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Insurance Guide PDS Supplement
we make it easy for you
Dated 30 September 2017 CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226 CARE Super (Fund) ABN 98 172 275 725
CareSuper has you covered 1
Employee Plan members 4
Personal Plan members 6
Tailoring your cover 7
How much cover do you need? 12
Insurance – what do I need to know? 14
Claiming an insurance benefit 18
Exclusions and restrictions 20
Definitions for insurance 22
Contents
The information in this Insurance Guide applies to Employee Plan members and Personal Plan members. It describes the insurance arrangements applicable from 30 September 2017.
PDS Supplement
The information in this document forms part of the CareSuper Member Guide Product Disclosure Statement dated 30 September 2017.
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CareS
uper has you covered
You wouldn’t think twice about insuring your car or house, yet you may not have thought about insuring your income, which could be one of your biggest assets. If that was suddenly taken away, insurance cover could help reduce the impact on you or your family.
CareSuper offers eligible members access to death, total & permanent disablement and income protection insurance cover at competitive rates.
The insurance arrangement available to you will depend on the type of membership you have with us. There are two types of membership: Employee Plan and Personal Plan.
Employee Plan members...
Receive default cover (if eligible) under CareSuper’s insurance policy. See page 4 for details on default cover.
Personal Plan members...
Have the option of applying for the cover that best suits their needs. See page 6 for more information.
Note: You may also be able to transfer insurance cover from another super fund to CareSuper, subject to conditions. Refer to page 14 for details.
Getting adviceThe advice in this Insurance Guide is of a general nature. It has been prepared without taking into account your particular financial needs, circumstances or objectives. You should assess your own financial situation before making a decision about your insurance cover. This may involve seeking the help of a licensed or authorised adviser.
Which insurance arrangement applies to you?
the insurance options available to you will depend on what type of membership you have
CareSuper has you covered
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CareSuper offers eligible members access to three types of insurance cover: death, total & permanent disablement (TPD) and income protection.
1 Death cover provides a lump sum payment to your beneficiaries if you die (certain restrictions apply). This can help you to ensure the ongoing wellbeing of family members, even if you are no longer around to provide for them. Early release of the death benefit may also be available if you are terminally ill (see the definition of terminal illness on page 23). You must be aged under 70 and meet other eligibility criteria to obtain death cover.
2 Total & permanent disablement (TPD) cover provides a lump sum payment if you are never able to work again due to illness or injury (specific definitions apply). This payment could be used to cover medical bills, rehabilitation expenses or medically required home modifications, and to ensure the overall security of your family and your home. You must be aged under 65 and meet other eligibility criteria to obtain TPD cover.
3 Income protection cover provides a temporary replacement income if you are unable to work due to illness or injury (specific conditions apply). This means you can continue to pay your bills while taking the time to recover and rehabilitate. You must be aged under 65 and on an ongoing basis be earning at least $16,000 p.a. or working 15 hours or more per week to be eligible for income protection cover (other eligibility criteria applies). Income protection cover is only available as voluntary cover.
Each type of cover is explained in detail in the following pages.
ImportantIf you have previously been paid a TPD payment of any type as a result of a TPD claim, you will only be eligible for death cover with CareSuper, not TPD or income protection cover.
If you have previously been paid a terminal illness benefit or have been diagnosed with an illness that reduces your life expectancy to less than 12 months, you will not be eligible for death, TPD or income protection cover with CareSuper.
If you aren’t eligible for cover as a result of a TPD payment, or terminal illness benefit or diagnosis, you will need to notify us or cancel your cover. Otherwise, premiums will continue to be deducted from your account despite the fact you do not have cover.
CareSuper has you covered (continued)
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Did you know?As the provider of an authorised MySuper product, CareSuper meets the minimum insurance requirements and is an eligible default fund for employers’ compulsory super contributions (where an employee does not choose their own fund). It’s important to think about insurance while you’re fit and well, as it can be difficult to obtain if you’ve suffered an illness or injury. Insurance cover through your super fund is purchased at group rates – which is usually cheaper than getting cover yourself. All insurance cover (including default cover) is subject to the insurer’s terms and conditions summarised in the following pages.
How it worksEmployee Plan members• At CareSuper, each eligible Employee
Plan member receives our default insurance cover under CareSuper’s insurance policy, however limited default cover (‘limited cover’) will apply if you are not in active employment for all of the first 30 days from the date your cover commences. For more information on limited cover see page 23.
• Default cover is provided in ‘units’ of death and TPD cover. The number of units you receive depends on your age and the amount of cover per unit depends on your age and occupation. With unit-based cover, the same premium per unit applies each year, but the amount of cover provided per unit decreases from age 30.
• If you are an eligible new Employee Plan member under the age of 60, you can also apply to increase this cover to up to 7 times your annual total income to a maximum of $750,000, and/or add income protection cover, by answering a few health questions. To do this, you need to apply within 90 days of the date on your Welcome letter or email. See page 24 for the definition of total income.
Personal Plan members• At CareSuper, Personal Plan members
are still eligible for great choices in cover.
• You can apply for cover at any time and it is subject to assessment and acceptance by the insurer. For details on tailoring your cover see page 7.
How much it costs• The premium for 1 unit of death cover
is $1.02 per week. The premium for 1 unit of TPD cover is $1.03 per week. The premium for 1 unit of death and TPD cover is $2.05 per week. These are the premiums for all occupational categories. The General occupational category will apply until we are otherwise advised by you. Premiums are subject to change.
• Different premiums may apply for tailored cover (see page 7).
• Insurance premiums are deducted from your CareSuper account and your account receives a 15% contributions tax rebate.
• This means you can pay for your insurance using your super so it doesn’t impact on your take-home pay. Refer to the Member Guide PDS for more information.
• Insurance premiums are calculated weekly and deducted monthly.
• A portion of the premium is contributed to CareSuper’s General Reserve. The Reserve is used to cover the administration and management of CareSuper’s insurance.
Tailoring your coverYou also have the option to choose fixed death and TPD cover, where your cover is set at a fixed dollar amount. The fixed cover you select must be in multiples of $1000.
With fixed cover, the amount you pay will increase with each birthday, but the amount of cover will remain the same. Fixed cover can also be indexed to increase by 5% on 1 July each year, offering added security against the rising cost of living. Premiums will be based on the increased cover.
Further information about tailored cover for Employee Plan members and Personal Plan members is provided on the following pages.
Insurance premiums are deducted from your account at the sell unit price. For information about investment unit prices see the Investment Guide available at caresuper.com.au/PDS.
CareS
uper has you covered
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Our default coverEvery eligible Employee Plan member receives default cover at the time of joining CareSuper.
Default insurance cover does not include income protection cover.
CareSuper’s default insurance cover
Age Death cover
TPD cover
Cost per week
15–29 1 unit 4 units $5.14
30–64 4 units 4 units $8.20
65–69 4 units – $4.08
Employee Plan members
Eligibility for default cover Your eligibility for default cover depends on your age and other conditions. Default cover is subject to restrictions and exclusions described later in this guide.
If you are not in active employment for all of the first 30 days from the date insurance cover commences, limited cover may apply. Refer to page 14 for details on when your cover starts, page 20 for other important terms and conditions, and page 22 for the definition of active employment.
Insurance needs often change over the course of an individual’s working life. Before 30, for instance, you might not have a lot of debt or anyone who relies on you financially, but you probably don’t have a lot of super to help if you suddenly stopped working. Meanwhile, those over 30 are more likely to have dependants or bigger financial commitments.
flexibility to adjust your cover to suit your needs
how much or what type of insurance you need depends on your
circumstances
insurance needs often change over the course of an
individual’s working life
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Available to eligible new Employee Plan members under age 60 within 90 days of the date on their Welcome letter or email
Under our New Member Options, you can:
1. Add income protection, and/or
2. Increase death and TPD cover up to 7 times your annual total income, to a maximum of $750,000. See page 24 for the definition of total income.
You need to apply for a New Member Option before you reach age 60 and within 90 days of the date on your Welcome letter or email, and answer a few health questions. You can apply by completing the Insurance application form available from caresuper.com.au/forms or by logging in to MemberOnline and going to the Insurance section. If you are not in active employment for all of the first 30 days after insurance cover commences, limited cover may apply. Refer to the Exclusions and restrictions section on page 20 for further details, and pages 22 and 23 for the definitions of active employment and limited cover.
Available to Employee Plan members any time after joining
Any time after joining CareSuper, you can:
• Increase your cover, either by nominating more units or adding a fixed cover amount, to a maximum of $10 million for death cover (limited to $3 million for Terminal Illness claims), $3 million for TPD
• Change your unit-based cover to fixed cover so the amount of cover stays the same
• Index your fixed insurance cover
• Take up or increase income protection cover
• Change your level of cover to reflect your occupational category
• Transfer your cover from another super fund if you are under age 60.
If you would like to apply for tailored cover, your application will need to be assessed and approved by the insurer, and medical evidence may be required. To apply, simply complete the relevant form available at caresuper.com.au/forms or log in to MemberOnline and go to the Insurance section.
To create a MemberOnline account, go to caresuper.com.au.
These options are discussed in more detail in the following pages.
The insurer may apply a medical exclusion and/or loading to your cover rather than decline your application. For more information call the CareSuperLine on 1300 360 149.
Your insurance optionsHow much cover you need depends on your individual circumstances. While you’ll receive the default level of cover if you are eligible, it’s a good idea to assess your actual insurance needs and adjust your cover accordingly.
Em
plo
yee Plan
mem
bers
Not sure how much cover you need?
A financial planner can help. To book a call-back from a planner, visit caresuper.com.au/advice
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Personal Plan members
Applying for insurance cover If you are not linked to an employer and make your own contributions to your super, you are a Personal Plan member. Personal Plan members do not receive default insurance, but can still apply for cover.
You can apply for cover up to the maximum levels below.
Your insurance options (evidence of health required)
Death Up to $10 million (unit-based or fixed)
TPD Up to $3 million (unit-based or fixed)
Income protection
Up to $40,000 per month* (unit-based only)
it pays to review your insurance from time to time...
You can apply for death only, TPD only or death and TPD cover. You can apply for income protection cover only or combine it with death or TPD or death and TPD cover.
If you have previously received a payment of any type as a result of a TPD claim, you are only able to apply for death only cover.
If you have been paid a terminal illness benefit or have been diagnosed with an illness that reduces your life expectancy to less than 12 months, you will not be able to apply for death, TPD or income protection cover with CareSuper.
Refer to page 8 to see how much cover each unit provides for your age and occupational category.
Additional choices
• Changing your unit-based cover to fixed cover so the amount of cover stays the same
• Indexing fixed insurance cover
• Applying for income protection cover
• Making sure you’re in the right occupational category so you receive the applicable level of cover
• Transferring your cover from another super fund if you are under age 60 (subject to additional maximum limits).
These options are discussed in more detail in the following pages.
How to applyOnce you have determined what type and how much cover you need, you can apply online via the Insurance section of MemberOnline, or complete the Insurance application form available at caresuper.com.au/forms.
To create a MemberOnline account, go to caresuper.com.au.
All applications for cover are subject to assessment by CareSuper’s insurer.
Note: You are required to have a minimum CareSuper account balance of $1500 before cover commences.
* The maximum benefit is 85% of the first $423,530 p.a. of income for the entire benefit payment period, plus 60% of the next $200,000 p.a. of income for the first 2 years of the benefit payment period.
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Tailoring your cover
CareSuper gives all eligible members the option of tailoring their cover to suit their needs.
Death and TPD cover Applying for cover If you’d like to tailor your death or TPD cover, the first step is to work out how much to apply for.
First determine your occupational category by answering the three questions on this page. Then use the tables on pages 8–9, and the examples on page 12, to calculate the extra cover you can apply for in relation to unit-based cover and what your premium will be depending on your occupational category (for fixed cover). Using the examples on page 12 as a guide, you can calculate how much cover you need, and the cost of this cover per week.
The premiums are deducted from your CareSuper account and your account receives a 15% contributions tax rebate. This means you can pay for your insurance using your super so it doesn’t impact on your take-home pay.
To tailor your cover (for example, by increasing your units, or fixing or indexing your cover), simply indicate your choices when filling out the Insurance application form available at caresuper.com.au/forms, or you can
apply online via MemberOnline. You will not be eligible for TPD cover if you have previously been paid a TPD benefit of any type. You will not be eligible for TPD or death cover if you have previously been paid a terminal illness benefit or have been diagnosed with an illness that reduces your life expectancy to less than 12 months.
Occupational categoriesTo reflect the different levels of risk associated with our members’ different roles and occupations, CareSuper has three different occupational categories. Each category has a different amount of cover per unit. The three categories are:
• General • Office, and • Professional.
Your occupational category will be reviewed each time you complete a new application form or apply to vary your insurance cover. You may be required to provide further health evidence and once your application is assessed, any additional cover may be subject to premium loadings and/or exclusions.
If you are eligible to receive default insurance it will be at the General occupational category level until your application to change your level of cover or occupational category is accepted by the insurer.
To determine your occupational category, answer the following questions:
1. Are the duties of your occupation limited to professional, managerial, administrative, clerical, secretarial or similar ‘white collar’ nature tasks which do not involve manual work and are undertaken entirely within an office environment (excluding travel time from one office environment to another)?
2. Are you earning* in excess of $100,000 p.a. from your profession?
3. Do you:
a) Hold a tertiary qualification or are you a member of a professional institute or registered as a practicing member of your profession by a government body?
or b) Work in a management role?
* To calculate your earnings, see the definition of total income on page 24.
If you answered no to Q1, you qualify for the General occupational category.
If you answered yes to Q1, you qualify for the Office occupational category.
If you answered yes to Q1 and Q2, and to either Q3a or Q3b, you qualify for the Professional occupational category.
Applying to change your occupational categoryWhen you apply to change your occupational category, you will need to answer a few simple health questions to ensure you’re eligible to change your cover.
You can apply to change your occupational category at any time by completing the Changing your occupational category form available at caresuper.com.au/forms.
Note: If changing your occupational category increases your cover, you will be subject to the active employment test. This means if you are not in active employment for all of the first 30 days from the date your cover increases then limited cover conditions apply to the increased cover until you return to active employment for 2 consecutive months, at which point full cover will apply. See the definitions of active employment and limited cover on pages 22 and 23.
Unit-based vs fixed coverBefore you think about tailoring your cover, it’s important to understand the difference between ‘unit-based’ and ‘fixed’ cover. Generally, with unit-based cover the amount of cover you have decreases with age but your premium stays the same. With fixed cover, your cover stays the same but your premium increases with age. We’ve covered unit-based and fixed cover in more detail on the following pages.
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Unit-based cover per unit of death and TPD ($)
Age General Office Professional
15 to 30 100,280 119,400 166,870
31 100,280 118,140 165,000
32 100,280 115,610 161,530
33 98,690 113,090 158,050
34 95,440 110,560 154,440
35 92,210 105,620 147,500
36 88,820 100,570 140,550
37 85,430 96,780 135,200
38 81,320 91,730 128,130
39 77,200 87,950 122,910
40 73,100 85,530 119,440
41 68,980 81,740 114,220
42 64,870 76,690 107,150
43 61,330 73,320 102,480
44 58,390 69,380 97,400
45 55,860 66,800 93,380
46 52,910 63,220 88,320
47 49,970 59,750 83,500
48 47,230 56,490 78,960
49 44,390 53,020 74,020
50 41,870 50,070 70,000
51 38,820 46,390 64,800
52 35,980 43,030 60,120
53 33,030 39,450 55,180
54 30,510 36,500 51,040
55 27,460 32,820 45,820
56 24,830 29,670 41,640
57 21,990 26,300 36,740
58 19,040 22,830 31,930
59 16,520 19,780 27,660
60 13,570 16,310 22,850
61 10,730 12,830 17,910
62 8630 10,310 14,430
63 8630 10,310 14,430
64 8630 10,310 14,430
65 to 69* 8340 9050 12,690
* Death only cover
Note: Your TPD cover will cease when you reach age 65 and your death cover (including terminal illness) will cease when you reach age 70.
Example
John is aged 40 and qualifies for the General occupational category, so 1 unit provides $73,100 of cover. He has determined that he needs $550,000 of cover.
Therefore, John needs 8 units of death and TPD cover and will have to apply for some or all of this cover depending on whether he has existing cover.
how much or what type of insurance you need depends on your
circumstances
= 7.52 units$550,000 $73,100
Unit-based coverWith unit-based cover, the amount of cover you have decreases as you age but your premium stays the same.
Tailoring your cover (continued)
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Premium per year per $1000 sum insured of fixed death and TPD cover ($)
Age General Office Professional
Death TPDDeath & TPD
Death TPDDeath & TPD
Death TPDDeath & TPD
15-30 0.52 0.53 1.05 0.44 0.45 0.89 0.32 0.32 0.64
31 0.52 0.53 1.05 0.45 0.45 0.90 0.32 0.33 0.65
32 0.52 0.53 1.05 0.46 0.46 0.92 0.33 0.34 0.67
33 0.53 0.54 1.07 0.47 0.47 0.94 0.34 0.34 0.68
34 0.55 0.56 1.11 0.48 0.49 0.97 0.34 0.35 0.69
35 0.57 0.58 1.15 0.50 0.51 1.01 0.36 0.37 0.73
36 0.59 0.60 1.19 0.52 0.53 1.05 0.38 0.38 0.76
37 0.61 0.62 1.23 0.54 0.55 1.09 0.39 0.40 0.79
38 0.64 0.66 1.30 0.57 0.58 1.15 0.41 0.42 0.83
39 0.68 0.69 1.37 0.60 0.61 1.21 0.43 0.44 0.87
40 0.71 0.73 1.44 0.61 0.62 1.23 0.44 0.45 0.89
41 0.76 0.77 1.53 0.64 0.65 1.29 0.46 0.47 0.93
42 0.81 0.84 1.65 0.68 0.69 1.37 0.49 0.50 0.99
43 0.87 0.89 1.76 0.71 0.73 1.44 0.51 0.52 1.03
44 0.91 0.93 1.84 0.75 0.77 1.52 0.54 0.55 1.09
45 0.95 0.97 1.92 0.78 0.81 1.59 0.56 0.57 1.13
46 1.00 1.02 2.02 0.84 0.86 1.70 0.59 0.60 1.19
47 1.06 1.08 2.14 0.89 0.91 1.80 0.63 0.64 1.27
48 1.12 1.14 2.26 0.94 0.96 1.90 0.66 0.68 1.34
49 1.19 1.21 2.40 1.00 1.02 2.02 0.71 0.72 1.43
50 1.26 1.28 2.54 1.06 1.08 2.14 0.75 0.76 1.51
51 1.36 1.38 2.74 1.14 1.16 2.30 0.81 0.84 1.65
52 1.47 1.50 2.97 1.23 1.25 2.48 0.89 0.90 1.79
53 1.60 1.63 3.23 1.33 1.36 2.69 0.96 0.98 1.94
54 1.73 1.76 3.49 1.45 1.48 2.93 1.04 1.06 2.10
55 1.91 1.96 3.87 1.61 1.64 3.25 1.15 1.18 2.33
56 2.12 2.17 4.29 1.78 1.81 3.59 1.27 1.29 2.56
57 2.39 2.45 4.84 2.01 2.05 4.06 1.44 1.47 2.91
58 2.77 2.83 5.60 2.30 2.35 4.65 1.65 1.68 3.33
59 3.20 3.26 6.46 2.67 2.73 5.40 1.90 1.95 3.85
60 3.88 3.96 7.84 3.24 3.30 6.54 2.30 2.35 4.65
61 4.92 5.01 9.93 4.11 4.20 8.31 2.94 3.00 5.94
62 6.12 6.24 12.36 5.11 5.21 10.32 3.66 3.73 7.39
63 6.12 6.24 12.36 5.11 5.21 10.32 3.66 3.73 7.39
64 6.12 6.24 12.36 5.11 5.21 10.32 3.66 3.73 7.39
65-69* 6.32 N/A N/A 5.84 N/A N/A 4.16 N/A N/A
* Death only cover Note: Your TPD cover will cease when you reach age 65 and your death cover (including terminal illness) will cease when you reach age 70. Fixed cover is available to all members on application to the insurer.
Example
Anna is in the General occupational category and has applied for $550,000 of fixed death and TPD cover (without indexation). Her premiums at various ages are shown below.
Age 40
$550,000 x $1.44 = $792.00 p.a. $1000
Age 45
$550,000 x $1.92 = $1056.00 p.a. $1000
Age 50
$550,000 x $2.54 = $1397.00 p.a. $1000
Age 55
$550,000 x $3.87 = $2128.50 p.a. $1000
Fixed coverWith fixed cover, your amount of cover stays the same but the premium you pay increases with age (and is determined by your age and occupational category).
You can choose to have your fixed cover indexed – meaning that it increases by 5% on 1 July each year to account for inflation. Premiums will be based on the increased cover. You must apply for a minimum of $10,000 of fixed cover and it must be in multiples of $1000.
To determine what your annual premium would be for fixed cover, divide your required level of cover by $1000, and multiply by the premium that corresponds to your age and occupational category.
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Income protection coverWho can apply?Anyone who is aged between 15 and 65, and earning on an ongoing basis at least $16,000 p.a. or working 15 hours or more per week, is eligible to apply for income protection insurance. This includes contractors, part-time employees and casual employees. You will not be eligible for income protection cover if you have previously been paid a TPD benefit, have been paid a terminal illness benefit, or have been diagnosed with an illness that reduces your life expectancy to less than 12 months.
How much income protection cover do I need?You can tailor income protection insurance to suit your circumstances, with the following options to choose from:
• A waiting period of 30, 60 or 90 days, and
• A benefit period of either 2 or 5 years.
The maximum amount of income protection cover you can apply for is determined by your income. How much you decide you need depends on your estimation of your required income if you are not working. Your cover will automatically increase by 5% on 1 July each year to account for inflation.
Premiums will be based on the increased cover.
See page 22 for the definition of income.
Tailoring your cover (continued)
The maximum benefit is 85% of the first $423,530 p.a. of income for the entire benefit payment period, plus 60% of the next $200,000 p.a. of income for the first 2 years of the benefit payment period.
Each unit of income protection cover provides a benefit of $425 per month of which $375 (less tax) is payable as a benefit to you and $50 is payable to your CareSuper account as a super contribution. Continued contributions to super help to keep you on track to meet your retirement goals and help maintain a sufficient balance in your account to continue covering your insurance premiums.
The maximum income protection cover you can apply for by answering a few health questions (if you are under age 60 and your application is received within 90 days of the date of your Welcome letter or email) depends on your occupational category, as below:
General category: an income of up to $72,000 p.a. (or 12 units) can be covered
Office category: an income of up to $102,000 p.a. (17 units) can be covered
Professional category: an income of up to $144,000 p.a. (24 units) can be covered.
If you need more cover, tailored income protection cover allows you to apply for as many units as you like up to the maximum monthly benefit.
Tailored cover will be subject to assessment and acceptance by our insurer. Premium loadings and/or exclusions may apply to some members.
How much does income protection cover cost?The cost of income protection cover is based on your age, your occupational category, the waiting period you select (30, 60 or 90 days) and the benefit period you choose (2 or 5 years).
The cost decreases if you wait longer to receive your benefit. If you do not make a selection a 30-day waiting period will apply.
The cost increases if you choose the 5-year benefit period. If you do not indicate a benefit period on your application form, the 2-year benefit period will apply.
Using the number of units you have determined you need (see page 13), use the tables on page 11 to calculate your weekly premium. The premiums are deducted from your CareSuper account and your account receives a 15% contributions tax rebate. This means you can pay for your insurance using your super so it doesn’t impact on your take-home pay.
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Premium per week per unit of income protection cover (2-year benefit period)
Waiting period
General Office Professional
30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days
Current age $ $ $
15–24 0.41 0.30 0.16 0.28 0.18 0.10 0.23 0.16 0.08
25–29 0.43 0.30 0.17 0.29 0.20 0.10 0.24 0.17 0.08
30–34 0.49 0.35 0.17 0.34 0.23 0.11 0.28 0.18 0.09
35–39 0.65 0.45 0.23 0.43 0.30 0.15 0.35 0.26 0.12
40–44 0.85 0.60 0.35 0.55 0.39 0.23 0.46 0.32 0.17
45–49 1.14 0.81 0.55 0.75 0.52 0.38 0.61 0.43 0.30
50–54 1.61 1.13 0.90 1.07 0.75 0.60 0.86 0.60 0.49
55–59 2.30 1.61 1.43 1.51 1.07 0.94 1.24 0.86 0.77
60–64 2.49 1.89 1.46 1.64 1.24 0.96 1.34 1.02 0.79
Premium per week per unit of income protection cover (5-year benefit period)
Waiting period
General Office Professional
30 days 60 days 90 days 30 days 60 days 90 days 30 days 60 days 90 days
Current age $ $ $
15–24 0.55 0.42 0.23 0.37 0.27 0.15 0.30 0.23 0.13
25–29 0.60 0.46 0.26 0.40 0.30 0.17 0.33 0.25 0.14
30–34 0.74 0.55 0.29 0.48 0.37 0.18 0.40 0.30 0.16
35–39 0.99 0.75 0.39 0.66 0.49 0.26 0.54 0.41 0.22
40–44 1.37 1.04 0.64 0.90 0.68 0.42 0.73 0.55 0.35
45–49 1.98 1.48 1.05 1.29 0.97 0.69 1.07 0.79 0.55
50–54 2.94 2.21 1.72 1.93 1.46 1.13 1.59 1.19 0.92
55–59 4.35 3.30 2.74 2.87 2.18 1.80 2.35 1.78 1.47
60–64 3.61 2.88 2.14 2.37 1.89 1.41 1.95 1.56 1.16
Note: Income protection cover will automatically increase by 5% on 1 July each year to account for inflation. Pro-rata premiums will apply to the increased cover.
Cost of income protection cover
Insurance premiums are deducted from your account at the sell unit price. For information about investment unit prices see the Investment Guide available at caresuper.com.au/PDS.
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Important questions Example# Your calculation
How much insurance cover would you need to meet your commitments in the event of your death or disablement? Consider your current financial needs – mortgage repayments, car loans, credit cards, school fees, food, clothing, etc. Keep in mind other assets, such as savings or super, which might be accessed to assist in meeting your commitments.
$400,000 (A)
Determine your occupational category using the information on page 7. Make sure you’re in the correct category to match your occupation type. All eligible Employee Plan members are allocated to the General occupational category unless they apply to change their occupational category.
In this example the member is aged 40 and qualifies for the Office category.
Changing occupational category will change the amount of cover per unit from $73,100 for General to $85,530 for Office.
Check what cover you may already have. If you have default cover, see page 4 for the number of units you receive. Refer to the table on page 8 and locate the benefit payable for the cover that applies to your age and occupational category. If the benefit amount (B) is less than the amount of your commitments (A), then you may not have enough insurance cover. This may depend on what other insurance cover you have directly or via another super fund. At this point, you might like to consider applying for tailored cover to meet any shortfall – for example, a fixed amount of cover (see page 9), or alternatively, please continue for unit-based cover.
$85,530# x 4
= $342,120 (B)
Work out the difference between your existing cover and the cover you want. Refer to the table on page 8 and locate the benefit payable for one unit of cover for your age and occupational category (C). To work out the number of units required, calculate A ÷ C. Round this figure up if not whole.
$85,530 (C) A ÷ C $400,000 ÷ $85,530 = 4.7 units rounds up to 5 units
How many units of death and TPD cover are required? (including the existing cover (A))
5 units of cover are required, providing cover of 5 x $85,530 = $427,650
How much will it cost? Unit-based cover is $2.05 per week per unit of death and TPD cover. In this example, for an extra cost of $2.05 per week, the member can increase their cover by $135,250 (comprising an extra $49,720 by updating their occupation category AND $85,530 for an additional unit of cover).
5 x $2.05 = $10.25 per week
# In this example the member has default cover, is 40 years old and can obtain cover under the Office occupational category (that is, the member has 4 units of death and TPD). Remember, unit-based cover decreases with age, so you should take this into consideration.
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How much cover do you need?
Death and TPD insuranceHow to calculate your death and TPD benefit and premiumIf you have default cover you can use the following table to calculate the number of units of cover needed to meet your insurance requirements for death and TPD, as well as the weekly cost of this cover. If you are a Personal Plan member you can also use the following table as a guide, keeping in mind that default cover does not apply. Refer to page 8 for the unit-based benefit table. Refer to page 3 for premiums applicable to unit-based cover. If you would like fixed cover, refer to page 9 for the premium table.
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Important questions Example* Your calculation
On average, how much income do you earn before tax each month? $2200
2 Multiply this by 85%.** The result is the maximum benefit amount you could receive per month if you make a claim.
$2200 x 0.85 = $1870
3 Divide this by $425 and round up to the nearest whole number. The result is the maximum number of units of income protection cover you may apply for. For every $425 benefit, $375 (less tax) will be paid into your nominated bank account and $50 will go into your CareSuper account.
$1870 ÷ $425 = 4.4 4.4 rounds up to 5 units
4 How much will it cost? Multiply the number of units of cover by the premium that relates to your age under the General, Office or Professional occupational category after selecting suitable waiting and benefit periods (see the tables on page 11). This is your weekly premium.
5 units x $0.45* = $2.25 per week
* In this example the member is aged 35, is covered under the General occupational category and has chosen a 60-day waiting period and a benefit period of 2 years.
** The maximum benefit is 85% of the first $423,530 p.a. of income for the entire benefit payment period, plus 60% of the next $200,000 p.a. of income for the first 2 years of the benefit payment period.
Note: Income protection must be applied for and, where medical evidence is required, is subject to acceptance by the insurer. Premium loadings and/or exclusions may apply to some members.
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Income protection insuranceHow to calculate your income protection benefit and premiumYou can use the following table to calculate the number of units needed to meet your insurance requirements for income protection, as well as the weekly cost of this cover. Refer to page 11 for premiums.
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Transferring your insuranceIf you are under age 60, you may be able to transfer your current super insurance arrangement to CareSuper without having to provide medical evidence.
To transfer cover to CareSuper you must:
• Provide an up-to-date statement or certificate of currency as evidence of cover held. We must receive this within 6 months of the date of issue of the statement or certificate of currency, and
• Transfer the whole account balance from your former fund to CareSuper. Before you leave your other fund, you should check if it is the right decision for you as you will lose any insurance entitlements you have with that fund. You should also check whether your other fund will charge you an exit fee or other fees.
Please note: If you are not in active employment for all of the first 30 days from the date your cover is transferred to CareSuper, you will receive limited cover only. See pages 22 and 23 for the definitions of active employment and limited cover.
To transfer your existing cover, please complete the Transfer your insurance form available at caresuper.com.au/ forms and provide the required documentation. This option is available to both Employee Plan members and Personal Plan members. Loadings, exclusions and/or limited cover may apply.
The maximum death only or death and TPD cover that can be in place in CareSuper without underwriting following a transfer is $2 million (inclusive of any existing death only or death and TPD cover you already have in CareSuper). If you want to transfer cover that would result in your total cover being greater than $2 million, you will need to be assessed and accepted by our insurer.
If the insurer accepts your application, your existing amount of death/TPD cover (subject to maximum limits) as at the transfer date under your former super fund will be added to any existing death/TPD cover held with CareSuper by allocation to your CareSuper account of sufficient units rounded up to the next whole unit (if you currently have unit-based cover in CareSuper), or sufficient fixed cover rounded up to the nearest $1000.
The maximum income protection cover that can be transferred is $10,000 per month. The waiting period and benefit payment period will be adjusted in line with CareSuper’s insurance design. For example, if the income protection cover transferred has a ‘to age 65’ benefit period, you will be provided with a 5-year benefit period under CareSuper.
The waiting period will be rounded up to the next highest waiting period under CareSuper (for example, a 45-day waiting period will be rounded up to 60 days under CareSuper).
Transferred income protection cover is not added to any current CareSuper income protection cover. Transferred cover will replace any existing income protection cover you have in CareSuper. However, if the amount of the existing cover exceeds the amount of
Insurance – what do I need to know?
transferred cover, the existing cover will continue and the transferred cover will be invalid.
Transferred cover will commence in CareSuper on the later of:
• The date the insurer accepts your application, and
• The date the existing insurance cover under your former fund is cancelled. This is generally the date your whole account balance is transferred to CareSuper.
Limited cover conditions apply if you are not in active employment for all of the first 30 days from the date your transferred cover commences. For more information on limited cover, see page 23.
When does my insurance cover commence?If you are an eligible Employee Plan member, your default cover commences on the later of:
• The first day of the period for which the first Superannuation Guarantee (SG) employer contribution is paid on your behalf by your employer (usually the date you commence work with your employer), or
• The date your employer becomes a participating employer of CareSuper. In some instances, this will be the date on which CareSuper receives the first SG employer contribution on your behalf, or
• The date 130 days before we receive your first SG employer contribution.
Any tailored or transferred cover you apply for commences on the date we advise you in writing.
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For Personal Plan members, cover commences on the date you are advised in writing that cover has been accepted. Personal Plan members are also required to have a minimum balance of $1500 before cover commences.
The first insurance premium payment deducted from your account will include all premiums accrued since your commencement date.
Please refer to the Exclusions and restrictions section on page 20 for further information about commencement of cover.
Can I change my cover later?Yes. You can apply to change the amount of cover you have at any time. For information about your insurance options, refer to page 5.
If you would like to increase your insurance cover, your application will need to be approved by the insurer. Your occupational category will be reviewed each time you complete a new application or apply to vary insurance cover. You may be required to provide further health evidence and once your application is assessed, any additional cover may be subject to premium loadings and/or exclusions.
To apply for an increase in insurance cover you can complete the Insurance application form at caresuper.com.au/forms, or apply online. To apply online log in to MemberOnline and go to the Insurance section.
To create a MemberOnline account, go to caresuper.com.au.
If you would like to decrease or cancel your cover, log in to MemberOnline and go to the Insurance section. Remember, if you do reduce or opt out of cover and you wish to increase or recommence cover at a later date, you will need to meet the insurer’s assessment requirements and you may be required to provide evidence of health. See page 16 for more information on recommencing cover.
When does cover stop?Death, TPD and income protection cover cease at the earliest of the following events:
• The date you stop being a member of CareSuper
• The date you reach the maximum insurable age for a particular benefit (see at right)
• The date a terminal illness benefit is paid. However, if your death cover is greater than the terminal illness benefit paid, death cover will continue while you remain a CareSuper member and maintain a sufficient balance to meet your insurance premiums. Your death cover will be reduced by the insured amount paid to you on terminal illness grounds
• The date of your death
• The date a TPD benefit is paid where the amount paid is greater than or equal to your death benefit amount. If your death cover is greater than your TPD cover, your death cover will continue when a TPD benefit is paid. Your death cover will be reduced by the amount of TPD cover paid to you
• In the case of income protection cover, the date you commence duty with the armed services of any country, other than the Australian Army Reserve (during scheduled Army Reserve exercises, but not if called up for active service)
• The date the policy is terminated or cancelled for any reason
• The date we receive your completed Request to reduce or opt out of insurance cover form or online request
• If there are insufficient funds in your account to meet premiums, on the last Friday of the month in which a premium deduction can be made from your CareSuper account.
Maximum insurable ageDeath cover (including terminal illness) – 70 years
TPD cover – 65 years
Income protection cover – 65 years
Is there a cooling off period?There is a cooling off period for tailored insurance cover. You have 21 days from the date we tell you in writing that we’ve accepted your cover. However, if you tell us in writing within 21 days that our offer has been refused, the cover will be deemed never to have started – this is known as the ‘cooling off period’.
You may cancel your tailored insurance via the Insurance section in MemberOnline. All premiums paid during the cooling off period will be refunded to your CareSuper account. If you wish to reduce your level of cover or opt out of insurance altogether after the cooling off period, you can also do this in MemberOnline.
There is no cooling off period for default cover or New Member Options cover.
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Insurance – what do I need to know? (continued)
Tax on death, TPD and income protection benefitsFor more information about taxation of insured benefits, go to ato.gov.au.
What happens if I leave or change my employer?Generally, your insurance cover is designed to continue regardless of any changes in employment as long as you remain a member of CareSuper, subject to the terms of CareSuper’s insurance policy (including terms relating to eligibility and cessation of cover) and have sufficient balance in your account to meet your insurance premiums.
If you become unemployed, your ability to claim any income protection benefits will be affected. Changes to employment may affect the definition of total and permanent disablement you must satisfy to claim a TPD benefit.
However, if your employer has been paying insurance premiums on your behalf as an extra employee benefit, if you leave that employer the premiums will be deducted from your super account instead.
What happens if I was a member of a Corporate insurance arrangement?If you have transferred into the CareSuper Employee Plan from a Corporate insurance arrangement, the amount of cover you had under that arrangement has been converted to fixed cover and continues while there is a sufficient balance in your account to cover ongoing premium deductions, as you are responsible for paying the premiums. All other terms and conditions as set out in this guide, apply to you.
Can I recommence my cover?Employee Plan membersIf you have previously opted out of cover, you will not be eligible for reinstatement of past levels of cover, and all future applications for cover will need to be assessed and accepted by our insurer. If accepted, insurance cover begins when we confirm acceptance to you in writing.
Your cover will cease when your CareSuper account balance reaches $0. You have 28 days from the date your account balance reaches $0 to make a contribution or roll-in to allow cover to be reinstated. The contribution can be a personal or employer contribution. Cover will recommence from the date your cover last ceased. The amount of cover will be the amount you had immediately prior to the cover lapsing. For income protection, the amount of cover, waiting period and benefit period will be the same as you had immediately prior to cover ceasing.
If your CareSuper account balance reaches $0 and a contribution is not received within 28 days, your cover may be reinstated if:
– A SG contribution is received within 6 months from the end of the month that cover ceased
– The commencement period of the contribution is within 6 months from the end of the month that cover ceased, and
– The SG contribution is paid on time according to legislative requirements.
peace of mind knowing your dependants will be covered
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Cover will recommence from the beginning of the period covered by the SG contribution to the amount of cover you had immediately prior to the cover ceasing. For income protection, the amount of cover, waiting period and benefit period will be the same as you had immediately prior to cover ceasing.
In all other circumstances, cover will be reinstated to the amount of default cover. For income protection, the amount of cover, waiting period and benefit period will be the same as you had immediately prior to cover ceasing. Cover will recommence from the date the SG contribution is received by the Fund.
You are required to be in active employment for all of the first 30 days from the date your cover recommences. If you are not in active employment for all of the first 30 days from the date your cover recommences, limited cover conditions apply. See pages 22 and 23 for the definitions of active employment and limited cover.
The insurance premium payment deducted from your account will include all amounts accrued since your cessation date.
Personal Plan membersIf your cover ceases (for example, you cancel your cover or there are insufficient funds in your account to pay for premiums), you must reapply and be accepted by the insurer to receive cover again.
NoteDepending on the circumstances, there may be a period between the date cover ceases and the date cover recommences where you won’t be covered.
Am I covered worldwide?Yes. You are covered indefinitely while you are outside Australia, subject to the conditions of the insurance policy. However, income protection benefit payments are restricted to 12 months while overseas (unless otherwise agreed in writing). You are not required to advise the Fund or insurer before you travel overseas.
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The maximum terminal illness benefit payable is $3 million, even if you are insured for a larger amount of death cover. If your death cover is higher than $3 million, you will retain the balance of that cover following payment of a terminal illness benefit, subject to you remaining a member of CareSuper, and retaining an account balance sufficient to cover your insurance premiums and remaining eligible for cover. You should consider your options prior to making a terminal illness claim for your full benefit and closing your CareSuper account.
You may qualify for a TPD benefit if you suffer (while insured) an illness or injury that meets the definition of total and permanent disablement in the insurer’s opinion (see pages 23 and 24).
If you have submitted a TPD claim and you die before the claim is finalised, your TPD claim may continue to be assessed as a posthumous TPD claim. A posthumous TPD claim is a TPD benefit that is paid to your beneficiaries after your death. In the event that your death cover is higher than your TPD cover, it will be assessed as a death claim and the death cover will be paid subject to eligibility.
How do I qualify for an income protection benefit?You may qualify for an income protection benefit if you suffer an illness or injury while you’re insured that meets the definition of total disability, and have been unable to work for your applicable waiting period. Refer to page 24 for the definition of total disability.
If you qualify for an income protection benefit and payment is permitted under superannuation legislation, it will remain payable for up to 2 or 5 years (depending on the applicable benefit period) from the date payments commence, provided you continue to meet the benefit conditions.
At the time of claim, you will receive the lesser of the following amounts:
a) The amount provided by the number of units of cover you have in place, and
b) 85% of the first $423,530 p.a. of income for the entire benefit payment period, plus 60% of the next $200,000 p.a. of income for the first 2 years of the benefit payment period.
No benefits are payable during the waiting period. After this, benefits will begin to accrue and will be payable monthly in arrears if you have met the requirements.
Claiming an insurance benefit
Important information about terminal illness benefitsIf you have been diagnosed with a terminal illness and are expected to live less than 24 months, you may apply to CareSuper for a full or partial early release of your CareSuper account balance.However, you should be aware that if you withdraw your full super account balance, any insurance cover through CareSuper will cease at that time, as you will no longer be a CareSuper member. In order to apply for an insured terminal illness benefit, which is based on a 12-month prognosis, you will need to maintain an account balance sufficient to cover your insurance premiums until you meet the 12-month prognosis criteria, and a claim for your insured terminal illness benefit can be lodged. This is due to a difference between the 24-month timeframe required by legislation and the 12-month timeframe relevant to your insurance cover.
How do I qualify for a death or TPD benefit?A death benefit will be paid if you die (while insured) before reaching the maximum insurable age, unless the circumstances of your death are subject to the conditions set out on pages 20 and 21.
If you become terminally ill you may apply for early release of your insured death benefit (see page 23 for the policy definition of terminal illness).
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The waiting period commences on the first day you are unable to work due to your total disability, and your condition is certified by a medical practitioner. If you are entitled to a benefit for part of a month, you will be paid 1/30th of the monthly benefit for each day you are entitled to a payment.
You must be employed (including self-employment) in order to apply for income protection cover. If after being accepted for cover you become unemployed (but wish to continue your cover to avoid reapplying), a benefit will not be paid should you become temporarily incapacitated during this time, unless you meet another condition of release. If you no longer require income protection cover, you must notify CareSuper.
What if I am receiving income from other sources?Your income protection benefit will be reduced by the amount of income you receive from any one of the following sources:
a) Any income (other than benefits received under CareSuper’s policy) or commutation (lump sum payment) of income, paid or payable to you as a result of your sickness or injury including:
• Sick leave payments
• Any amounts payable under legislation such as workers’ compensation or motor accident compensation
• Any benefits payable under other income protection insurance policies, and
b) Any super contributions from your employer while disabled, and
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c) Any income that, in the opinion of the insurer, you could reasonably be expected to earn in your occupation while disabled. However, where you are fit to return to work in a reduced capacity but such work is not available with the existing employer, the insurer will not offset any income you should be able to earn from this employer.
Any income described in paragraph a) which is in the form of a lump sum (or is exchanged for a lump sum) is treated as a monthly amount equivalent to 1/60th of the lump sum over a period of 60 months.
What happens if I die while receiving a benefit?Your income protection benefits will cease upon your death, with a final payment equal to 3 times the monthly benefit.
What happens if my disablement reoccurs?If you have been receiving income protection benefits, subsequently recover and therefore cease benefits, then within 6 months of your recovery become totally disabled again due to the same cause or a related cause, this period of total disability will be treated as a continuation of the previous claim and there will be no further waiting period, provided you are still a member. After 6 months back at work, normal waiting periods apply. The period in which benefits were paid previously will form part of the maximum benefit period for the relevant condition.
The maximum period for which benefits will be paid for the same or related cause is the maximum benefit period. This is regardless of how often you are disabled due to this cause.
What happens if I return to work and earn less?
If you return to work and are earning an income that is less than your pre-disability income, as a result of being totally disabled, you may be eligible for a partial disability benefit. You must have satisfied the definition of total disability for at least 14 days and still have a reduced income at the end of the waiting period.
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For all types of cover (death (including terminal illness), TPD and income protection), the following applies:
• If you have two or more accounts with CareSuper, you will not be entitled to insurance cover from more than one account. In the event of a claim, the insured benefit of the oldest account is normally used. However, if the insured benefit of a newer account has been underwritten to a higher level, the insured benefit of the newer account will be used.
• The insurer will not pay a benefit caused directly or indirectly by an act of war.
• If you have previously been paid a TPD benefit of any type from any source including another super fund or a personal insurance policy as a result of a TPD claim, you will only be eligible for death cover with CareSuper; not TPD or income protection cover.
• If you have previously been paid a terminal illness benefit or have been diagnosed with an illness that reduces your life expectancy to less than 12 months, you will not be eligible for death, TPD or income protection cover with CareSuper.
• If you apply for death, TPD or income protection insurance, during the assessment period you will only be insured for interim accident cover as it pertains to your application. See page 22 for the definition of Interim accident cover.
For Employee Plan members, the following exclusions and restrictions also apply:
• Default cover is automatically accepted by the insurer (subject to eligibility). However, automatic acceptance of cover may only occur once while you are a member of CareSuper. If you have received automatic acceptance on more than one occasion, the insurer may adjust the cover accordingly.
• Limited cover will apply when cover commences, recommences or increases:
1. If you are not in active employment for all of the first 30 days from the date your cover commences, recommences or increases until you return to active employment for at least 2 consecutive months
2. If we do not receive employer contributions on your behalf within 120 days of you being first eligible for cover, until 2 years have passed and you return to active employment for at least the 2 consecutive months immediately prior to the expiry of that 2-year period. Otherwise limited cover will continue until you have returned to active employment for at least 2 consecutive months.
Exclusions and restrictions
See pages 22 and 23 for the definitions of active employment, first eligible and limited cover.
• When limited cover applies, including for non-default insurance cover, intentional self-inflicted injury or infection, suicide or attempt at suicide (whether it is determined that you were or were not sane at the time) will not be covered within the first 12 months of cover commencing, increasing or recommencing.
• You are able to apply to have limited cover removed at any time subject to the insurer’s assessment requirements.
• Premium loadings and/or exclusions may apply to some members.
Important: Some restrictions or exclusions can only be determined or assessed at the time a claim is made.
Death and TPD cover specificIn addition to the ‘all cover’ exclusions and restrictions, the following also apply to death, terminal illness and TPD cover.
• In the event of pandemic outbreak, the insurer reserves the right to alter when cover commences for new members, in order to exclude any pandemic illness that could cause the member to die within 30 days of the date his or her cover commenced, provided the condition was present at the date the cover commenced.
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Premium loadings and/or exclusions may apply to any cover that you apply for and have been assessed by the insurer.
• The insurer will not pay a benefit for you if your death, terminal illness or TPD is caused directly or indirectly by an act of war. However, this condition will not disentitle you to a benefit should you die on war service. The war exclusion is only applicable to wars occurring during the policy period.
Income protection cover specificIn addition to the ‘all cover’ exclusions and restrictions, the following also apply to income protection cover.
• Income protection must be applied for and is subject to acceptance by the insurer.
• No benefit is payable under CareSuper’s income protection insurance policy if your illness or injury is directly or indirectly caused by:
– Intentional self-inflicted injury or infection, or attempt at suicide
– Your service in the armed forces of any country
– Normal pregnancy or childbirth, or
– An act of war.
• CareSuper’s insurer will not make a payment under the policy if the payment would cause them to infringe the Private Health Insurance Act 2007 (Cth), Private Health Insurance (Prudential Supervision) Act 2015 (Cth), Health Insurance Act 1973 (Cth), or the National Health Act 1953 (Cth), or any succeeding legislation in connection with health insurance.
• Benefits will only be paid for you for one disability at a time.
• The maximum length of time a benefit for disability resulting from any one or related cause will be paid is the number of months in the benefit payment period. The number of months in the benefit payment period will include any months in which the benefit is reduced or is calculated to be $0.
• The maximum time in total a benefit will be paid for while you are outside Australia is 12 months, unless otherwise agreed in writing.
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Definitions for insurance
Active employmentActive employment means you are employed to carry out identifiable duties, are actually performing those duties and, in the insurer’s opinion, are not restricted by sickness or injury from carrying out those duties on a full-time (where full-time means 35 hours per week) basis, or the duties of your usual occupation on a full-time basis (even if not then working on a full-time basis).
Dependant or Interdependency relationship
For the definition of ‘dependant’ or ‘interdependency relationship’, see Nominating your beneficiaries at caresuper.com.au/PDS.
Note: a different definition of ‘dependant’ applies for taxation purposes.
First eligibleThe later of the date your employer selects CareSuper to be the default super fund to receive employer contributions, and the date you commence your employment with that employer.
Income (for the calculation of income protection benefits)Means:
a) The total salary package value of remuneration received by you from your employer averaged over the most recent 12 months immediately prior to becoming disabled (including overtime, commission, bonuses and shift allowances, but excluding employer contributions).
b) If you have been working with your employer for a period of less than 12 months immediately prior to becoming disabled, then the total monthly value of remuneration will be averaged over the period since you last commenced employment with your employer.
Accidental total and permanent disablement cover
The insurer will pay a benefit if the application received from you is for total and permanent disablement cover and you become totally and permanently disabled as a result of an accident that occurs during the interim accident cover period (as outlined below), provided the date of disablement is within 90 days of the date the accident occurred.
Amount of benefit
The benefit will be the amount of death or total and permanent disablement cover or additional insured cover you requested, as applicable. However, this benefit will not exceed the maximum accident cover of $1 million less any amount of insured cover
Interim accident cover period
Interim accident cover will start on the application date and will end on the earliest of the following dates:
a) The date the application for insured cover is withdrawn
b) The date the insurer accepts the application for insured cover on standard or special terms
c) The date the insurer rejects the application for insured cover
d) The date the insurer cancels the interim accident cover
e) 120 days from the date we receive the application for insured cover and
f) The termination of the insurance policy.
Interim accident cover benefit – effect on application for cover
If the insurer pays you a benefit under this condition, your application for cover or an increase in cover will be cancelled and you may not seek any further cover under the insurance policy.
No doubling up of benefits
A payment for interim accident cover is only payable to you once.
c) If you are unemployed immediately prior to becoming disabled, the total monthly value of remuneration will be averaged over the lesser of the most recent 12-month period immediately prior to becoming disabled or the period since you last commenced employment with your most recent employer.
d) If you are self-employed then the pre-tax income that is generated by you or the business as a result of your personal exertion (i.e. income that would stop if you could not work due to illness or injury), and:
(i) Includes any allowances or fringe benefits paid to you which you may convert into cash salary at your option, or which the insurer agrees to treat as part of your income, but
(ii) Does not include any necessary business expenses incurred in producing that income.
Paragraphs b) and c) above will be subject to a minimum averaging period of 3 months for casual employees. No minimum averaging period applies to permanent employees.
Where you have multiple employment arrangements, the salaries (which may be either permanent or casual) will be combined to provide a total gross annual figure.
Interim accident coverInterim accident cover applies while the insurer considers your request for insured cover
The insurer will provide interim accident cover from the date they are notified in writing of the request for insured cover as set out below.
Accidental death cover
We will pay a benefit if the application received from you is for death cover and you die as a result of an accident that occurs during the interim accident cover period (as outlined below), provided your death occurs within 90 days of the date the accident occurred.
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Defin
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Limited coverLimited cover means you are only covered for claims arising from:
• A sickness which first became apparent, or
• An injury which first occurred
on or after the date the cover last commenced, recommenced or increased for you in CareSuper.
Terminal illnessYou are able to apply for the early release of your insured death benefit if you suffer from an illness which:
a) Two medical practitioners, with at least one specialising in your terminal illness, certify in writing that despite reasonable medical treatment the illness will lead to your death within 12 months of the date of certification, and
b) CareSuper’s insurer is satisfied on medical or other evidence that despite reasonable medical treatment the illness will lead to your death within 12 months of the date of certification.
The illness from which you suffer must occur, and the date of the certification referred to in a) must take place, while you are insured under the policy. See page 18 for important information about terminal illness benefits.
Total & permanent disablement Means:
Where you are or have been employed or self-employed within the 12 months prior to the onset of an injury or illness leading to permanent incapacity, you are totally and permanently disabled if you:
Have suffered:
• The permanent loss of two or more limbs – a limb being the whole hand or foot, or
• The complete and irrecoverable loss of sight in both eyes, or
• The loss of one limb and the complete and irrecoverable loss of sight in one eye.
And
• In the insurer’s opinion, on the basis of satisfactory medical and other evidence, you are unlikely to be able to engage in any occupation whether or not for reward.
Or
• Are aged less than 65 years and as a result of sickness or injury, have been absent from all employment for 3 consecutive months from the date of disablement, and the insurer is satisfied on the basis of medical and other evidence you are unlikely ever to be able to engage in any occupation, whether or not for reward.
Or
• All of the following paragraphs (i – iv) apply if:
(i) You were, on the date of disablement, aged less than 65 years
(ii) You are absent from all work as a result of suffering cardiomyopathy, primary pulmonary hypertension, major head trauma, motor neurone disease, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia, hemiplegia, diplegia, tetraplegia, dementia and Alzheimer’s disease, Parkinson’s disease, blindness, loss of speech, loss of hearing, chronic lung disease or severe rheumatoid arthritis (specific definitions apply)
(iii) The insurer is satisfied that on the basis of medical and other evidence you are unlikely ever to be able to engage in any occupation, whether or not for reward
(iv) You are likely to be so disabled for life.
Or
Where you have been unemployed for a continuous period of 12 months before the onset of total disability leading to the permanent incapacity, you are totally and permanently disabled if you:
Have suffered:
• The permanent loss of two or more limbs – a limb being the whole hand or foot, or
• The complete and irrecoverable loss of sight in both eyes, or
• The loss of one limb and the complete and irrecoverable loss of sight in one eye.
And
• In the insurer’s opinion, on the basis of satisfactory medical and other evidence, you are unlikely to be able to engage in any occupation whether or not for reward.
Or
• You have in the opinion of the insurer, after consideration of medical and/or other evidence, become permanently incapacitated to such an extent as to prevent you from engaging in any occupation, whether or not for reward.
And
• The insurer is satisfied that you have become so disabled by bodily injury or illness that you will never be able to perform at least two of the following activities of daily living:
– Dressing – the ability to put on and take off clothing without assistance
– Bathing – the ability to wash or shower without assistance
– Toileting – the ability to use the toilet, including getting on and off without assistance
– Mobility – the ability to get in and out of bed and a chair without assistance
– Feeding – the ability to get food from a plate into the mouth without assistance.
24
And
• In the insurer’s opinion, on the basis of medical and other evidence satisfactory to the insurer, you are unlikely to be able to engage in any occupation whether or not for reward.
Or
Where you perform full-time unpaid domestic duties, you are totally and permanently disabled if you:
Have suffered:
• The permanent loss of two or more limbs – a limb being the whole hand or foot, or
• The complete and irrecoverable loss of sight in both eyes, or
• The loss of one limb and the complete and irrecoverable loss of sight in one eye.
And
• In the insurer’s opinion, on the basis of satisfactory medical and other evidence, you are unlikely to be able to engage in any occupation whether or not for reward.
Or
• Have been unable to perform your unpaid domestic duties for 3 consecutive months and in the opinion of the insurer, after consideration of medical and/or other evidence, are incapacitated to such an extent that it is unlikely that you will again be able to engage in your unpaid domestic duties, or in any occupation, whether or not for reward.
And
• Are so incapacitated that you are unable to leave your place of residence without the assistance of another person.
Where:
‘Assistance’ means the help of another person.
‘Occupation’ means an occupation or gainful employment for which you are reasonably qualified by education, training or experience.
Total disability/disablement (income protection)You are totally disabled if you:
a) Have ceased to be gainfully employed because of sickness or injury and are unable to perform at least one income producing duty of your own occupation, and
b) Are under the regular care of, and following the advice of, a medical practitioner, and
c) Are not working in any occupation, whether or not for reward.
Or, if the paragraph above does not apply:
You are totally disabled if you:
a) Have a sickness or injury and (on the basis of medical or other evidence) in the insurer’s opinion you are permanently incapacitated because of that sickness or injury, and
b) Are under the regular care of, and following the advice of, a medical practitioner, and
c) Are not working in any occupation, whether or not for reward.
‘Permanently incapacitated’ means you are unlikely to engage in any occupation for which you are reasonably qualified by education, training or experience.
Total incomeThe total salary package value of remuneration received from your employer averaged over the most recent 12 months (including overtime, commission, bonuses and shift allowances, but excluding employer contributions).
If you have been working with your employer for a period of less than 12 months, then the total value of remuneration received since you last commenced employment with your employer should be converted up to an annual figure.
If you are self-employed, the total annual value of pre-tax income that is generated by you or the business as a result of your personal exertion (i.e. income that would stop if you could not work due to illness or injury), and:
1) Includes any allowances or fringe benefits paid to you which you may convert into cash salary at your option, or which the insurer agrees to treat as part of your income, but
2) Does not include any necessary business expenses incurred in producing that income.
Where you have multiple employment arrangements, the salaries (which may be either permanent or casual) will be combined to provide a total gross annual figure.
The insurance information contained in this Insurance Guide is a summary only. There are other defined terms in the insurance policies. The insurance terms and conditions, including payment of benefits, are applied in line with the policies and super legislation. In the event of any inconsistency between this summary and the policies, the policies will prevail.
Definitions for insurance (continued)
25
You can write to:CareSuperLocked Bag 5087 Parramatta NSW 2124Email [email protected]
Make sure we can find you too!If you have changed your address, or if you are about to, don’t forget to let CareSuper know. This way, you’ll be sure to receive your important superannuation statements and other valuable information.
Call the CareSuperLine, or log in to MemberOnline via caresuper.com.au/login to advise your new details.
Manage your super through MemberOnline. Simply log in to view your account balance, change your details or change your investment options.
Register for your password directly via caresuper.com.au/register.
Keeping in touchcall usCareSuperLine 1300 360 149
For easy access to your CareSuper account information, just call and talk to one of our friendly staff 8am – 8pm Monday to Friday AEST.
visit uscaresuper.com.au
Visit caresuper.com.au to access the latest news and information, check out how CareSuper is performing and to download the latest member publications and forms.
log inMemberOnline
applying for insurance cover online is easy!Simply log on to MemberOnline, go to the Insurance section and click on InsuranceOnline.InsuranceOnline is a secure, convenient way to alter your cover and also provides a calculator to help you assess your insurance requirements. To create a MemberOnline account, go to caresuper.com.au.
You can also complete the Insurance application form available at caresuper.com.au/forms.
about our insurerInsurance cover for CareSuper members is provided by our insurer, MetLife Insurance Limited (MetLife) ABN 75 004 274 882, AFSL 238 096.
MetLife is committed to delivering exceptional service and providing a member-friendly claims experience.
With 145 years of experience, MetLife has become a global leader in the delivery of insurance solutions.
MetLife is one of the largest group insurers in Australia and currently helps protect 2.7 million Australians through a range of innovative insurance solutions.
CareSuper has mentioned the names, products and/or services of third party companies with their consent. This consent had not been withdrawn at the date of publication.
Co
ntact u
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CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725 Page 1 of 8
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insurance application formApply onlineYou can complete the insurance application process online via the Insurance section of MemberOnline at caresuper.com.au/login
CR/SUP/INS/APP/710.1 02/17 ISS10
Instructions ● To apply to change your occupational category, complete sections 1, 2 and 7 and ensure you read sections 7a and 7b. ● To apply for a New Member Option (Employee Plan members only), complete sections 1, 2, 3, 4 and 7. ● To apply for tailored cover, complete sections 1, 2, 5, 6 and 7 and follow all instructions.
● If you wish to opt out or reduce your level of default cover, please call the CareSuperLine on 1300 360 149. Please do not complete this form.
Please complete the form in blue or black pen and BLOCK letters.
Do
NO
T de
tach
form
s
2. Occupational categories
1. Your personal detailsCareSuper member number
Date of birth (DD/MM/YYYY) Title / /
Surname
Given names
Address
Suburb/town
State/Territory Postcode
Telephone (home) Mobile number
Employer name
Occupation
What industry do you work in?
Do you work at least 15 hours per week? Total income per year Gender
Yes No $
Male Female
Email address
Determine the category that applies to you. This will determine your premiums or the unit-based cover amount that will apply to you.
CareSuper offers three different categories of cover to reflect the different levels of risk associated with our
members’ occupations. Please complete the following questions to determine the category that applies to you:
1. Are you:
a) Off work because you are ill, injured or have had an accident? Yes No
b) Unable to perform all of the duties of your usual occupation, without any restrictions,
on a full-time basis (at least 35 hours per week), regardless of whether you are
currently working full-time, part-time or casually?
Yes No
c) In your usual occupation, but your duties have changed or been modified in
the last 12 months because of accident, illness or injury?
Yes No
If you answer ‘yes’ to any of the above questions, you are not eligible to change your occupational category.
If you answer ‘no’ to all of the above questions, please complete the following questions to determine the
category that applies to you. 1. Are the duties of your occupation limited to professional, managerial, administrative,
clerical, secretarial or similar ‘white collar’ tasks which do not involve manual work
and are undertaken entirely within an office environment (excluding travel time from
one office environment to another)?
Yes No
2. Are you earning in excess of $100,000 per year from your profession?
(Please see the Insurance Guide at caresuper.com.au/PDS for a definition of ‘total income’) Yes No
CareSuperLine 1300 360 149
caresuper.com.au
we make it easy for you
CR/INS/GDE/PDSIBR 855.1 09/17 ISS12
ecoStar is an environmentally responsible paper made Carbon Neutral. The greenhouse gas emissions of the manufacturing process including transportation of the finished product to BJ Ball Papers Warehouses has been measured by the Edinburgh Centre for Carbon Management (ECCM) and offset by the Carbon Neutral Company and the fibre source has been independently certified by the Forest Stewardship Council (FSC). ecoStar is manufactured from 100% Post Consumer Recycled paper in a Process Chlorine Free environment under the ISO 14001 environmental management system.