been included as members of the VOA Income Continuance Plan. In some cases medical evidence may be required before membership of the Plan can be confirmed. This may involve providing further details over the telephone or attending a medical examination at New Irel s expense. 5 6 Are all applications accepted? In a small percentage of cases membership of the Plan may be refused. In such cases applicants will receive a letter confirming that they have not been accepted into the Plan. In other cases, membership may be offered subject to the condition that certain medical conditions are excluded from cover or subject to the payment of an additional contribution. What does it mean if my application is subject to exclusions, extra premium, or even refused? This means that New Irel believe they cannot, because of your health history, offer you the cover sought or they believe it is necessary to charge an extra premium, exclude certain conditions or restrict the level of cover. New Irel make such decisions only after careful consideration of the information supplied by you on your application form together with any details they have received from doctors you have attended. Applicants may seek additional clarification from their own doctor who can contact New Irel to request reasons for their decision. 4 When does my membership end? Membership of the Plan ends: If you no longer fulfil the eligibility requirements as set out or If your contributions to the Plan cease (please bear in mind that the responsibility to ensure that the correct contributions to the Plan are paid rests with you). It is important to remember that Cornmarket may not be notified by your employer when you retire. It is vital therefore that you notify Cornmarket at least 10 weeks in advance of your retirement date so that we can stop contributions to the Plan. 8 VOA ICP Policy

9 Terms of employment What if I have a second job? This may be taken into account in calculating any benefit paid should you make a claim from the Plan. It is vital, therefore, that you notify Cornmarket in writing at the time of joining the Plan if you have a second job. Likewise you should notify Cornmarket in writing if, after joining the Plan, you take on a second job. In the event that you have a second job at the time of joining the Plan or take on a second job after joining the Plan, New Irel reserves the right to refuse cover or withdraw cover in respect of your normal job. This could happen where, for instance, New Irel believes that your second job involves a greater degree of risk than that involved in your normal job. The cover provided by the Plan does not extend to your second job. If you would like disability cover on your second job you should contact Cornmarket about the possibility of insuring yourself against disability through an individual policy. What if I have unearned income? In general, investment rental income will not be taken into account when making a claim under the Plan. Benefit from any accident or sickness policy may however be taken into account except benefits paid under a critical/serious illness policy (see page 10, Q3: What if I take out a critical illness policy? page 11, Q9: What are the maximum benefits paid under the VOA Plan? for details). What if I take a career break? Generally, members of the Plan who take a career break fall into one of the following categories: a) Members who wish to continue their full cover under the Plan for the duration of their career break because they are taking up alternative employment. If you are in this category you may apply within 2 months of taking a career break to transfer benefits similar to those you enjoyed under the Plan to any new job. This is, however, at New Irel s discretion subject to your new job being acceptable to New Irel from an underwriting point of view, e.g. that your new job does not involve a greater degree of risk than that in your normal job. Naturally the rate amount of your contribution benefit level will be determined by your pre-career break salary as you will no longer be an active member of the Plan. You should remember to notify Cornmarket on taking up your normal job at the end of your career break if you wish to re-activate your membership of the Plan. The level of cover applying when you take up your membership again may be higher than that you enjoyed while on your career break. b) Members who do not wish to continue the Disability Benefit element of their cover but who wish to re-activate their membership on completing their career break without having to undergo any medical underwriting. If you are in this category you may apply within two months of taking a career break for immunity from medical underwriting This will allow you to re-activate your membership of the Plan before a specified date when your career break is over without the need for medical underwriting. To secure immunity from medical underwriting you must pay a reduced contribution of 33 1 /3% of the normal contribution for Disability Benefit. These payments are based on your pre-career break salary must be paid annually in advance during your career break. c) Members who simply decide to discontinue membership of the Plan. If you are in this category, or do not notify Cornmarket of your intention to take a career break, your cover under the Plan will cease as soon as your salary stops. Thereafter you must complete a full medical application form undergo medical underwriting should you wish to rejoin the Plan upon returning to work. What if I am not in the Superannuation Scheme? If you are not contributing to the Superannuation Scheme, you are not entitled to an Early Retirement Pension should you become disabled. However, if you are not a member of the Superannuation Scheme you will be paying full PRSI contributions therefore may be entitled to a State Illness Benefit in the event of disability. Therefore, if you are not a member of the Superannuation Scheme, any benefit under the Plan will be 25% of salary after 26 weeks of illness in any 12 month period. After 52 weeks disability in a four year period the benefit paid will be 75% of your pre-disability salary less State Illness Benefit entitlement, whether paid or not, plus any income you may receive from your employer. What if I leave the Veterinary Officers Association? In such circumstances you are no longer eligible for membership of the Plan. You should therefore write to Cornmarket to cancel your membership. Cornmarket may, depending on your circumstances, be able to offer you an individual policy providing similar cover. Is my benefit affected by the PRSI contribution I pay? Many members are paying PRSI contributions on the lower D1 PRSI rate so pay less PRSI than those members on the A1 PRSI rate. If a member paying PRSI at the D1 rate retires on an Ill Health Early Retirement Pension (ERP) under the Superannua t ion Plan he or she is not entitled to any State Illness Benefit. On the other h members paying the higher A1 PRSI rate may be entitled to a State Illness Benefit if they suffer prolonged illness. Members in this situation may also be entitled to an Ill Health Early Retirement Pension. The benefit payable under the Plan is the amount needed to top up any Ill Health Early Retirement Pension any State Illness Benefit to 75% of pre-disability pensionable salary. In effect this means that whether you are a D1 or an A1 PRSI contributor, taking both the Ill Health Early Retirement Pension the State Illness Benefit into account, the combined amount you receive in the event of disability is the same. VOA ICP Policy 9

10 What happens if I change my terms of employment or my normal occupation? If your terms of employment change, this may affect your cover under the Plan. For instance, if you reduce the overall number of hours you are working each week or change to a job which involves reduced earnings, your benefits under the Plan may be affected. Similarly if you change your job to one that may involve a greater degree of risk from an underwriting point of view it is vital that you notify Cornmarket in writing. What benefits does the Plan provide for Job Sharers Work Sharers? The benefits contribution rate for job sharing work sharing members are based on job sharing work sharing salary. What if I take unpaid parental, maternity, or adoptive leave? If you avail of your entitlement to take unpaid Parental, Maternity or Adoptive Leave, are making your contributions to the Plan through salary, no contributions will be collected in respect of periods for which you are on leave as you will not be paid a salary while on leave. Nonetheless your cover will continue unaffected while you are on leave no repayment of the skipped contributions will be sought. However this is subject to the period of unpaid leave being no longer than 18 weeks in total in any 12 month period. Where the period of leave is more than 18 weeks in total in any 12 month period, members should contact Cornmarket for details of their options. These will be similar to those available to members who take a career break. Members must notify Cornmarket at least 4 weeks in advance of the commencement of unpaid leave. What if I take unpaid leave to take care of a dependant relative? If you avail of your entitlement to take unpaid Carer s Leave, are making your contributions to the Plan through salary, no contributions will be collected in respect of periods for which you are on leave as you will not be paid a salary while on leave. Nonetheless your cover will continue unaffected while you are on leave no repayment of the skipped contributions will be sought. However, this is subject to the period of leave being no longer than 18 weeks in total. Where the period of leave is more than 18 weeks, members should contact Cornmarket for details of their options. These will be similar to those available to members who take a career break. You must notify Cornmarket at least 4 weeks in advance of the commencement of unpaid leave so contributions can be cancelled. What if I travel abroad? As long as you remain resident within Irel, you are covered wherever you travel in the world for holiday purposes. However, should you decide to reside abroad or work abroad temporarily, you should notify Cornmarket immediately as New Irel reserve the right to vary your contributions or benefits or cancel membership of the Plan in such circumstances Calculation of benefit On what salary is my cover based? If, like most members you are making your contributions to the Plan through salary, your cover contributions are based on the pensionable salary you receive from your employer i.e. basic salary plus any allowances taken into account for sick pay Superannuation purposes. The level of cover you enjoy the amount of contributions you pay will be increased periodically (see page 11, Q5: Does my cover increase in line with my rising salary? for details). Your income will be calculated on your pensionable salary at the end of the deferred period excluding bonuses, commissions, overtime any other fluctuating emoluments. Does it affect my benefit under the Plan if my disability is due to an injury at work? Yes. If you are injured at work, depending on the circumstances, social welfare benefits, etc., you may be entitled to payments in excess of 75% of pensionable salary. In such cases, as you would already be receiving a payment greater than 75% of your predisability pensionable salary, you would not be entitled to any benefit under the Plan. What if I take out a Critical Illness policy? Critical Illness policies (otherwise known as Serious Illness/ Specified Illness Benefit) pay out a lump sum on the diagnosis of certain specified serious illnesses. Benefit paid under such policies are often taken into account when assessing the level of benefit to be paid under Income Protection Plans. However, New Irel has agreed special preferential arrangements for members of the Plan. This means that currently payments under a Critical Illness policy will not be taken into account when calculating the benefit to be paid to you under the Plan. What if I take out a Specified Injury or Accident Benefit Policy? Typically, Specified Injury/Accident Benefit Policies pay out a flat weekly amount over a fixed period (usually 52 weeks) on the diagnosis of certain specified serious injuries. In addition, these policies often pay a lump sum for specific injuries or accidents. No tax relief applies on contributions paid under such policies so they tend to be expensive. In contrast, the VOA Income Continuance Plan is designed to top up your sick pay to 75% less any pension entitlements /or State Illness Benefit at a singe person s rate if applicable, until you recover, return to work, retire, die, or reach age 65. Unlike Specified Injury/Accident Benefit Policies, contributions are eligible for full tax PRSI relief. Important: Benefits under these policies are very often taken into account when calculating the amount of benefit to be paid under the Income Continuance Plan. 10 VOA ICP Policy

11 5 6 7 Does my cover increase in line with my rising salary? One of the great advantages of the Plan is that it allows for your cover to be increased in line with salary rises, promotions, etc. This means that the cover you enjoy under the Plan remains realistic over the years ahead. As members contribute by deduction at source (through salary) cover increases automatically every time your salary increases. This is because New Irel automatically increases your cover in line with salary rises without any need on the part of the member to complete new application forms or go for medicals. Members contributing by Direct Debit: For those few employees who are contributing to the VOA Plan by Direct Debit from a current account, contributions cover will be increased periodically. These increases will be in line with the rise in the Consumer Price Index or the average increase in members salaries over the period since the last increase was applied. Again such increases are currently applied without the need for medical underwriting members will receive prior notification. If I am claiming from the VOA Plan, does the amount I receive increase each year? Yes. The benefit paid to you by the VOA Plan increases by 5% each year or the rate of increase in the Consumer Price Index if lower. This helps ensure the benefit you receive remains realistic despite the effect of inflation. You should bear in mind that any Early Retirement Pension you receive will generally increase each year in line with salary rises awarded to working members. What if I already have some form of Income Protection? If you already have an Income Protection or Permanent Health Insurance policy you should bear in mind that the cover provided by such a policy may overlap with that provided by the Plan i.e. it will be taken into account when calculating how much benefit should be paid under the Plan to ensure you receive 75% of pre-disability pensionable salary. You should therefore contact your local Cornmarket consultant for advice before joining the Plan. 9 What are the maximum benefits paid under the Plan? 75% of your pensionable salary as paid by your employer less: (a) any amount of salary, earning, profit, reward or remuneration which you are in receipt of from your normal occupation (b) any amount of new or increased income from any other occupation or business (c) the Ill-Health Retirement Pension entitlement calculated on the normal basis as set down by your employer, irrespective of whether you are receiving this amount or not (d) an amount equal to the State Illness Benefit payable to a single person, if entitled (e) any benefit you are receiving under the Social Welfare Act other than sickness, disability or treatment benefits payable to you under the Social Welfare Acts (f) any benefit you are entitled to under any other insurance against accident or sickness or other similar arrangement (where appropriate such an amount will be annualised except benefits paid under a Critical/Serious Illness policy) (see page 10, Q3: What if I take out a critical illness policy? for details) (g) any annualised amount awarded by an arbitration tribunal or court of law or agreed settlement sum or ex-gratia payment attributable to loss of earnings arising out of any action relating to your disablement. or (h) The maximum Income Continuance benefit currently 90,000 per annum. 8 Will I receive money back if I never claim under the Plan? No. As with health or car insurance, your contributions go to meet the cost of cover for you your colleagues. This keeps the cost of membership to a minimum means that there is no cash value paid out to those who never make a claim under the Plan. VOA ICP Policy 11

12 Tax Relief Claiming from the Plan 1 Do I have to pay tax on benefits from the Plan? Benefit paid by the Plan will be treated as normal income as such is liable to income tax, PRSI the health levy. New Irel will deduct any tax due from the payment made to the member in the same way as an employer deducts PAYE PRSI from an employee. 1 How do I claim from the Plan? Cornmarket s role is to help guide members through the claims procedures ensure that all legitimate claims are paid promptly by New Irel, the insurers of the Plan. Cornmarket has considerable experience in this area on behalf of claimants, works closely with New Irel to ensure that all legitimate claims are paid. 2 How do I claim my tax relief on contributions? If you are making your contributions through salary Tax relief is provided automatically if you are making your contributions through your salary. If you are making your contributions through Direct Debit Once you have been accepted for membership of the VOA Plan, Cornmarket will forward you a letter confirming your membership. With this letter you will receive details of the information your tax inspector needs in order to award you tax relief on your contributions to the VOA Plan. Simply forward these details to your tax inspector together with a covering letter. Tax relief is usually granted within a few weeks of receipt of this information. Cornmarket is not automatically notified of your absence from work through illness. This means that if you intend to make a claim under the Plan you must notify Cornmarket of this fact. You must contact Cornmarket (Tel: (01) ) for a claim form approximately 12 weeks in advance of the date your salary is due to reduce to half pay or is stopped altogether (see page 4: How the Plan works for details). Cornmarket will explain the additional documentation you will need to submit. Prior to completing your claim form please consult with Cornmarket. Upon receipt of your claim form, Cornmarket will process your claim with New Irel. You should note the following: All evidence reasonably required by New Irel must be provided by the member Over the years ahead you may need to update your tax inspector on any increases in your contributions to the VOA Plan as your contributions rise in line with your increasing salary. To do so you should telephone or write to Cornmarket who will be happy to forward you up to date details of the contributions you are making. You should in turn send this on to your tax inspector who will increase you tax relief accordingly. The member may be required to undergo medical examinations (at New Irel s expense) or an assessment by an occupational therapist Admittance of a claim is subject to New Irel being satisfied based on medical evidence received, that you are totally disabled from following your normal occupation You may also be asked to undergo medical rehabilitation with a view to being rehabilitated back to your normal occupation. New Irel may also arrange for one of its Health Claims Advisors to call to you at your home address, either before any decision is made to admit the claim, or while the claim is in payment. The purpose of the home visit service is to explain the claims process, offer advice on social welfare re-training if applicable, as well as outlining the various rehabilitation clauses contained in the policy. It must be emphasised that information required (including your claim form) by New Irel as outlined above must be dealt with fully promptly. Undue delay, or failure to produce such information, may invalidate your claim. In the event of you failing to follow the advice of your own or any qualified medical practitioner all benefits payable or being paid under the policy may cease. 12 VOA ICP Policy

13 a step-by-step guide STEP 1 Contact Cornmarket STEP 2 Cornmarket is not notified automatically by your employer of your absence from work through illness. It can take a number of weeks to process your claim as various pieces of information must be gathered together for New Irel about your health, salary, etc. This means it is essential that you contact us at least 12 weeks in advance of the date your salary is due to reduce to half pay or is stopped altogether (see page 4: What happens when your sick pay runs out? for details) Your Claim Pack Once you contact us we will send you a claim pack containing 3 forms: Claim Form This is the first piece of documentation you ll need to return to us. You should return this to us even before you have gathered together the other documentation. If you need any help in completing this form, simply contact our experienced staff on / In some cases New Irel may arrange for a Health Claims Advisor to visit you to assist you in the completion of the Claim Form. Checklist Letter A letter containing a list of the documents (listed below) you will need to provide in order for your claim to be processed. Documents you will need to provide: Your original or certified birth certificate If you are female married, your original or certified marriage certificate (this confirms the link between your present surname that on your birth certificate). Copy of payslip. Authorisation Form This authorises us to contact your employer to request the documentation listed below. Documents we will get from your employer on your behalf: Confirmation of your salary details at the date of disability Confirmation of the date your salary ceased or confirmation of date half pay commenced Breakdown of your sick leave dates over the last 4 years Confirmation of your State Illness Benefit /or Early Retirement Pension/Pension rate of pay Detailed description of your job Your PPS Number. VOA ICP Policy 13

14 Claiming from the Plan a step-by-step guide STEP 3 Processing your claim Once we receive your completed Claim Form we will send it to New Irel so that an assessment of your claim may begin immediately. Thereafter we will send on any documentation as we receive it we will liaise between you New Irel throughout the claim process. STEP 5 STEP 4 Medical Examination Medical evidence will be assessed by New Irel s Chief Medical Officer. In most cases New Irel will request that you attend an independent medical examination (at its expense) to confirm you are indeed disabled from carrying out your normal job because of your disability. Your medical examination may be arranged with a doctor locally. However in some cases you may need to travel to attend for your medical examination. New Irel will pay reasonable travel, accommodation meal expenses. Additional Medical Evidence In some cases New Irel s Chief Medical Officer may require additional medical evidence from doctors /or specialists who have attended to you. You may possibly be requested to attend a further medical examination again New Irel will cover any medical costs involved including reasonable travel, accommodation meal expenses. Note: During the assessment of your claim we will keep you up-to-date on medical reports documentation received. STEP 6 Decision on your claim Once all the medical evidence documentation has been received, New Irel s Chief Medical Officer will make a decision on your claim. Should your claim be successful we will write to you confirming the amount of benefit payable. New Irel will then arrange to pay your benefit directly to your bank account. If you do not have a bank account your benefit will be paid by cheque. If your salary has been reduced to half pay or stopped altogether by the time your claim is approved, your benefit will be backdated to the date your salary was reduced/ceased. Please note: If your claim is unsuccessful you are unhappy with the outcome, a series of appeals procedures are available: 1 Direct Appeal 2 Appeal to the Financial Services Ombudsman 3 Arbitration You will find details of these on page 17, Q9: What happens if my claim is rejected? We will of course be happy to help you with any appeal you wish to make. 14 VOA ICP Policy

15 Once a claim is being paid, payment of the benefit is made by New Irel monthly in arrears at the end of each calendar month. Benefit repayments are subject to income tax. New Irel will request the Revenue Commissioners to issue a tax credits certificate to New Irel (as the employer) in relation to your claim payment. This will enable New Irel to apply the correct tax rate for future payments. However the first payment may have emergency tax rates applied (any overpayment of tax will be subsequently paid back). STEP 7 Your benefit Your benefit will continue to be paid for as long as you remain unfit to carry out your normal job because of illness or injury. Benefit payments will stop when: You recover i.e. when New Irel decides, based on the medical evidence that you are no longer prevented from doing your normal job because of illness or injury or You return to work or You die or Your 65th birthday whichever is earliest. In certain cases, benefit may be paid where you return to work at a reduced level of earnings due to partial disability. From time to time New Irel may require medical evidence confirming that you remain unfit to work. These steps are designed to help you through the claims process ensure any benefit you are entitled to is paid out in time. If you have any questions please do not hesitate to contact us on (01) or (01) VOA ICP Policy 15

16 Claiming from the Plan continued 2 3 How disabled do I have to be to qualify for benefit under the Plan? To qualify for benefit under the Plan, New Irel must be satisfied that you are totally unable to carry out your duties under your normal occupation because of illness or injury that you are not following any other occupation. Who decides whether or not I m fit to work? New Irel, advised by its Chief Medical Officer (CMO), will decide whether you are fit to work based on an assessment of all medical information. To qualify for benefit under the Plan, New Irel must be satisfied that you are totally unable to carry out the duties pertaining to your normal occupation because of illness or injury that you are not following any other occupation. In certain cases benefit may be paid where the member returns to work to take up another occupation, but at a reduced level of earnings due to partial disability (see page 17, Q11: What happens if I return to work but at a reduced salary or take up a different, less well paid job? for details). While you are being paid benefit under the Plan, New Irel will seek regular medical certificates from your doctor. This is because you must continue to be disabled unable to work in order to be entitled to continue to claim under the Plan. New Irel may also require an independent medical examination or specific information from your doctors. These medical examinations will be at New Irel s expense. You may also be visited by a New Irel Health Claims Advisor from time to time. In the event of you failing to follow medical advice during the course of benefit payments New Irel reserve the right to cease paying benefits. 5 Are claims ever turned down by the Insurer? The great majority of claims, typically over 90%, are paid. However, experience has shown that when difficulties do arise, they usually arise because: When joining, the member did not disclose his or her full medical history In such cases New Irel reserves the right not to pay a claim. It is very important when applying to join the Plan that you ensure you make a full disclosure in relation to any questions asked on the application form during any medical examination you may undergo. If you don t, any claims you make may be turned down cover under the Plan may be cancelled. Medical opinion is that the member is not disabled from carrying out his or her normal occupation Dependent upon the medical condition at issue, specialist opinion may be required. If ultimately in New Irel s view, the medical opinion is that you are not disabled as defined under the Plan, benefit will not be paid regardless of whether you have been retired on grounds of ill health by your employer. In the event of a dispute you may appeal to the insurer by providing additional specialist evidence. Should your appeal be unsuccessful you have the right to seek the assistance of the Financial Services Ombudsman who may take up your case without cost to you. Finally, if all other avenues fail, you can take your case to the courts, using the arbitration procedures provided for under the Plan. Throughout the appeal procedures, Cornmarket staff will assist you. 4 Please note that the fact you have been granted early retirement on the grounds of ill health under the rules of the Superannuation Scheme does not mean that you will automatically be entitled to a benefit under the Plan. This is because New Irel reserves the right to undertake its own medical examinations its own determination as to whether you are disabled under the terms of the Plan. Are there any exclusions under the VOA Plan? There are no general Policy exclusions under the VOA Income Continuance Plan. Please bear in mind that in some cases individual members may be accepted into the Plan subject to exclusions in respect of specific illnesses (see page 7, Q1: What medical details must be confirmed when applying to join? for details). 6 When does benefit payment under the Plan begin? Once New Irel has accepted your claim, benefit payment under the Plan will begin as soon as your pay is reduced to half pay or is stopped altogether. Please remember that it can take a number of weeks to process your claim as various pieces of information medical evidence must be gathered. Therefore it is vital that you contact Cornmarket at least twelve weeks in advance of the date your salary is to reduce to half pay. If your salary has been reduced to half pay by the time your claim is approved, your benefit may be backdated to the date your salary was reduced/ceased. New Irel will arrange to pay your benefit directly to your bank account. If you do not have a bank account your benefit will be paid by cheque. 16 VOA ICP Policy

17 7 For how long will I be paid benefit under the Plan? The Plan will continue to pay benefit as long as your illness or injury prevents you from doing your normal job you are not following any other occupation. Payments will stop when either: you recover; i.e. when it has been determined by New Irel, based on medical evidence, that you are no longer prevented from doing your normal job because of illness or injury or you return to work or you reach age 65 or your death, whichever is earliest. Once your complaint has been accepted as a matter for investigation your financial service provider will be asked to respond to the issue raised. If your complaint cannot be accepted for investigation by the Ombudsman you will be informed as to the reason why. All the circumstances surrounding the complaint will be examined. Further information or supporting documentation may be requested from you. Every case is judged on its individual merits. In some cases it may be possible to reach a settlement to the satisfaction of both parties. If this is not possible, the Ombudsman will adjudicate upon the matter In certain cases benefits may be paid where the member returns to work but at a reduced level of earnings due to partial disability. (see this page, Q11: What happens if I return to work but at a reduced salary or take up a different, less well paid job? for details). Claims which have been in payment for at least 10 years will no longer be subject to periodical medical reviews therefore are guaranteed to be paid, subject to financial review only (e.g. to confirm that the member is not receiving a new or increased income from some other source), until age 65 or death, if earlier. Do I have to pay my contributions if I am claiming from the Plan? No. While you are claiming benefit from the Plan no contributions are deducted in respect of the VOA Income Continuation Plan. What happens if my claim is rejected? If the claim is rejected, there are a series of appeal procedures. These are as follows: Direct Appeal This involves individual claimants making an appeal in which they should include any additional evidence to support their claim. Any such evidence is submitted for consideration by New Irel where relevant by New Irel s Chief Medical Officer. If the evidence is accepted, the claim is paid. Appeal to the Financial Services Ombudsman In the event that a direct appeal is not successful the claimant is dissatisfied with the outcome, an appeal may be submitted to the Financial Services Ombudsman. This process involves obtaining from New Irel a signing off letter submitting this letter to the Financial Services Ombudsman with a request for a complaint form. When the complaint form is issued, Cornmarket will assist the claimant in completing the form returning it together with any relevant documentation to the Financial Services Ombudsman Following adjudication, the complainant or the financial service provider concerned may appeal the Ombudsman s decision to the High Court. Arbitration In the event that the Ombudsman finds against the claimant the claimant is dissatisfied with the Ombudsman s decision, the case can be taken to arbitration by the claimant under the Arbitration Acts. In such an eventuality, legal counsel are appointed by both parties who jointly agree on an arbitrator who will act as judge. Normally a full hearing is held during which the legal teams put their respective cases to the arbitrator witnesses are called. Cross-examination by the other side is a common part of the process. Following the hearing, the arbitrator will make a decision. If the arbitrator finds in favour of the claimant, New Irel will make payment in accordance with the policy terms conditions. What happens if I return to work only to find that I become ill again a few months later? If you return to work after a period claiming benefit through the Plan only to find that you fall ill again, your claim will be considered immediately by New Irel i.e. you will not have to wait the usual period before your benefit is paid. Naturally this is subject to New Irel being satisfied that you are totally unable to carry out your duties under your normal occupation because of an illness or injury that you are not following any other occupation. What happens if I return to work but at a reduced salary or take up a different, less well paid job? If you are able to return to work in your normal job on a reduced basis as a result of ill health, New Irel will continue to pay you a proportionately reduced income, i.e. your benefit under the Plan will be reduced to take account of additional income you are now earning. Should you be unable to follow your normal job take up a different job at a lower rate of pay, again New Irel will continue to pay you a proportionately reduced income. VOA ICP Policy 17