Anglo - Saxons Friendly Society. Membership Application

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1 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 1 Anglo - Saxons Friendly Society Registered Office: ANGLO-SAXON HALL, BERKLEY ROAD, GRAVESEND, KENT DA12 2EU Telephone: Gravesend (01474) Facsimile: (01474) (Authorised and Regulated by the Financial Conduct Authority No ) Membership Application Sickness Benefit Plan and Board of Management Discretionary Grants Product Summary This plan provides income to help pay expenses if you become incapacitated by a sickness or injury

2 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 2 SUMMARY OF BENEFITS After 6 moths membership SICKNESS BENEFIT per week (In the case of long - term sickness any benefit is halved after the first 52 weeks and halved again after a futher 52 weeks). SUBSCRIPTIONS AGE NEXT BIRTHDAY PER MONTH SUBSCRIPTIONS PER YEAR Subscription premium fixed As a Member of Anglo - Saxons, it is your responsibility to keep your subscriptions up to date

3 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 3 The Board of Management s Discretionary Grants After 12 months membership Year 2 Year 3 Year 4 DENTAL OPTICAL MISCELLANEOUS MEDICAL (Register Practitioner) Inc:- Specialist Consultancy Health Screening Surgical Appliances Welfare Payments HOSPITAL IN PATIENT 30 per night, max 50 nights in 52 weeks MATERNITY 200 Forward receipts for expenditure To the Operations Officer. At age 65 years contributions and sickness benefit cease, entitlement is restricted to above Discretionary Grants only. These Discretionary Grants do not form any part of your membership and must not be treated as an expectation; grants are considered on merit and are available for consideration upon request. The Board of Management will only consider these applications on the understanding that there are funds available to satisfy such grants. If circumstances dictate the board may reduce or withdraw these Discretionary Grants at any time. By submitting any claim for sickness or consideration for a Discretionary Grant you are agreeing to the society carrying out random validity checks. Should members require the return of original documents or sick notes please enclose a Stamped Addressed Envelope RENTED ACCOMMODATION Priority will be given to members to rent one of the society s properties.

4 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 4 This document explains our sickness benefit plan. Please read it carefully and keep it somewhere safe for future reference. The cover we provide The sickness benefit plan - an explanation A plan designed to provide a benefit of 40 per week when you are unable to work through incapacity as a result of illness or injury before you are 65, in exchange for a monthly contribution. Other important facts about your sickness benefit plan You can be covered by this plan if you are at least 16 and under 55 years of age on the date you apply. You will only be covered when your application has been accepted in writing. The board of management has the right to refuse admission to membership, or to impose special terms for admission, without giving a reason for its decision. No sickness benefit is payable in respect of the first six months of membership. You must give us all the information we ask for when applying for membership, and when claiming benefit. If you do not, we may not pay benefit. Payment of benefit depends on certain conditions being met. These are detailed below. The benefit you may receive reduces for lengthy claims and is unlikely to be sufficient on its own to replace income lost through being unable to work. No premiums are due and no sickness benefit is payable once you reach 65th birthday. You will remain a Member of the society and continue to be eligible to apply for a Discretionary Grant. The value of benefits payable may be reduced by inflation over the term of the contact. You pay regular premiums to keep the benefits in force until you reach your 65th birthday. You will not be covered if you stop paying your contributions before then. Contributions remain payable in the first two years during which you receive benefits, having made a claim. After that, contributions are waived for the balance of the duration of your sickness. Once your application has been accepted, and provided you keep up your contributions, the Board only has the right to cancel your membership in exceptional circumstances. Our right to cancel, disqualification and forfeiture of membership.

5 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 5 Summary of benefits When you are unable to work, benefits are currently paid at the rate of 40 per week for the first 52 weeks of incapacity, reducing by 50% to 20 per week for the next 52 weeks, and by a further 50% to 10 per week thereafter. The reduction to the rate of 10 per week is referred to as a quarter scale. On quarter scale a member is no longer liable to pay membership contributions but will continue to receive sickness benefit at this level (quarter scale) until the member either returns to work, is declared fit for work, dies or reaches the age of 65 years. This plan has no facility for members to increase their sickness benefit by increasing their premiums. Individuals should review the adequacy of their overall sickness cover on a periodic basis. Any claim arising within 52 weeks of the previous claim will be treated as a continuation of that claim. What is not covered No sickness benefit is payable: For the first 26 weeks of your Society membership. Once you have reached your 65th birthday As a result of pregnancy or for any illness or disability arising from pregnancy or childbirth. In respect of injuries or illness induced by drunkenness, fighting (except in self-defence) or any unlawful game, exercise or pursuit. * In respect of illness as a result of certain conditions from which you are already suffering when you apply for membership. You will be notified in our written acceptance of your application if this applies to you. Payment of benefit may cease at the discretion of the Board of Management if, in the opinion of your doctor, you have taken action detrimental to your recovery. Should a member be detained under the Mental Health Act 1983 as may be amended or replaced from time to time, no sickness benefit will be payable unless the member has dependants, when the benefit will be paid for their relief and maintenance. Other features Friendly societies are owned by their members and run by them through a Board of Management. The members of that Board are elected by the members. Each year the Society holds two meetings for members at its Gravesend Head office where issues relevant to the membership are discussed and the members are entitled to vote on various issues affecting the Society, including the election of the Board. You will be notified of the meetings by newsletter.

6 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 6 The Society invests a significant part of its funds in property in Gravesend and the surrounding areas. When letting these properties, priority is given to members. From time to time the Society pays discretionary benefits to its members, but only to the extent that the investment performance of its funds enables it to do so. These benefits are not guaranteed, and may be withdrawn at any time. Currently the discretionary benefits that may be applied for are as follows: On death, a grant of 1,600 for those who have been a members for at least five years. After 12 months membership, grants may be available towards the following expenditure: Dental Optical Hospital in patient stays - (maximum of 50 nights in any 52 week period) Miscellanous medical expenses, including Specialists consulatations, Health screening. Maternity - on production of the child s birth certificate Multiple births are counted as one. At age 65, contributions and sickness benefit cease, and entitlement is restricted to the above Discretionary Grants only. These Discretionary Grants do not form any part of your membership and must not be treated as an expectation; grants are considered on merit and are available for consideration upon request. The Board of Management will only consider these applications on the understanding that there are funds available to satisfy such grants. If circumstances dictate the board may reduce or withdraw these Discretionary Grants at any time.

7 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 7 How to apply for membership You will need to complete our application form fully, and send it to us through the post. Once you have been accepted for cover, we will send you confirmation of your plan in the post. This will include some details about your personal circumstances which you will need to check. If the details are not correct, you must tell us immediately. Note that the Board of Management has the right to refuse admission to membership without giving a reason for that refusal. Paying your premiums Level of premiums Your contributions are determined by the age you join the Society, and remain fixed throughout your membership. They are currently as follows: Age next birthday at entry Calendar monthly contribution Contributions are determined by the age at which you join the Society. Your first contribution must be paid with your Membership Application. Thereafter, contributions can be paid direct to the Society s office in cash or by cheque, by post or by calling in person. These contributions can be paid in advance monthly, quarterly or annually. Contributions may also be paid by standing order or direct debit. Arrears of contributions If contributions are more than 14 weeks in arrear then no further benefits are payable until eight weeks after the arrears have been brought within the 14 week limit. if the arrears continue until 26 weeks, membership is terminated. If your membership has ceased because your contributions fell into arrears of 26 weeks or more you may, on production of a medical certificate and subject to the approval of the Board of Management, re-enter as a new member.

8 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 8 Your right to cancel If you are not satisfied with your policy for any reason, you may cancel it within 30 days of the date we issue it. Within this welcome pack we have enclosed a document called Your right to change your mind. It is important that uoi read this document and fully understand its content. if after reading this document you feel you do not wish to continue with your application for membership, the form should be completed and returned to the Society within (30) days. We will then return any money you have paid without any deduction. Ceasing membership After the initial cancellation period has passed, a member may terminate his or her membership by giving one calendar month s notice in writing to the registered office of the Society which is on the front / back of this document. Membership will cease on the death of the member. Our right to cancel, disqualification and forfeiture of membership We will give you written notice if, in exceptional circumstances, we intend to cancel your policy. Examples of why we may cancel your policy are: You commit a serious breach of the Rules of the Society. You made an untrue declaration on your application for membership. You bring the Society into disrepute. How to claim You can claim benefit when you are unable to work because of an illness or accident and are unable to perform your normal occupation. All requests for payment of benefit should be made in writing to the Society at its registered address which is in the next section of this document within twelve months of the onset of sickness. Except for the first 8 days of incapacity, all applications must be accompanied by a sickness certificate signed by your doctor. From the eighth day of sickness and for sickness which counts as continuous, medical certificates signed by a qualified medical practitioner are required to cover the period until sickness benefit ceases. The Society reserves the right to ask you to attend a medical examination by a doctor of its choosing for determination of entitlement to sickness benefit.

9 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 9 How to apply for a discretionary grant Application for any of the Discretionary Grants described above can be made in writing to the Secretary at the Society s offices within twelve months of the treatment or event giving rise to the application. It must be accompanied by all receipts and documentation in support of the request. Remember that the Discretionary grants are not part of your membership and must not be treated as an expectation. The Board of Management will only consider applications on the understanding that there are funds available to satisfy such grants. Useful information You can contact us as follows: By post at Anglo Saxons Friendly Society, Anglo-Saxons Hall, 2 Berkley Road, Gravesend, Kent DA12 2EU By telephone at By fax at By at Complaints procedure If you wish to complain about any aspect of your membership or the service you have received from the Society, please let us know by any of the means shown above. If you choose to do so by letter, please address it to the Chief Executive. When we receive your complaint we will acknowledge its receipt and provide you with a copy of our complaints procedure. We will then investigate your complaint and try to resolve it with you. If, when we have completed our investigation and issued you with our final response, you are not satisfied with the outcome, or if after 8 weeks we have failed to issue you with a final response, you can refer your complaint to the Financial Ombudsman Service (FOS) at: Address: Exchange Tower, London E14 9SR Telephone No Website:

10 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 10 Financial Services Compensation Scheme In the unlikely event that the Society cannot meets its financial obligations, you may be entitled to compensation from the Financial Compensation Scheme (FSCS). More information is available from the FSCS at: Address: 10th Floor, Beavfort House, 15 St Botoplh Street, London EC3 7QU Telephone No Website: Other important information Terms and conditions This product Summary gives a guide to our Sickness Benefit Plan. It does not contain all the relevant terms and conditions. These are included in our Rules, a copy of which can be obtained by contacting us and requesting them. Please note that the Rules of the Society may be altered in future by a meeting of the members of the Society. Tax Under current Inland Revenue rules and regulations, any benefit you receive is free from UK income tax and capital gains tax. Please note that Inland Revenue legislation may change in the future. Law The law of England and Wales applies to this policy. Website: Registered under the Friendly Societies Act Registered Office: Anglo-Saxons Hall, 2 Berkley Road, Gravesend, Kent DA12 2EU. Registered number 189F. Authorised and regulated by the Financial Conduct Authority. & The Prudential Regulatory Authority - firm number

11 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 11 Financial Services Compensation Scheme In the unlikely event that the Society cannot meets its financial obligations, you may be entitled to compensation from the Financial Compensation Scheme (FSCS). More information is available from the FSCS at: Address: 7th Floor, Lloyds Chambers, Portsoken Street, London E1 8BN Telephone No Website: Other important information Terms and conditions This product Summary gives a guide to our Sickness Benefit Plan. It does not contain all the relevant terms and conditions. These are included in our Rules, a copy of which can be obtained by contacting us and requesting them. Please note that the Rules of the Society may be altered in future by a meeting of the members of the Society. Tax Under current Inland Revenue rules and regulations, any benefit you receive is free from UK income tax and capital gains tax. Please note that Inland Revenue legislation may change in the future. Law The law of England and Wales applies to this policy.

12 Anglo Saxon 12pp A5_August 2016.qxp_Layout 1 08/08/ :58 Page 12 Anglo - Saxons Friendly Society Membership Application Title...(Mr. Mrs. Miss or Ms) First Name(s) (Block Capital)... Surname:... Address: Postcode:... Date of Birth...Age Next Birthday... *ONE MONTH s Subscription enclosed:... *ONE YEAR s Subscription enclosed:... I declare that to the best of my knowledge I am not suffering from any chronic disease, long term illness or disability. Should this declaration be proven false, I hereby agree to forfeit all benefits of the Society. Signed:...Date:... Name of Proposer:... Membership Number:... Please enclose copies of the following identifications with your application: 1. Photo ID Passport or Photo Driving Licence 2. Address Utility bill or Bank Statement *Delete as required

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