> 1 Income Protection insurance provides a fortnightly income of up to 75% of your salary while you are off work due to temporary or permanent incapacity for a maximum period of 24 months or to age 60, whichever occurs first. Most members joining Triple S automatically receive Income Protection insurance if they: are an active Triple S member working either full time or part time are aged less than 60 have not previously opted out of Income Protection Insurance. Income Protection Insurance is provided to these members regardless of their current state of health and medical history. Income Protection insurance Casual Triple S members can apply Casual Triple S members are not automatically provided with Income Protection Insurance, however they can apply. See the Applying for Income Protection Cover section in this fact sheet. 1 Or SA Ambulance staff who transferred into Triple S from the SA Ambulance Service Scheme. Description Cost Features Options Benefit Helps to protect your greatest asset your ability to earn an income if you re unable to do so for a period of time due to injury or illness. 0.2% of salary. This fee is deducted automatically from your employer contributions, so it does not affect your take-home pay. Maximum benefit: 75% of salary Waiting period: 30 days Benefit period: maximum two years or to age 60 Opt in Casual employees do not automatically receive Income Protection insurance but can apply. Opt out of cover Most Triple S members can opt out of Income Protection insurance at any time. Triple S Police and SA Ambulance Operational 1 members cannot opt out of Income Protection insurance. Provides a fortnightly income of up to 75% of your salary while you re off work due to injury or illness for a maximum period of 24 months or to age 60, whichever occurs first. John is employed full time. His salary is $58,000 per annum. His Income Protection Insurance is calculated as up to 75% x $58,000 = $43,500 per annum, which is payable fortnightly for a maximum period of 24 months or to age 60 whichever occurs first, while he is unable to work due to illness or temporary disablement. The annual premium for Income Protection Insurance is 0.2% of John s salary which is $116.
> 2 Triple S members not eligible for Income Protection Insurance include: members aged 60 or older non-active or preserved Triple S members contributory members of the Lump Sum Scheme, Pension Scheme and Police Pension Scheme who either salary sacrifice or have their Government Co-contributions paid into Triple S spouse members SA public sector employees who are employed for a specified time period and remunerated by a fee, allowance or commission (eg members of boards and committees) casual employees (unless they opt in to Income Protection Insurance). Opting out of Income Protection Insurance Triple S members (except SA Police officers and SA Ambulance Operational employees) may opt out of Income Protection Insurance at any time by completing the Income Protection Insurance - Opt Out form. However, if in the future you decide to opt back into Income Protection Insurance you will be required to provide information about your health and limitations may be applied to your cover for any pre-existing medical conditions. Does Super SA use premium loadings? Unlike many insurance providers, Super SA does not load, or increase premiums for members who have certain medical conditions, undertake certain activities or have different types of jobs. Leave Without Pay Income Protection insurance cover ceases when you commence LWOP. It recommences on the day that you return to work. If you are on LWOP for 12 months or more, you will not be covered for any medical condition that was known to you on the day you returned to work for a period of two years from the date you returned to work. What is the eligibility criteria for members claiming Income Protection Insurance? To be eligible to claim Income Protection Insurance payments you: must be temporarily or permanently incapacitated for work must be aged under 60 must lodge your claim within six months of ceasing to be engaged in employment due to illness or temporary disablement (the day you last physically went to work) or within six months of ceasing paid leave entitlements if taken immediately following incapacity. must have waited for a period of 30 consecutive calendar days following the day on which you ceased work due to your temporary disablement cannot be receiving compensation through workers compensation cannot be receiving annual leave, long service or sick leave payments Will I need to supply medical information when applying for or receiving Income Protection Insurance payments? Yes. If you apply or want to continue receiving Income Protection Insurance payments you must supply Super SA with updated medical information as requested. When will Income Protection Insurance payments start? You are not eligible to receive Income Protection entitlements until you have been off work due to incapacity for a continuous period of 30 calander days. During the 30 day waiting period, you can use sick leave or other forms of paid or unpaid leave. You can lodge an application for Income Protection entitlements during the waiting period but your claim will not be assessed until the 30 day waiting period has expired. Super SA cannot pay Income Protection for a period of less than one week commencing from the expiry of the 30 day waiting period.
> 3 When will Income Protection Insurance payments stop? Your Income Protection Insurance payments will cease to be paid if you: terminate your employment for any reason are taken to have terminated your employment 12 months after ceasing to work on a casual basis reach age 60 are no longer ill or temporarily disabled resume your normal working hours commence receiving workers compensation benefits or paid leave entitlements reach the end of the 24-month maximum benefit period receive work income that exceeds the total benefit you would otherwise be entitled to from Super SA are approved a Terminal Illness benefit die request payments be suspended (note: the period of suspension will count towards the 24-month maximum entitlement period). Can I make multiple claims for Income Protection Insurance? You can receive up to a maximum of 24 months of Income Protection Insurance payments during any 48-month period for the same illness. If you suffer a different illness, you may claim for up to a further maximum period of 24 months. How to make a claim To make a claim for Income Protection Insurance, contact Super SA. The time taken to assess your claim, once Super SA has received your Income Protection Insurance claim form and all other relevant documentation, depends on the conditions you have and the information that is available. A claim can take anywhere from a few weeks to several months, particulary if we have to wait for information from doctors. We will keep you informed of progress and how you may be able to help us if there are any delays outside of Super SA s control. If you require further information on Super SA s underwriting processes, please contact the Claims Management team on 1300 369 315 or email medicalsuper@sa.gov.au. Applying for Income Protection Insurance You can apply for Income Protection Insurance if you have previously opted out or if you are a casual employee. To purchase Income Protection Insurance, you will need to complete and return the Income Protection Insurance Application form to Super SA. The form can be downloaded from the Super SA website. Pre-existing medical conditions When you complete the Income Protection Insurance Application form, you will be asked questions about your medical history and you will need to provide details of any medical conditions and symptoms you may be suffering. If you do not disclose a previous or existing medical condition and a claim is later made for Income Protection Insurance, the entitlement may be reduced or declined.
> 4 What if I do not disclose a medical condition on my application form? When a member lodges a claim for income protection, part of the claim process is to review the claim/medical information received in conjunction with your original application. If there is medical evidence stating that a condition or symptoms existed before you were granted your additional insurance, and this was not disclosed on your application, Super SA has the right to deny this insurance claim. This is known as non-disclosure, and any insurance cover can be declined where non-disclosure occurs. Limitations A limitation refers to an increased risk of illness or disablement. For example, a person who has heart problems, now or in the past, is more likely to suffer heart disease in the future than a person who does not have heart problems. If you do have a limitation placed on your insurance, it is important to remember that you are still covered for all other events not related to the limitation. Super SA has a smoking policy, which means if you are, or have been a smoker in the last five years, you will have a smoking related illnesses limitation placed on your cover. Once you have ceased smoking for a period of five years, this limitation may be removed by providing a statutory declaration. Super SA also has a weight and height policy, which means if you are under or over what is considered a healthy weight range for your height you will have a weight related illnesses limitation placed on your Income Protection cover. To enable removal of this limitation you must be within the indicated weight range corresponding to your height for at least 12 months. It is important to note that the final decision of whether or not to fully insure you lies with the Super SA Board. If the Super SA Board feels your pre-existing illness or injury puts you at a greater risk of illness or injury, they have the right to apply limitations to the cover. What does the limitation mean for me? If Super SA places a limitation on your Income Protection Insurance cover, any future claims you make which are medically connected to your limitation will be declined. During the claim process, Super SA will ascertain if there is a connection when reviewing your medical history and will seek expert medical opinions. If there is a proven connection between your limitation and your illness or disablement, any claim for Income Protection will be declined.
> 5 Further information The following fact sheet and Product Disclosure Statement (PDS) may be helpful if read in conjunction with the information presented above: Death and TPD Insurance Leave Without Pay Triple S PDS Fact sheets on a range of topics relating to your super are available on the Super SA website and from Super SA. Alternatively, if you have any enquiries regarding fees or any other matters raised in this fact sheet, please contact Super SA. Contact us Address Ground floor, 151 Pirie Street Adelaide SA 5000 (Enter from Pulteney Street) Postal GPO Box 48, Adelaide, SA 5001 Call (08) 8207 2094 1300 369 315 (for regional callers) Email supersa@sa.gov.au Website www.supersa.sa.gov.au Disclaimer The information in this document is intended to help you understand your entitlements in Triple S. Super SA does its best to make sure the information is accurate and up to date. However, you need to be aware that it may not include all the technical details relevant to the topic. For the complete rules of Triple S, please refer to the Southern State Superannuation Act 2009 and Southern State Superannuation Regulations 2009. The Act and accompanying Regulations set out the rules under which Triple S is administered and entitlements are paid. You can access a copy from the Super SA website. Triple S is an exempt public sector superannuation scheme and is not regulated by the Australian Securities and Investments Commission (ASIC) or the Australian Prudential Regulation Authority (APRA). Super SA is not required to hold an Australian Financial Services Licence to provide general advice about Triple S. The information in this document is of a general nature only and has been prepared without taking into account your objectives, financial situation or needs. Super SA recommends that before making any decisions about Triple S you consider the appropriateness of this information in the context of your own objectives, financial situation and needs, read the Product Disclosure Statement (PDS) and seek financial advice from a licensed financial adviser in relation to your financial position and requirements. Super SA and the State Government disclaim all liability for all claims, losses, damages, costs or expenses whatsoever (including consequential or incidental loss or damage), which arise as a result of or in connection with any use of, or reliance upon, any information in this document. The Chant West ratings logo is a trademark of Chant West Pty Limited and used under licence. SuperRatings does not issue, sell, guarantee or underwrite this product. Go to www.superratings.com.au for details of its rating criteria.