Risk Protection Plan Product Disclosure Statement Commencement date 1 June 2011 Glenelg, SA
Important information Contents Who might need the Risk Protection Plan? 3 The Risk Protection Plan at a glance 5 All products offered under the Risk Protection Plan are provided under a master Group Life Policy held by Statewide Financial Management Services Limited ABN 69 092 109 209 AFSL 239063 (hereafter referred to as SFMS). SFMS performs administrative functions in relation to the insurance, including receiving and processing applications and collecting premiums. SFMS is your point of contact. SFMS will advise you of any changes to your insurance cover offered by the master Group Life Policy. Metlife Insurance Limited, ABN 75 004 274882, AFSL No. 238096 is the insurer of the Group Life Policy. A closer look at the Risk Protection Plan for individuals 6 A closer look at the Risk Protection Plan for businesses/employers 7 A closer look at Income Protection Insurance 8 A closer look at Death and Total and Permanent Disablement (TPD) Insurance and Death Only Insurance 14 What else do you need to know about the Risk Protection Plan? 18 Tax 22 Fees and other costs 23 Other information you should know 24 SFMS will forward relevant premiums to the insurer as per the master Group Life Policy. Any benefit payable will be paid by the insurer to SFMS These products are not deposits in, nor liabilities of, and are not guaranteed by any company whether related to the insurer or not. General advice warning Please read this Product Disclosure Statement (PDS) carefully before deciding to buy the insurance cover. The information contained in this PDS is general information only. It does not take into account your individual objectives or financial situation. You should consider the appropriateness of the insurance arrangements in regard to your objectives, financial situation and needs. You should seek advice from your financial adviser before deciding on appropriate insurance cover. About Statewide Financial Management Services Statewide Financial Management Services Limited is a wholly owned subsidiary of Statewide Superannuation Pty Ltd ABN 62 008 099 223. SFMS administers all divisions of StatewideSuper including employer sponsored, personal superannuation, pension, master trust (trading as Choice Plus) and also provides stand alone administration services. In addition SFMS holds an Australian Financial Services Licence. Who should read this PDS? This document was prepared by Statewide Financial Management Services Limited ABN 69 092 109 209 and issued on I June 2011 as the PDS for the Risk Protection Plan. It provides an overview of the product, its benefits and any risks, as well as its fees and charges. The information in this PDS is up to date at the time of preparation. However, some of the information may change from time to time. We will issue a supplementary or replacement PDS if there is a materially adverse change or omission to the PDS. Other changes including updates may be obtained at any time by visiting our website at www.statewide.com.au or calling Client Services on 1300 88 56 65 who will provide a printed copy free of charge. Page 2 Risk Protection Plan
Who might need the Risk Protection Plan? The Risk Protection Plan (the Plan) offers a range of simple, flexible and cost effective insurances to provide financial security when you, your family or your business need it most. It s not a savings plan like superannuation; the sole purpose of this Plan is to provide an insurance benefit in the event of death or disablement. Let s look at who might need the Risk Protection Plan: Who needs Risk Protection? Individuals (see page 6) Businesses/employers (see page 7) OR Why? Many Australians have an insurance entitlement with their super fund. But if you don t, or you have your own Self Managed Super Fund (SMSF) or even no super at all provided you meet the eligibility criteria - you can have the peace of mind of having Death and Total and Permanent Disablement and Income Protection Insurance with our Risk Protection Plan. The Plan provides Keyperson Insurance, which simply means life insurance on a key person within a business. In a small business, this is usually the owner, the senior manager or one or more key employees. Should a key person in your organisation be unable to work due to ill health, then the business receives an insurance payment on that person, which can help ensure the business can cover the loss of a valuable key person. As an extra benefit of their employment you may wish to consider providing your staff with low cost Death Only, Death and Total and Permanent Disablement (TPD) and Income Protection Insurance. Risk Protection Plan Page 3
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The Risk Protection Plan at a glance The Risk Protection Plan offers a range of flexible insurance options to meet your personal or business needs: Death Only Insurance (including a Terminal Illness benefit) Total and Permanent Disablement (TPD) Income Protection Insurance. Insurance at a glance Cover available Overview Benefit payable Minimum age to receive cover (next birthday) Maximum age to receive cover (next birthday) Death Only Provides a lump sum benefit paid to the policy owner in the event of death. See pages 14-17. Agreed lump sum benefit to a maximum of $5,000,000 16 70 Terminal Illness* Provides a lump sum benefit for terminal illness (see below)*. Agreed lump sum benefit to a maximum of $5,000,000 16 70 Total and Permanent Disablement (TPD) - must be taken in conjunction with Death Insurance Provides a lump sum benefit if an illness or injury prevents you from ever working again, or see pages 14-17 for more information. Agreed lump sum benefit to a maximum of $3,000,000 16 70 Income Protection Provides a regular income should you or your staff member/ partner/director (Keyperson Insurance) become temporarily disabled. Up to 75% of income to a maximum monthly payment of $30,000 16 65 *The Insurer will pay a Terminal Illness benefit where a person who has death cover suffers from an illness which: Two medical practitioners, one of whom specialises in the covered person s illness, certify in writing that despite reasonable medical treatment the member s death is expected within 12 months of the date of the certification, and The Insurer is satisfied, on medical or other evidence that despite reasonable medical treatment the member s death is expected within 12 months. See page 16 for more information. Risk Protection Plan Page 5
A closer look at the Risk Protection Plan for individuals The Risk Protection Plan offers a comprehensive range of insurance for those looking for cover outside of super or inside their Self Managed Super Fund (SMSF). And when it s outside of super (ie not an SMSF), the benefit can be paid according the policy and is not subject to the Superannuation Act dependency test. For example, as an adult child you could have a policy on your parent s life that would be automatically be paid to you upon their death. You may be self employed, ineligible for automatic acceptance insurance through your super fund, be a member of a SMSF or simply want to boost the cover you already have. Whatever the reason, the Risk Protection Plan provides a simple, cost effective solution. You re able to apply for Death and TPD, (including a Terminal Illness benefit), and Income Protection Insurance. Let s look at an example Meet Diana, she s an HR manager with a large accountancy firm. She has two young children and is buying a new home. Diana earns $125,000 per year. After speaking with her accountant, she has established a SMSF. She still wants to have her insurance through super (ie through her SMFS) and chooses to take advantage of the Risk Protection Plan for both her Death and TPD and Income Protection Insurance. Diana wants to ensure she has maximum Income Protection Insurance to cover her mortgage and to pay for the children s education until they leave school a long way off right now! To cover her expenses, Diana opts for cover of 75% of salary with a 30 day waiting period and a maximum benefit period to age 65. Should Diana get sick and be unable to work for an extended period of time, after a 30 day waiting period, which would be covered by the sick leave she has already accrued with her employer, based on her current income, she would receive an Income Protection benefit of $93,750 per year (75% x $125,000), paid monthly in arrears, up to her 65 th birthday, or when she returns to work (whichever is applicable). See pages 8-13 for more information on Income Protection. Page 6 Risk Protection Plan
A closer look at the Risk Protection Plan for businesses/employers There are two different ways that the Risk Protection Plan can meet your business needs: Keyperson Insurance If you re a business owner you ve probably wondered what you would do if a key member of your staff, or one of your directors or perhaps your business partner, became ill and were unable to work for a period of time, or worse still, became permanently incapacitated or even died. What would be the impact on your business? Where would you find the money to employ new staff and bring them up to speed, or find temporary help? Keyperson Insurance offers you valuable cover in these unfortunate circumstances, at a time when your business would really need extra help. How? The amount that your key person is insured for is paid directly to your business, ensuring that it remains viable in the absence of your key person. An extra employment benefit for your staff Alternatively, you may want to offer your staff insurance cover as an additional benefit of their employment with you. The Risk Protection Plan provides a package that you can tailor to meet the needs of your team. Client Services or your financial planner will be able to help you put it all together. Let s look at an example Burt is an IT Consultant for an electrical supply company, Patty s Electrical. He has specialist knowledge of the company s IT systems and is relied upon for ongoing maintenance and troubleshooting. Burt s employers realise that they will be in serious trouble if anything should happen to him. The business owner chooses to take out Keyperson Death and TPD Insurance with the Risk Protection Plan to cover Burt should he be unable to work in the future. So should anything happen to Burt, the insurance cover will provide a lump sum to the company which will contribute towards paying for recruitment costs, salaries, temporary staff or any other expenses involved in covering his important role in the company. See pages 14-17 for more information about Death and TPD. Risk Protection Plan Page 7
A closer look at Income Protection Insurance For individuals and group* members The ability to generate an income is one of your most important assets. If you re unable to work due to illness or injury you ll still need to pay bills, mortgage payments, credit card and other loan repayments. This is where Income Protection Insurance can really support you and/or your family. Income Protection Insurance pays a regular monthly benefit (calculated as a percentage of income) when you re absent from work due to injury or illness. For businesses If you re a business owner and you ve purchased Keyperson Insurance, if a key person in your business is on sick leave for an extended period of time, you re able to cover the costs associated with recruiting temporary staff to cover your team member while they are absent. You re also able to purchase Income Protection Insurance on behalf of your team as a staff benefit. How does Income Protection work? Generally, before a benefit is paid, a person needs to be disabled for the duration of the waiting period, which may be 30, 60 or 90 days depending on the type of cover (shorter waiting periods attract a higher premium). After the expiry of the waiting period, benefits begin to accrue and are paid monthly in arrears. Disabled means that a person is unable to perform the important duties of their normal occupation due to illness or injury, are not working in any occupation (either paid or unpaid) and are under the regular care and are following the advice of an approved medical practitioner. How much does it cost? Income Protection premiums are dependent on the level and type of cover, a person s age, gender, occupation, state of health and smoking status. Premium rates have been calculated to cover administration costs, and your financial adviser s remuneration (if applicable) and include GST. To find out what Income Protection Insurance premiums are, call the Client Services team on 1300 88 56 65 or contact your financial adviser (if applicable). *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Page 8 Risk Protection Plan
What options are available? You can tailor an Income Protection package to suit your personal or business requirements. Your options are to choose: your income replacement ratio (the percentage of your normal income that will be paid out in the event of a claim) you can choose either 50%, 66%, or 75% of income your waiting periods you can choose between 30, 60 or 90 days your maximum benefit payment period ie 2 years, 5 years, to age 60 or to age 65. If you fail to nominate a benefit payment period, the default payment period is two years. The maximum monthly benefit for Income Protection is $30,000 per month. Automatic Acceptance - eligible group* members only Automatic Acceptance of Income Protection Insurance may apply to eligible group* members who join the Plan within 120 days of commencing employment. Contact Client Services on 1300 88 56 65 for more information. If you did not join the Risk Protection Plan through your employer, but joined as an individual (eg as a member of a SMSF or as an individual purchasing Income Protection Insurance outside of super) there is no Automatic Acceptance for Income Protection Insurance and you ll have to apply for any level of cover, which is subject to approval by the Insurer. Applying for cover You can apply for, or increase your Income Protection Insurance by completing the Application form, available at www.statewide.com.au. Any additional cover will be subject to acceptance by the Insurer, and exclusions or premium loadings may apply. You may also wish to talk to you financial adviser. Maximum application age The covered person must be aged under 65 years to apply for this cover and must be working a minimum of 15 hours per week. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Risk Protection Plan Page 9
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What else do you need to know about Income Protection Insurance? What definition of income is used for Income Protection Insurance? Employees who are in permanent employment. Income is defined as the total monthly regular income received from their employer for personal exertion for their usual occupation (including salary sacrifice amounts but excluding overtime, profit distributions, director s fees and any other non-regular payments). Where income includes commission and bonuses, these components will be averaged over three years. For employees not employed on a permanent basis. Income is the average of their total monthly regular income from their employer over the previous 12 months or the actual period of employment if less than 12 months, subject to a minimum averaging period of six months. If you directly or indirectly own part of or all of the business or professional practice from which you earn a regular income, earnings will include the gross revenue generated by the business as a result of your personal exertion less eligible business expenses. Earnings exclude investment income, business expenses and mandated super contributions. Monthly income will be averaged over the previous 12 months. What definition of disabled is used for Income Protection Insurance? A person will be regarded as being disabled or having a disability, if, solely as a result of an illness or injury occurring whilst the policy is in force, they are: unable to perform at least one income producing duty of their occupation not working in any occupation, whether or not for reward, and under the regular care as well as following the advice of a medical practitioner. When will Income Protection cover cease? Cover for Income Protection Insurance will cease from the earliest date of any of the following: the day a person ceases to be a member of the Plan a person s 65th birthday death the day a request that cover be cancelled is made upon commencement of duty with the military services (other than the Australian Armed Forces Reserve and not on active duty outside Australia) of any country the policy is cancelled or terminated for whatever reason, or if the policy renewal is not paid and a period of 30 days has elapsed. Risk Protection Plan Page 11
When is an Income Protection benefit paid? Generally, a person must be disabled for the duration of the previously chosen waiting period before a benefit becomes payable. Benefits will be paid monthly in arrears and will be reduced by any payment made under a similar policy and by any Workers Compensation payments or any other statutory compensation. Social Security payments will also be offset in some circumstances. A benefit will not be paid where the disability is caused directly or indirectly by self inflicted injury, attempted suicide, an act of war, service in any armed forces, and for uncomplicated pregnancy, childbirth or miscarriage. Benefits may not be paid for longer than 12 months in some circumstances (eg if a person is a non resident of Australia, Canada, NZ, UK or USA). A proportional benefit is paid if a person resumes employment at a reduced rate of income while still partially disabled, provided the waiting period has ended (see below for more information on partial disablement). The waiting period is waived if a person suffers a recurrence of a disability from the same or related injury or illness within six months of ceasing to receive benefits. However, the claim will be treated as a continuation of the previous claim for benefits. Will the benefit increase to keep up with inflation? If a person has been disabled and receiving benefits continuously for 12 months after the expiry of the waiting period, the benefit will be automatically increased. If the maximum benefit period is greater than two years, the benefit will be further increased at the end of each 12 month period during which continuous benefits have been paid. The amount of the increase shall be the lesser of the following: 5% or the percentage increase in the CPI over the 12 month period concluding at the end of the last reported quarter prior to the benefit review date. Are benefits paid for a partial disability? A person is eligible to receive a monthly partial disability benefit if they are partially disabled and the waiting period has ended. The benefit will be paid monthly in arrears and the amount of your benefit accrues daily on a pro rata basis. The amount of any partial disability benefit depends on how many hours a person is able to continue in paid work. Partially disabled means a person: has been disabled for at least seven days of the first 12 working days of the waiting period, and is unable to work in their occupation at full capacity as a result of the illness or injury resulting in the disability, and is working in their occupation or any other occupation but only in a limited capacity, and is earning a monthly disability income less than their prior monthly income, and is under the regular care and following the advice of a medical practitioner. The amount of the partial disability benefit will depend on how much income a person is earning, according to the following formula: (previous monthly income current monthly disability income) x disability monthly benefit previous monthly income To help you understand let s have a look at Sarah. Sarah works on a full time basis as a hairdresser earning $3,000 per month. She is insured a maximum monthly benefit of $2,000. She recently became ill and as a result now, after temporarily ceasing work is only working 3 days a week in her normal job. She is therefore receiving a reduced salary of $1,800 per month from her employer. Page 12 Risk Protection Plan
Sarah s partial benefit claim has been accepted by the Insurer. Her benefit will be calculated as follows: (previous monthly income current monthly disability income) x disability monthly benefit previous monthly income ($3,000 - $1,800) x $2,000 (her current insured cover) $3,000 Sarah will receive a partial disability benefit of $800 per month for the remaining benefit period. When will an Income Protection benefit cease? Disability benefits will cease to be paid where a person: is no longer disabled, or partially disabled dies reaches age 65 has been disabled or partially disabled from the end of the waiting period for the maximum benefit period, or is no longer under the regular care of a medical practitioner. Rehabilitation expense benefit If a person becomes disabled, they may be able to receive a rehabilitation expense benefit to cover the cost of rehabilitation expenses, up to a maximum of six times the amount of their monthly disability benefit. The rehabilitation benefit will be payable if a person is disabled or partially disabled and: the Insurer approves the rehabilitation expenses in writing before they are incurred, and the rehabilitation expenses are incurred to directly assist a person to return to work or undertake a vocational retraining program. The amount of the rehabilitation expenses benefit will be reduced by any amounts that can be claimed for the rehabilitation expenses from any other source and any rehabilitation expense benefit will be paid directly to the provider of the rehabilitation service. Death benefit If a person dies whilst receiving a disability benefit or partial disability benefit through Income Protection Insurance the policy owner will receive an amount equal to the sum of three times the insured person s disability monthly benefit. Income Protection Insurance checklist - individuals and eligible group* members Do you know what your weekly expenses would be with no regular income to rely on? Don t forget to regularly review Income Protection Insurance requirements Need help? Talk to one of our Client Services Officers on 1300 88 56 65 or your financial adviser. Get a quote to find out how much your insurance will cost you. Income Protection Insurance checklist - businesses seeking Keyperson Insurance How much would it cost you per week to keep your business running smoothly if one of your key people were unable to work for an extended period of time? Talk to one of our Client Services Officers on 1300 88 56 65 to get a quote. Need help working out your business needs? Talk to your financial adviser. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Risk Protection Plan Page 13
A closer look at Death and Total and Permanent Disablement (TPD) and Death Only Insurance The Risk Protection Plan offers a high level of flexibility in respect of the level of Death and TPD Insurance available. Cover is provided for a fixed dollar amount, as opposed to an amount determined by your salary. In addition, because of the strong relationship that we have with our Insurer, MetLife Insurance Limited, insurance premiums are very competitive when compared to those available through other providers, eg through your bank. Insurance premiums have been calculated to cover administration costs, your financial adviser s remuneration (if applicable) and include GST. Premiums will reflect a person s age, gender, occupational risk, state of health and smoking status. To obtain Death and TPD Insurance premiums (rates) contact the Client Services team on 1300 88 56 65, or talk to your financial adviser (if applicable). Automatic Acceptance for Death and TPD Insurance for eligible group* members only Automatic Acceptance for Death and TPD Insurance may apply to eligible group* members of 10 or more who join the Plan within 120 days of commencing employment. Talk to Client Services on 1300 88 56 65 or your financial adviser (if applicable) for more information. What is the maximum amount of Death and TPD Insurance? The maximum insurance cover available, subject to underwriting, is $3 million per person for TPD Insurance and $5 million for Death Only Insurance, however, your combined Death and TPD and Death Only Insurance cannot exceed $5 million. Applying for cover You can apply, or increase your Death and TPD Insurance by completing the Insurance Application and Personal Statement form, available at www.statewide.com.au/members/riskprotectionplan.aspx. Any additional cover will be subject to acceptance by the Insurer, and exclusions or premium loadings may apply. Or you may wish to talk to your financial adviser. Maximum application age The covered person must be aged under 65 years to apply for this cover. Let s look at Jamie Jamie s 40, single and works as an occupational therapist in his own private practice. Jamie has taken out Death and TPD Insurance with the Risk Protection Plan as an Individual member. His mortgage is his major financial commitment and his expenses do not vary greatly from year to year. He has fixed his mortgage repayments so he knows that his repayments will stay the same for the next five years. He has fixed his insurance cover at the amount of $500,000. This amount covers his mortgage and also allows for any other debt he might incur, for example, buying a new car. Jamie is aware that his insured amount will stay at $500,000 and not decrease over time, and that the premium will increase each birthday. He will review his insurance again in five years to see if it would still meet his financial obligations should the worst happen. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Page 14 Risk Protection Plan
What else do you need to know about Death and TPD Insurance? What is the definition for Total and Permanent Disablement? Total and Permanent Disablement means: Part 1: For a person who at the date of disablement was less than age 65 and in permanent employment working at least 15 hours per week, where one of the following Part 1 a, b, c or d applies: a) The person suffers the permanent loss of use of two limbs or the sight of both eyes or the loss of use of one limb and the sight of one eye (where limb is defined as the whole hand or the whole foot), b) The person is absent from their occupation through illness or injury for six consecutive months and provides proof to the satisfaction of the Insurer that they are incapacitated to such an extent as to render them unlikely ever to engage in or work for reward in any occupation or work for which they are reasonably qualified by reason of education, training or experience, c) Through illness or injury and having provided proof to the satisfaction of the Insurer, they are permanently unable to perform two of the following six basic activities of everyday living: bathing to shower or bathe dressing to dress or undress toileting to use the toilet including getting on and off feeding to eat and drink continence to control bladder and bowel functions mobility to get out of bed or chair or wheelchair. If a person is able to perform the activity using special equipment they will be considered able to perform the activity. d) Through illness or injury, they suffer the permanent deterioration or loss of intellectual capacity and provide proof to the Insurer s satisfaction that they are required to be under continuous care and supervision by another adult person for six consecutive months and that this care is likely to be on a permanent daily basis and ongoing. Part 2: Where a person is not in permanent employment working at least 15 hours per week at the date of disablement or is aged between 65 and 70 years at the date of disablement, if one of the following Part 2 a, b or c applies: a) A person suffers the permanent loss of use of two limbs or the sight of both eyes or the loss of use of one limb and the sight of one eye (where limb is defined as the whole hand or the whole foot), b) Through illness or injury and having provided proof to the satisfaction of the Insurer, they are permanently unable to perform two of the following six basic activities of every day living: bathing to shower or bathe dressing to dress or undress toileting to use the toilet including getting on and off feeding to eat and drink continence to control bladder and bowel functions mobility to get out of bed or chair or wheelchair. If a person is able to perform the activity using special equipment they will be considered able to perform the activity. c) Through illness or injury, a person suffers the permanent deterioration or loss of intellectual capacity and provides proof to the Insurer s satisfaction that they are required to be under continuous care and supervision by another adult person for six consecutive months and this care is likely to be on a permanent daily basis and ongoing. Risk Protection Plan Page 15
Part 3: Where at the date of disability a person whose occupation is a home maker, one of the following Part 3 a, b, c or d applies: a) A person suffers the permanent loss of use of two limbs or the sight of both eyes or the loss of use of one limb and the sight of one eye (where limb is defined as the whole hand or the whole foot), b) Through illness or injury and having provided proof to the satisfaction of the Insurer, a person is permanently unable to perform two of the following six basic activities of everyday living: bathing to shower or bathe dressing to dress or undress toileting to use the toilet including getting on and off feeding to eat and drink continence to control bladder and bowel functions mobility to get out of bed or chair or wheelchair. If a person is able to perform the activity using special equipment they will be considered able to perform the activity. c) Through illness or injury, a person suffers from the permanent deterioration or loss of intellectual capacity and provides proof to the Insurer s satisfaction that they are required to be under continuous care and supervision by another adult person for six consecutive months and this care is likely to be on a permanent daily basis and ongoing. d) As a result of illness or injury a person who is under the regular care of a medical practitioner and for a minimum period of six consecutive months is unable to: perform normal domestic duties leave their home unaided, and be engaged in any employment and at the end of six months provide proof to the satisfaction of the Insurer that they have become incapacitated to such an extent as to render them likely to require permanent ongoing medical care and be unlikely ever to engage in normal domestic duties or any occupation. Home maker is defined as the duties normally performed by a person who remains at home and is not working in regular employment for income. These duties normally include cleaning the home, washing, shopping for food, cooking meals and caring for children and the family on a full time basis. Persons who meet the occupational definition under Part 3 will not be considered under Part 1 and Part 2. What happens in the case of terminal illness? The Insurer will pay a terminal illness benefit where a person who has death cover suffers from an illness which: Two medical practitioners, one of whom specialises in the person s illness, certify in writing that despite reasonable medical treatment the person s death is expected within 12 months of the date of the certification, and The Insurer is satisfied, on medical or other evidence that despite reasonable medical treatment the persons s death is expected within 12 months of the date of the certification referred to in the previous paragraph. When will Death and TPD and Death Only Insurance cease? Insurance will cease from the earliest date of any of the following: a person s 70 th birthday the day a written request that cover be cancelled is made upon commencement of duty with the military services (other than the Australian Armed Forces Reserve and are not on active duty outside Australia) of any country the date that premiums are not paid a TPD or Death benefit is paid the policy is cancelled or terminated for whatever reason, or if the policy renewal is not paid and a period of 30 days has elapsed. Page 16 Risk Protection Plan
Death Insurance Death Insurance provides peace of mind, knowing that upon death before age 70, as long as insurance is maintained, a lump sum payment will be paid. TPD Insurance may be taken in conjunction with Death Insurance. This amount will be paid to the Policy owner. Your Death and TPD Insurance checklist individuals and eligible group* members Is your current Death and TPD Insurance enough to cover all your debt? Don t forget to regularly review your Insurance requirements. Receiving your Renewal Notice each year is a great reminder! Need help? Talk to one of our Client Services Officers on 1300 88 56 65. Get a quote to find out how much your insurance will cost you. Or talk to your financial adviser. Your Death and TPD Insurance checklist businesses seeking Keyperson Insurance How much would it cost you per week to keep your business running smoothly if one of your key people were unable to work again? Talk to one of our Client Services Officers on 1300 88 56 65 to get a quote. Need help working out your business needs? Talk to your financial adviser. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Risk Protection Plan Page 17
What else do you need to know about the Risk Protection Plan? Providing evidence of health All applications for insurance are subject to acceptance by the Insurer, except in the case of Automatic Acceptance (see pages 9 and 14 for further information). The Insurer reserves the right to ask for additional medical evidence to be provided and we will contact the policy holder if this is required for the application. The Insurer will assess applications and advise whether or not cover will be granted. They may also impose special conditions of acceptance including exclusions and/or the payment of additional premiums. 24 hour worldwide cover Insurance cover is provided worldwide, 24 hours a day, subject to any terms and conditions noted on the membership certificate. The Insurer may require the person covered by the policy to return to Australia at the covered person s expense for assessment in the case of a disability claim. Income Protection benefits may be limited to payment over 12 months unless the person named on the policy is continuously resident in Australia, Canada, New Zealand, the United Kingdom, the United States of America or any other country to which the Insurer may agree. When does cover commence? Where Automatic Acceptance does not apply, insurance cover will usually commence once an application form is completed, an initial premium is paid and cover is accepted by the Insurer. If Automatic Acceptance applies (see pages 9 and 14 for eligibility), cover will normally commence on the day a person becomes eligible to join the Plan (which in most circumstances is on commencement of employment). This is providing the employee was in Active Employment (see below). What is Active Employment? Active Employment, for both Income Protection and Death and TPD Insurance, means a person who is employed by the employer and in the Insurer s opinion is capable of performing their identifiable duties without restriction by any illness or injury for at least 30 hours per week (whether or not they are actually working those hours). What is limited cover? Limited cover means that the person is only covered for an illness that first becomes apparent, or an injury that first occurs, on or after the date cover commenced. Increasing, reducing or cancelling insurance cover Any policy holder may request in writing for their cover levels to be increased or decreased. The Insurer will assess the increase requested by the completion of a personal statement and will advise if they have any additional requirements to be met and if the increase in cover is accepted or declined. Insurance may be cancelled at any time by giving written notice to SFMS. Such cancellation will be effective from the date the cancellation is received by SFMS. Although a proportionate premium refund will be available in respect to premiums paid there is no entitlement to any cash value this is not a savings or investment plan. Disability, Death and Total and Permanent Disablement by Accident benefit For individual members who have applied for Death or Income Protection Insurance, or a group* member applying for additional Death or Income Protection Insurance, interim accident cover** applies for an accident resulting in death, total and permanent disablement or disability. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. ** If you have applied for insurance and your application has not yet been approved by the Insurer, you will still receive a benefit should you have an accident (if it occurs with 90 days of application), providing your application is later accepted. You will not receive a benefit if your original application is refused by the Insurer. Page 18 Risk Protection Plan
The benefit payable will be limited to the amount of personal cover or total group* insurance cover applied for up to $1,000,000 for Death Insurance or $10,000 per month for Income Protection Insurance. Additionally, for Death and TPD accident cover, death or total and permanent disablement must occur within 365 days of the accident (other conditions apply). This cover starts from the date the Insurer receives the fully completed application and the initial premium and continues until: the application is withdrawn the application is accepted or denied, or 90 days have passed from the date the application is received. Any additional insurance cover requested will only commence when: a person is accepted for membership in accordance with the Risk Protection Plan rules and eligibility conditions as specified in the insurance policy, and the application is accepted by the Insurer. Are there any circumstances where you can increase your insurance without providing extra health information? A Death Only or Death and TPD covered person may elect to increase their cover without us assessing their insurability upon undergoing one of the following events: a) getting married b) adopting or becoming the natural parent of a child c) obtaining a mortgage on a newly purchased property in which the covered person intends to reside in immediately after its purchase. The covered person must apply for and provide us with evidence satisfactory to us to confirm that any of the above events has taken place within 60 days of the event occurring. Where a covered person is not in Active Employment on the day we receive their application to increase cover, Limited Cover will apply to the amount of the increase in cover until the Covered Person returns to Active Employment for 30 consecutive days. Any increase in cover is limited to the lesser of $100,000, 25% of the cover held by the covered person at the date of the event which was received under automatic acceptance or the amount of the mortgage. The election may only be used once per covered person during the term of the Policy. This option is not available in respect of Income Protection Insurance. Can current insurance held with another super fund or insurance company be transferred to the Risk Protection Plan? Yes, a person may apply to transfer Death and TPD, Death Only or Income Protection Insurance held in a super fund or individual insurance policy into the Risk Protection Plan, providing the external insurance is equivalent to what is available under the Risk Protection Plan. This may assist in reducing the fees paid and in simplifying insurance. Any restrictions (such as loadings or exclusions) that apply to any external cover will be maintained and if the transfer of insurance is successful, the applicant will not be eligible for any Automatic Acceptance cover. To transfer external Income Protection Insurance into the Risk Protection Plan, the waiting period and benefit period must both be available under the Risk Protection Plan. A maximum of $1,000,000 of Death and TPD or Death Only Insurance can be transferred and a maximum of $15,000 per month of Income Protection Insurance. Applications will need to be accompanied by additional information, including certified copies of statements from the fund(s) or the previous insurer being transferred from confirming the type and amount of insurance cover currently held. The Insurer will then consider this information and confirm whether the cover will be provided. Note: It will be the applicant s responsibility to cancel existing cover if the application to transfer cover is accepted by the Insurer. If it is not cancelled the Insurer may be able to reduce any insurance benefit payable having regard to the amount of insured cover provided through the other fund or policy. If you would like more information on continuation of cover contact Client Services on 1300 88 56 65. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Risk Protection Plan Page 19
What if you leave your employer? If you re a group* member and you cease employment you can maintain your Death and TPD Insurance without any alteration of cover, as long as you continue to cover the cost of premiums. This is usually the most cost effective and flexible option especially in respect of maintaining existing benefits and insurance arrangements. Please contact Client Services on 1300 88 56 65 or your financial adviser (if applicable) if you have any questions. What if we have the wrong information in relation to insurance? If the recorded age or gender is incorrect, the Insurer has the right to adjust the premium or the benefit based on the correct information. The insurance certificate should be checked to see if all the details are correct. Are there any exclusions? Death and TPD cover In the case of an insured person: no death benefit will be payable if the individual commits suicide whether sane or insane within the first 12 months of the commencement, increase or reinstatement date of insurance cover and all premiums will be forfeited no terminal illness or TPD benefit will be payable if the individual submits a claim arising out of or in connection with any self-inflicted injury (or complications arising thereafter) whether sane or insane within the first 12 months. Income Protection No income protection benefit will be paid for a person if his or her illness or injury resulting in disability or partial disability is directly or indirectly caused by: any intentional self inflicted injury or any attempt to commit suicide war, or normal and uncomplicated pregnancy, including but not limited to morning sickness, backache, varicose veins and swelling and bladder problems. A benefit may not be payable if the death or disability is a result of: a physical condition which is known about prior to commencement of cover but was not disclosed on the application, or engaging in any pursuit or occupation that was not disclosed in the application that the Insurer would not normally cover. Duty of Disclosure (Insurance Contracts Act 1984) Please read the following section on Duty of Disclosure. It applies if you re applying for insurance or applying to increase insurance. Before you enter into a contract of insurance with an Insurer, you have a duty to disclose to the Insurer every matter that you know or could reasonably be expected to know that is relevant to the Insurer s decision whether to accept the risk of the insurance and if so, on what terms. You have the same duty to disclose those matters to the Insurer before you extend, vary or reinstate a contract of insurance. This duty, however, does not require disclosure of a matter: that diminishes the risk to be undertaken by the Insurer that is common knowledge that the Insurer knows or, in the ordinary course of his/her business, ought to know, or where the requirement for disclosure is waived by the Insurer. Please note that your Duty of Disclosure continues until we advise you or your employer of the Insurer s decision in relation to an application for insurance. *Group members are multiple members who are covered within the same Plan. Group members (more than 10) may be eligible for Automatic Acceptance. See pages 9 and 14 for more information. Page 20 Risk Protection Plan
How to make a claim Our Client Services team should be notified on 1300 88 56 65 as soon as reasonably possible after an event that is likely to give rise to a Death, TPD, Terminal Illness or Income Protection claim. We will then send you the claim forms which should be completed and returned to us. The claim forms will generally require information and evidence such as medical practitioner reports, employer reports and health certificates. You re responsible for meeting any costs incurred in completing the claim forms. For TPD, Terminal Illness or Income Protection claims, the Insurer may request additional information or require the insured person to be examined by a medical practitioner or professional of the Insurer s choice. Generally, the Insurer will pay the costs associated with additional information requests. It s important that all requested information is provided, otherwise the claims process may be delayed. In the event that a claim is made, the Insurer reserves the right to investigate the claim including but not limited to conducting surveillance and requesting information and medical examinations. It s important that, in the event of death, a relative or legal representative notifies us as soon as possible so that the claims process can begin. Once we receive formal written notification of death, we will contact the relatives or legal representative to obtain further documentation and finalise the claim. Otherwise we will follow the instructions provided by the person s adviser (if applicable). What are the significant risks? The risks associated with becoming a member of the Risk Protection Plan that need to be considered include: whether membership of the Risk Protection Plan will provide the necessary cover required if the duty of disclosure is not complied with, the claim may be rejected in full or part if terms and conditions applicable to membership are not complied with (eg premiums not paid by the due date or delayed lodgement of a claim and the Insurer s/policy owner s interests have been prejudiced by the delay), entitlements may be cancelled in full or part if membership is cancelled a person will receive nothing. Membership does not include any savings or investment element the claim not being accepted premium rates are not guaranteed, and an event including the Insurer s insolvency which may prevent the payment of a claim. It is recommended that you seek professional financial advice from a suitably qualified financial adviser to determine your particular needs and requirements to ensure the right product is provided to match your needs whilst minimising risks that might apply to you. Risk Protection Plan Page 21
Tax It is important to know how tax affects the Risk Protection Plan. The tables below summarise the tax treatment of both premiums and benefits paid with regard to the Risk Protection Plan. This is a general guide only as your individual circumstances may be different, which may affect your eligibility for the tax treatment outlined below. We recommend you seek professional advice from a suitably qualified licensed financial adviser or tax adviser to determine the correct tax treatment that applies to you. Premiums tax treatment Insurance type Tax deductibility of premiums - individuals outside of super Tax deductibility of premiums - Self managed super funds or super funds Tax deductibility of premiums - businesses (eg Keyperson Insurance or as a staff benefit) Death Premiums are generally not tax deductible (eg personal member,). Premiums are generally tax deductible for the Trustee of a super fund, provided that the policy is in the name of the Trustee and that the beneficiaries are members of the super fund. The premiums may be tax deductible for businesses that insure key people s income to the business. The premiums are not tax deductible if the purpose of the insurance is to provide a lump sum capital payment to the business, but the benefits received from the policy do not incur taxes. The employer may also incur an FBT liability in relation to premiums paid. Death and TPD Premiums are generally not tax deductible for individuals who have purchased insurance outside of super. Premiums may be tax deductible for a Trustee of a super fund but this is on a case by case basis on who is the owner of the policy and the beneficiaries of the policy. The premiums may be tax deductible for businesses that ensure key people s income to the business. The premiums are not tax deductible if the purpose of the insurance is to provide a lump sum capital payment to the business, but the benefits received from the policy do not incur taxes. Income Protection Premiums are generally deductible, however, there are certain exceptions. Premiums are generally tax deductible under Section 8-1 of the Income Tax Assessment Act (1997). Any amount paid to the insured is assessable income and will be taxed at the recipient s marginal tax rate. If the policy includes lump sum benefits (such as occupationally acquired HIV), the premium for the risk is not tax deductible and benefits received are not assessable for income tax purposes. Premiums may or may not be tax deductible. Specialist tax advice should be sought. Premiums may or may not be tax deductible. Specialist tax advice should be sought. Benefit payments tax treatment Insurance type Tax payable on benefits - individuals outside of super Tax payable on benefits - Self managed super funds or super funds Tax payable on benefits - businesses (eg Keyperson Insurance or as a staff benefit) Death Payments are generally not subject to income tax. Generally tax free if Trustee pays benefit to dependant(s). Benefits received under the policy may be assessed as income to the business and could incur tax. Death and TPD Payments are generally not subject to income tax. On death generally tax free if Trustee pays benefit to dependant(s). On TPD generally tax free if paid to a member who is over 60. Subject to certain requirements, part of the benefit paid to a member under age 60 may be tax free. Benefits received under the policy may be assessed as income to the business and could incur tax. Income Protection Where a tax deduction is received for the premium, any amount paid is assessable income and will be taxed at the recipient s marginal tax rate. If the policy includes lump sum benefits (such as occupationally acquired HIV), the premium for the risk is not tax deductible and benefits received are not assessable for income tax purposes. Income Protection benefits are generally taxable at the member s marginal tax rate. Benefit payments may or may not be tax deductible. Specialist tax advice should be sought. Government taxes and charges SFMS will pass on, with immediate effect, any government taxes or charges (including stamp duty and/or Goods and Services Tax (GST) relating to or arising through the operation of the Risk Protection Plan. Page 22 Risk Protection Plan
Fees and other costs This section contains information about the fees and charges that apply to the Risk Protection Plan. If there is an alteration to either the premium rates applied by the Insurer or any charges applied in the ongoing administration of the Risk Protection Plan, we will give you 30 days written notice before application of any increase in rates or charges. Member fee An annual membership fee of $93.60 for each member is applied to cover the administration costs to maintain your records. This is payable in addition to the premium. Please ring our Client Services team on 1300 88 56 65 for a quote on the cost of your insurance. You will be sent a premium notice each year when your policy is due for renewal. Claims administration fee Insurance premiums include a charge of 10% for Death and TPD and 25% for Income Protection to assist us in dispersing expenses associated with the effective management of claims. What if you have an adviser*? If you purchase this Plan through a financial adviser, the adviser selling you this product may receive payment (remuneration) for the sale of this Plan. Your adviser has to meet their expenses from this remuneration and may also rely on it to provide them with an income. Your adviser may negotiate with you a service fee as a percentage of the insurance premium to cover costs associated with agreed service deliveries to you. Your adviser may charge you directly a fee for service. How premium payments are determined Your financial adviser can provide you with a detailed illustration of the premiums and charges that will apply to your particular circumstances. The total cost that may apply may vary if your adviser elects to lower the level of their remuneration, or alternatively by agreement with you increase their remuneration. Insurance premium frequency Premiums are paid annually in advance or as a new member joins. * This information is not applicable if you do not have a financial adviser. Risk Protection Plan Page 23
Other information you should know Read the following information carefully to ensure you have all the information about the SFMS Risk Protection Plan that you need to make the right decision for you. Keeping you informed We will communicate with you via the telephone, brochures, email, the post and through your financial adviser to ensure you get all the information you need. Copies of this PDS can be obtained electronically at statewide.com.au/members/ RiskProtectionPlan.aspx. If your details change, please let our Client Services team know so that we can update your records. Call 1300 88 56 65. Cooling off period If you are not completely satisfied with your cover and have not made a claim, you may cancel it by notifying SFMS in writing within the 14 day cooling off period (which begins on the fifth day after the issue of your Certificate of Insurance). Cover will be cancelled from commencement and we will refund any premiums that have been paid. If your cover is not part of a super fund, the premiums will be refunded directly to you. If your cover was part of your super fund entitlements, your super fund Trustee will receive the refund of the premiums paid. Complaints handling process We continually strive to provide exceptional service to members. If we do not meet your expectations and you have an enquiry or complaint, in the first instance please call your financial adviser (if you purchased the Risk Protection Plan through an adviser) or call the Client Services team on 1300 88 56 65. They will deal with your enquiry or complaint as a matter of urgency. If you re unhappy with their response and you wish to lodge a written complaint, please write to: The Complaints Officer Risk Protection Plan GPO Box 1572 Adelaide SA 5001. Given that some enquiries or complaints can take time to research, we aim to deal with a complaint within 45 days. If you re not satisfied with our handling of your complaint, or with the decision, you can contact the Financial Ombudsman Service (FOS), an independent service that handles complaints involving life insurance. FOS offers it services free of charge and can be contacted on 1300 78 08 08. Protecting your privacy The Risk Protection Plan complies with the National Privacy Principles (NPPs) outlined in the Privacy Act 1998. The Privacy Act requires us to tell you that the purpose of the collection, use and storage of your personal and sensitive information is to: provide insurance cover pay any benefits, or handle enquiries, complaints or claims. Page 24 Risk Protection Plan
SFMS must disclose personal information to third parties such as insurers, doctors, lawyers, your financial adviser or anyone else as required by law. SFMS will also disclose certain details to its mailing house for mailouts or to the regulators, such as the Australian Prudential Regulation Authority (APRA), the Australian Securities and Investment Commission (ASIC), AUSTRAC and the ATO. SFMS will not trade, rent or sell your personal information to any third parties, but we or other related entities and business partners, may use your personal information to tell you about other products and services or offerings. You can access your information at any time and it is asked that you notify Client Services of any change in your personal information to ensure records are up to date and for direct marketing purposes. If you don t want to receive marketing materials, please call one of our Client Services Officers on 1300 88 56 65. The policies adopted by SFMS in order to comply with the NPPs are available on request from Client Services, phone 1300 88 56 65. You can read the Privacy Policy Statement on the website, www.statewide.com.au/ Members/RiskProtectionPlan.aspx. All your enquiries relating to any of the above, or questions regarding your policy, should be directed to: Risk Protection Plan Client Services GPO Box 1572 Adelaide SA 5001 Telephone 1300 88 56 65 Fax 08 8217 8595 Email service@sfms.com.au Website www.statewide.com.au/members/riskprotectionplan.aspx Where to find more information Copies of this PDS can be downloaded from our website at www.statewide.com.au under Risk Protection Plan. Obtaining a copy of the MetLife Insurance Policy All insurance and benefits payable are subject to the terms and conditions of the relevant insurance policy. You may obtain a copy of the insurance policy by calling Client Services on 1300 88 56 65, Metlife s details are as follows: MetLife Insurance Limited Level 9, 2 Park Street, Sydney NSW 2000 ABN 75 004 274 882 AFSL No. 238096 www.metlife.com.au Risk Protection Plan Page 25
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The issuer and policy owner is Statewide Financial Management Services Limited ABN 69 092 109 209 AFSL 239063 ADDRESS Statewide House, 99 Gawler Place, Adelaide SA 5000 POSTAL ADDRESS GPO Box 1473, Adelaide SA 5001 T 1300 88 56 65 F (08) 8217 8595 W www.statewide.com.au E service@sfms.com.au RPPDS01