Income Protection Fact Sheet

Transcription

1 Income Protection Fact Sheet Who should read this fact sheet? The information in this fact sheet applies to most Defined Contribution (accumulation) members of Energy Super. It is not relevant to Defined Benefit members, former ESI Super members (who became members of Energy Super as a result of the fund merging with SPEC Super on 1 April 2011) or members who have been issued with a Part Two Energy Super Other Information. What insurance cover does Energy Super offer? Energy Super offers three types of insurance cover: Income Protection (IP) (detailed in this fact sheet) Death and Total & Permanent Disablement (TPD) (detailed in a separate fact sheet), and Death Only cover (detailed in a separate fact sheet). All these insurances are offered to you at competitive rates. You are generally covered worldwide 24 hours a day, seven days a week, whether you are at work, at home or on holiday. Energy Super s IP insurance means you can still have a regular income for up to two years (and then for additional years to age 65 if you choose - subject to approval by the Insurer) if you are unable to work temporarily because of either total or partial disability. What level of cover am I eligible to receive when I join? The insurance cover you are initially eligible to receive is determined by how you join Energy Super, either through an Energy Super employer or as a public offer member by direct application. Joining through an Energy Super employer You can apply for cover on your Member Application Form when you first join the Fund. If your employer does not nominate an alternative default, or if you do not make a choice, the default cover applicable to Category B will apply. Standard IP cover with a payment period of up to 2 years is compulsory for all members who join Energy Super on starting work with a registered or participating employer. Joining as a public offer member You do not receive an automatic level of cover when you join Energy Super. However, you can apply for IP cover on the Member Application Form when you first join. Am I eligible for cover? Where you join Energy Super on starting work with a registered or participating employer, you are eligible for automatic standard IP cover provided you are Actively at Work on the day you start work. Other members are eligible to apply for standard IP cover provided they are Actively at Work and earning an Income. You are not required to provide evidence of your good health when you apply. However, cover for any Pre-existing sickness will be excluded for two years from the commencement of your cover. (See page 35 of the Energy Super Member Guide Product Disclosure Statement for definitions of Actively at Work, Income and Pre-existing sickness.) When does standard cover start? Employed members Where you join Energy Super on starting work with a registered or participating employer, your automatic standard IP cover starts on the day you start work if: Energy Super is your employer s default fund, and you do not elect to join another fund, and a contribution is made for you within 120 days of starting work, provided you are Actively at Work on the day you start work. Cover for other members starts on the day your application for cover is accepted, provided you are Actively at Work and a contribution is paid. Pre-existing sickness conditions will apply. (See page 35 of the Energy Super Member Guide for definitions of Actively at Work and Pre-existing sickness.) Members joining via public offer Cover starts on the day your application for cover is accepted by the Insurer. Is there a waiting period? Yes, the waiting period for standard cover is 14 days. How much does standard cover cost? The amount you pay for IP insurance depends on the level of cover you choose and whether you are covered by Workers Compensation. The cost of your insurance is deducted from your Energy Super account monthly in arrears. Continued over page > 1 of 6

2 Cost of standard cover for a benefit period of 2 years The benefit levels and costs are as follows. Please note, from 1 April 2013 the standard IP cover and cost will be indexed by 5%. Category Year from Benefit level (per week) With Workers Compensation Total Cost Without Workers Compensation A (Income up to $182,000) 1 April 2012 $ 3, $ $ April 2013 $ 3, $ $ B (default) (Income up to $121,333) 1 April 2012 $ 2, $ $ April 2013 $ 2, $ $ C (Income up to $97,066) 1 April 2012 $ 1, $ $ April 2013 $ 1, $ $ D (Income up to $72,800) 1 April 2012 $ 1, $ $ April 2013 $ 1, $ $ E (Income up to $60,666) 1 April 2012 $ 1, $ 9.45 $ April 2013 $ 1, $ 9.92 $ F (Income up to $48,533) 1 April 2012 $ $ 7.35 $ April 2013 $ $ 7.72 $ April 2012 $ 4, $ $ April 2013 $ 4, $ $ April 2012 $ 5, $ $ Additional cover 1 April 2013 $ 5, $ $ April 2012 $ 6, $ $ April 2013 $ 6, $ $ April 2012 $ 7, $ $ April 2013 $ 7, $ $ What is the cost to extend the payment period to age 65? The cost of extending your payment period to age 65 (which is a separate option that applies after the initial two year period has elapsed) depends on the level of cover you choose, your age and whether you are eligible for a White Collar/Professional discount. For the definition of White Collar/Professional see page 35 of the Energy Super Member Guide. Can I increase, reduce or cancel my cover? You are able to increase your IP cover at any time. However if you increase your cover it must be within the maximum amount of cover. Pre-existing sickness conditions will apply, for the amount of the increase. IP is compulsory for all members of Energy Super who join on starting work with a registered or participating employer. If your employer pays for your automatic IP cover you cannot reduce your cover below this level. However, if your employer does not pay for your IP cover and the automatic cover is more than 90% of your income you can reduce the amount of cover by providing proof of your income. Other members can reduce or cancel their cover at any time by notifying Energy Super in writing. Continued over page > 2 of 6

3 Cost of cover for a benefit payment period to age 65 The benefit levels and costs are as follows. Please note, from 1 April 2013 the extended IP benefit levels and costs will be indexed by 5% as shown: Category Year from Benefit level (per week) Total cost With white collar discount Without white collar discount 14 yrs & 9 mnths to to to to yrs & 9 mnths to to to to 65 A 1 April 2012 $ 3, $ $28.67 $ $ $ $ $ $ April 2013 $ 3, $ $30.10 $ $ $ $ $ $ B 1 April 2012 $ 2, $ $19.11 $ $ $ $ $ $ April 2013 $ 2, $ $20.07 $ $ $ $ $ $ C 1 April 2012 $ 1, $ $15.29 $ $ $ $ $ $ April 2013 $ 1, $ $16.05 $ $ $ $ $ $ D 1 April 2012 $ 1, $ 7.64 $11.47 $ $ $ $ $ $ April 2013 $ 1, $ 8.03 $12.04 $ $ $ $ $ $ E 1 April 2012 $ 1, $ 6.37 $ 9.56 $ $ $ 9.10 $ $ $ April 2013 $ 1, $ 6.69 $10.03 $ $ $ 9.56 $ $ $ F 1 April 2012 $ $ 5.09 $ 7.64 $ $ $ 7.28 $ $ $ Additional cover 1 April 2013 $ $ 5.35 $ 8.03 $ $ $ 7.64 $ $ $ April 2012 $ 4, $ $38.22 $ $ $ $ $ $ April 2013 $ 4, $ $40.13 $ $ $ $ $ $ April 2012 $ 5, $ $47.78 $ $ $ $ $ $ April 2013 $ 5, $ $50.16 $ $ $ $ $ $ April 2012 $ 6, $ $57.33 $ $ $ $ $ $ April 2013 $ 6, $ $60.20 $ $ $ $ $ $ April 2012 $ 7, $ $66.89 $ $ $ $ $ $ April 2013 $ 7, $ $70.23 $ $ $ $ $ $ What is the maximum amount of cover I can have? The weekly benefit for standard IP is the lesser of: (a) The level of cover you received automatically or applied for, and (b) 90% of your Income. You will also receive 10% of your Income as a superannuation contribution into your Energy Super account. The above is subject to an overall maximum of $7,350 per week. The monthly benefit for IP cover to age 65 is the lesser of: (a) The level of cover you applied for, and (b) 85% of your Income. You will also receive 15% of your Income as a superannuation contribution into your Energy Super account. The above is subject to an overall maximum of $30,000 per month. 3 of 6

4 Payment periods Your standard IP benefit payment period is generally up to two years and commences after your waiting period (14 days) has expired. If you also select and pay for the option to extend your insurance cover to age 65 (and you are under age 65 at the end of your standard two year benefit period) your benefit payments will generally further continue until you reach age 65. The maximum period that your IP benefits will be paid depends on your age. Maximum benefit period (if you have standard cover) Age attained 64 and under 65 and over (if you are not on claim when you turn 65) On claim when you turn 65 Sickness is defined as a state of being ill which is first contracted, or which you first become aware of, while this insurance is in force and which continues for a period of not less that the waiting period and excludes any Pre-existing sickness or Injury. Injury is defined as a physical injury caused by a violent, external and visible means which occurs while this insurance is in force and which results in payment of any benefits within 12 months from the date of its occurrence, but does not include any condition which is also a Sickness. Maximum benefit period (if you have extended your cover to age 65) Age attained Benefit period 2 years or until you turn 65, whichever happens first 12 weeks (for sickness benefit) or 52 weeks (for injury benefit) or until you turn 70, whichever happens first An additional 12 weeks (for sickness benefit) or 52 weeks (for injury benefit) to a maximum of 2 years total benefit period Benefit period 64 and under To age 65 Payments may cease before the maximum benefit periods in certain circumstances. Please refer to the How long will the benefit be paid section for more information. When your IP benefit will be reduced Your standard IP benefit (with a benefit period of two years) will be reduced by sick leave payments you receive, other not at work related payments you receive, or should receive and Workers Compensation or other statutory benefits you are entitled to receive. The Insurer will pay you the difference between the sick leave payments, other not at work relatedpayments, Workers Compensation payments and your insured amount. Your IP benefit to age 65 will be reduced by any income you are entitled to from other sources (whether that income was actually received or not). Income from other sources includes: any benefits payable under other IP policies any benefits payable under Workers Compensation or other legislation any benefits payable in respect of any claim for past or future economic loss arising from any personal injury claim you have made. The Insurer will pay you the difference between the income from other sources, and your insured amount. How long will the benefit be paid? If you qualify for an IP payment, your standard IP benefit will be paid for up to two years. Payments will be made fortnightly in arrears and will stop: if you resume work or are deemed fit to resume work, or if you die, or at the expiry of the maximum benefit period If you choose cover to age 65, pay for that option and qualify for an IP payment, your extended IP benefit will be paid until you reach age 65. Payments will be made monthly in arrears and will stop if: you are no longer totally or partially disabled, or you die, or you reach age 65, or you are no longer under the regular and continuous care of a doctor, or you fail to provide the Insurer with all requested information and other evidence reasonably required to assess your claim. Continued over page > 4 of 6

5 When will your eligibility to claim end? You may be ineligible to claim your standard IP cover with a benefit period of up to two years in the following situations: 60 days after ceasing to be a member of Energy Super, or if you cease to be Employed for a continuous period of 6 months, or when you reach age 70, or if you die, or 30 days after there is insufficient funds in your account to pay insurance costs due, or when you have been on unpaid leave for more than 12 months, or if you join the armed forces (excluding Reserves residing in Australia), or when cover for every member ceases under the group insurance policy. You may be ineligible to claim your IP cover with a benefit period to age 65 in the following situations: 60 days after ceasing to be a member of Energy Super, or If you retire or cease to be Employed, or when you reach age 65, or if you die, or 60 days after there are insufficient funds in your account to pay insurance costs due, or if you join the armed forces (excluding Reserves residing in Australia), or you cancel your cover. How do I qualify for an Income Protection benefit? You may qualify for an Income Protection benefit if: as a result of an injury or sickness you are prevented from engaging in your usual occupation with your employer or your usual occupation if you are a selfemployed person that generates your primary source of personal exertion income and you are still a member of Energy Super. You must have been Actively at Work at the time your injury or sickness occurred, and must be under the regular care of and acting in accordance with the instructions or professional advice of a medical practitioner (who is not yourself), or you are partially disabled as a result of an injury or sickness and you are prevented from engaging in a substantial part of your usual occupation and you are still a member of Energy Super. You must have been Actively at Work at the time your injury or sickness occurred, and you must be under the regular care of and acting in accordance with the instructions or professional advice of a medical practitioner (who is not yourself). If injury or sickness occurs within 60 days of you ceasing employment, you may still qualify under the above criteria if you can show evidence that you have alternative employment which would have commenced within the 60 day period with another employer and you remain a member of Energy Super. If you cannot provide this evidence or you have been unemployed for a period of more than 60 days at the time of injury or sickness, and are still a member of Energy Super and have IP cover, you may be eligible to claim if you are not able to engage in any occupation which you could reasonably be expected to perform based on your education, training and experience. However, you cannot claim if you have been continuously unemployed for 6 months or more. Are there any exclusions or restrictions? The following exclusions apply to your standard IP cover with a benefit period of up to two years: Benefits are not payable where the disability arises from: any consequences of war, invasion or civil war, or any intentional self-inflicted injury, including any attempt at suicide, or uncomplicated pregnancy, childbirth or miscarriage. The following exclusions apply to your IP cover with a benefit period to age 65: Benefits are not payable where the disability arises from: any consequences of war, invasion or civil war, or any intentional self-inflicted injury, including any attempt at suicide, or uncomplicated pregnancy, childbirth or miscarriage, or service in the armed forces of any country (not including the Australian Army Reserve). 5 of 6

6 Pre-existing sickness conditions For members who do not have automatic cover, IP insurance is not payable where the disability arises from a Pre-existing sickness during the first two years of cover. If your cover recommences after having ceased for some reason, disability arising from a Pre-existing sickness is excluded for two years from recommencement of cover. If you increase your cover, the amount of the increase is not payable for a disability arising from a Pre-existing sickness for two years. (See page 35 of the Energy Super Member Guide for the definition of Pre-existing sickness.) Are there any additional benefits? The following benefits, which are at the sole discretion of the Insurer as to whether or not they will be paid, may help you with your rehabilitation or return to work. Both these benefits will be limited to 24 times your insured monthly benefit. Rehabilitation Assistance Rehabilitation Assistance will help you with arranging for training or advice from a licensed vocational school, provided such training or advice is undertaken with the agreement of your attending medical practitioner. Assistance may also include family counselling to help you and your family cope with your disability and to enable you to live an independent life. What is the partial income benefit? If, after receiving at least one IP payment, you return to work on reduced ordinary income you may be eligible for a partial IP benefit. The reduction of ordinary income must result from the same injury or illness and you must be working on a restricted basis or in a different occupation. The IP payment will increase your monthly income up to the amount of your insured monthly benefit. What is a recurrent disability? If you suffer from the same disability again within six months immediately following a period of disability, it is a continuation of the original claim. Is the Income Protection benefit taxable? Yes, the IP payments are taxed as part of your ordinary income. You will have to disclose this income in your annual tax return to the Australian Taxation Office (ATO). How do I get more information? If you would like more information about IP insurance please read the Energy Super Member Guide, see our website or call us on ENERGY ( ). Return to Work Assistance Return to Work Assistance will help you with arranging for professional assistance to improve your physical and/or emotional condition. Assistance includes special equipment for and/or modifications to your normal home or workplace. The Rehabilitation Assistance and the Return to Work Assistance will be paid to the service provider and may be reduced if the expense can be claimed or reimbursed from another source. More information Call ENERGY ( ) info@energysuper.com.au or visit energysuper.com.au This document provides general financial product advice only and should not be relied on as legal or taxation advice, nor does it take the place of such advice. It has been prepared for the general information of members of Energy Super. It does not take into account any member s individual financial objectives, financial situation or needs. Any statements of law or proposals are based on our interpretation of the law or proposals as at 1 April We recommend that you seek help from a licensed financial adviser before acting on any information in this fact sheet or making any decision about your superannuation benefit. You should obtain a Product Disclosure Statement (PDS) and consider the PDS before making any decision. While all due care and diligence has been taken in the preparation of this document, the Trustee reserves the right to correct errors or omissions. If there are inconsistencies between the terms of Energy Super s Trust Deed and this document, the terms of the Trust Deed prevail. Any information or advice included in this Fact Sheet is provided by ESI Financial Services Pty Ltd (ABN AFSL ). Electricity Supply Industry Superannuation (Qld) Ltd (ABN AFSL ) is the Trustee for Energy Super (ABN ). 6 of 6