Section 8. Insurance in your super

8.1 What we cover

We offer  Death and Total & Permanent Disability (TPD), TPD Only,  Death Only or Income Protection insurance cover options. Any death cover also includes Terminal Illness cover. If you elect to have TPD Only cover, you will not be covered for death or Terminal Illness, but you may apply for death cover at any time.

Your insurance premiums are used to cover the cost of the insurance policy as well as the cost of its administration, i.e. 0.745% of the insurance premiums are retained by the fund and goes towards the administration cost of providing insurance.

Please note: Insurance cover on all inactive super accounts will be cancelled, regardless of the account balance. This is to ensure that arrangements for insurance in super are appropriate and members are not paying for insurance that they do not know about or premiums that inappropriately erode their retirement savings.

A member’s account is considered inactive if we have not received a contribution or rollover into that account for a continuous period of 16 months and the member has not made a written request or positive election to be provided with cover even where the account becomes inactive. Hostplus will write to affected members to notify them of their options to maintain their insurance cover, should they wish to do so.

Hostplus Insurance Premium Adjustment Mechanism

On 1 July 2017 Hostplus entered into an arrangement with MetLife that included a Premium Adjustment Mechanism (PAM) in respect of the default Death and Total & Permanent Disability insurance cover and the MetLife Income Protection insurance cover. This agreement reduces the insurers risk exposure due to claims volatility and allows Hostplus to negotiate lower overall premiums for members.

Any premium adjustment payment made to us is allocated to a separate insurance reserve for this arrangement and is governed by our reserving policy. Our reserving policy requires that any premium adjustment payments we receive from the insurer are only passed-on to members when we negotiate our premiums. We will report details of any distributions of the PAM proceeds in our Annual Reports.

The PAM agreement does not currently apply to the Income Protection cover referred to in section 8.17 of this document.

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8.2 Automatic Death and Total & Permanent Disability (TPD) insurance cover for Industry and Personal Super Plan Members (Default cover)

Generally, Industry members joining Hostplus through a Participating Registered Hostplus Employer, (Participating Employer) and Personal Super Plan Members joining directly, can receive automatic unitised Death and TPD insurance cover based on the Automatic (also referred to as default cover) Death & TPD Default Unitised Cover Table (see section 8.14) at the standard occupation classification. The number of automatic default units you will receive varies and is based on your age next birthday.

To be eligible for automatic insurance cover, you must:

• be an Eligible Person
• not already have insurance under Hostplus
• not have previously held automatic insurance cover on the same account,
• not be inactive.

If you are eligible, your automatic insurance will commence when you first meet the following criteria as required under the Putting Members’ Interests First legislation:

- You are aged at least 25 years; (where applicable*); and
- Your account in Hostplus has a balance of at least $6,000 on or after 1 November 2019.

Prior to meeting the above criteria, you can also Opt-in to have automatic insurance cover for the first time (subject to terms, conditions and eligibility requirements). If you Opt-in, your automatic insurance will commence from the Cover Commencement Date.

*If you joined Hostplus on or after 1 April 2020, the minimum eligibility age for automatic insurance cover is 25 years, unless you Opt-in to have cover at a younger age.

If you are joining Hostplus through an employer who was previously a default employer of Club Super you may also automatically receive Income Protection insurance cover. Further information, including the terms and conditions of this cover are disclosed in section 8.17 of this PDS.

See section 8.3 for details about when your default cover will be Restricted Cover

To view what automatic Default Cover is applicable to Industry member see section 8.14 Industry Member Automatic Death & TPD Default Unitised Cover Table.

You may opt out or vary your insurance at any time by contacting us.

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8.3 When your Default Cover is Restricted Cover – Death and Total & Permanent Disability (TPD)

If you are an Industry Member or Personal Super Plan Member and you do not meet the requirements for Full Cover, your automatic insurance cover may be Restricted Cover which will not cover Pre-existing Conditions for 24 consecutive months. Pre-existing Conditions are an illness, injury, condition or related symptom which you were aware of or reasonably should have been aware of within the 2 years prior to your cover commencing.

For Full Cover from the Cover Commencement Date, you must satisfy all the following requirements:

• We must receive an employer contribution into your account or you must commence employment with a Participating Employer, within 120 consecutive days immediately prior to the Cover Commencement Date;
• You must be in Active Employment for the first 30 consecutive days from the Cover Commencement Date;
• Within 6 months immediately prior to the Cover Commencement Date you:
• have not been diagnosed with or experiencing symptoms of, are not seeking medical opinion for or under investigation and have not been advised to undergo investigations for, a Degenerative Condition; and
• have not been absent from work or been on restricted duties or hours for more than 7 consecutive working days due to illness or injury.

If you do not meet the above requirements for Full Cover, your Restricted Cover will be replaced with Full Cover after 24 months provided you are Actively Employed for the last 30 consecutive days of the 24 month period. If you are not Actively Employed for the entire 30 day period, Restricted Cover will continue until you have been Actively Employed for 30 consecutive days.

If on or prior to the Cover Commencement Date, you have been diagnosed with a terminal illness or you have claimed or are eligible to receive a benefit in relation to terminal illness or total and permanent disablement cover from any source, your  automatic insurance cover will be Restricted Cover. You will only be able to remove the restriction by making an application to the insurer, which is subject to their assessment of your medical history and health. If your application is accepted, Restricted Cover will be replaced with Full Cover from the date your application is accepted.

Please see Section 8.10.6 If your cover starts again, for more information

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8.4 Special insurance offer

As a new insured member aged under 65 you have a once off opportunity to increase your default Death and TPD insurance cover up to certain limits, when you Opt-in to automatic death and TPD cover. To take up the special offer, you must apply within 60 days after the date the Hostplus Welcome Letter is issued to you.

Under the special insurance offer, you can:

• increase your unitised Death and Total & Permanent Disability cover up to a total of 16 units if you are aged 11 to 24, or 20 units if you are aged 25 to 64, or
• apply for fixed benefit Death and Total & Permanent Disability cover of up to $500,000; and
• you may also apply for Income Protection insurance cover for up to $4,000 per month for a benefit period of two years, with a waiting period of 30, 60 or 90 days. See for more information.

Acceptance will remain subject to your application being approved by the insurer. We will notify you of the outcome of your application.

Cover provided under the special insurance offer will commence from the date the application is accepted, and will be subject to the following:

• If you are not Actively Employed on the date the insurer receives your application, the increased amount will be Restricted Cover until you are Actively Employed for 30 consecutive days at which time Full Cover will replace your Restricted Cover; and
• The same exclusions, restrictions and other special insurance conditions (if any) which apply to existing cover you hold.

Important note: Members aged 65 or over, those that fail to apply within the prescribed timeframe and those that are not eligible for or have cancelled Default Cover, are not eligible for the Special insurance offer.

You can apply for the special offer via Member Online at hostplus.com.au.
The insurer may elect not to cover certain occupations, so please refer to Excluded occupations.

See Section 8.10.1 When does Death and Total & Permanent Disability insurance cover start? (Industry and Personal Super Plan Members) for important information.

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8.5 Making an insurance claim?

If you or your beneficiaries need to lodge an insurance claim with Hostplus please call us on 1300 467 875. We have a dedicated Claims Team who will assist you every step of the way with your claims enquiry and documentation required - at no cost to you - so there is no need for you to engage a third party person to do this on your behalf.

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8.6 How to Cancel your Insurance Cover

You can apply to increase, decrease or cancel your insurance at any time by logging into Member Online at hostplus.com.au. You can also cancel your cover over the phone or by contacting us in writing. 

If you prefer not to have insurance cover, you can elect to cancel your cover upon joining, or cancel it at any time online or by sending us an email at info@hostplus.com.au or by writing to us at the address below. You can also cancel your insurance by calling us on 1300 467 875.

HOSTPLUS
Locked Bag 5046
Parramatta NSW 2124

Premium deductions will be stopped from the date your request is received. If you cancel within 14 calendar days of receiving a confirmation of cover from Hostplus, any premiums we have already deducted from your account in relation to this new insurance arrangement will be refunded.  No insurance will be payable to you if you cancel within the 14 days.

If you cancel your insurance cover and subsequently decide that you would like to re-apply for insurance cover down the track, you can do so by completing a new online insurance application online by clicking here. Any application for insurance made at this time will be subject to approval by the insurer and may require underwriting. We cannot reinstate your original cover once you have decided to cancel it.

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8.7 Death and Total and Permanent Disability and Death Only insurance

8.7.1 What’s Death and TPD insurance cover?

Death and TPD insurance cover provides you with an insured benefit, payable to either you, if you become Totally and Permanently Disabled, or to your dependants or legal personal representative(s) in the event of your death. This is additional to your super account balance.

8.7.2 What’s a Death benefit?

In the unfortunate event of your death, a Death benefit provides a lump sum payout to your dependants (for example, your children or partner) or your legal personal representative (executor of your estate). It is designed to provide your dependants with financial support. 

Under legislation, in the event of your death, your Death benefit is only payable to your dependants or legal personal representative(s). Your benefit is paid in addition to your Hostplus account balance. For more information and to find out who you can nominate to receive your benefit if you die, see Section 2: How super works – Death benefit nominations.

8.7.3 What's a Terminal Illness benefit

If you are insured for Death cover, you will also be covered for a Terminal Illness benefit. 

A Terminal Illness benefit is payable, if you suffer a ‘terminal illness’, as defined in 8.13 Definitions.

You are unable to claim a TPD benefit if you lodge a claim for a Terminal Illness benefit. Your death benefit will be reduced by the amount of the Terminal Illness benefit paid to you.

8.7.4 What's a Total & Permanent Disability (TPD) benefit?

A TPD benefit provides a lump sum payout to you if you become totally and permanently disabled. It is designed to replace your future earning capacity via a lump sum payment and provide you and your dependants with the financial support you need.

If you apply for a TPD benefit, your assessment will depend upon your age and employment status on the date your illness or injury stops you working (Date of Disablement). Where you were aged less than 65 years and employed or have been unemployed for less than 12 months, on the Date of Disablement, you will need to satisfy one of parts 1, 2, 3, 4 or 5 of the TPD definition to receive the TPD benefit. Otherwise, you will need to satisfy one of parts 2, 3, 4 or 5. See 8.13 Definitions for an explanation of the TPD definitions.

Note: If you have previously received, had a claim admitted , or were eligible to receive a TPD benefit from any other source (including a superannuation fund or otherwise), your cover will be restricted to Death Only insurance cover at any time. However, you may apply for TPD Cover and be eligible for this cover, if your application is accepted by the insurer. If you fail to inform us that you’ve received a TPD benefit either prior to or at the time you commenced your membership with Hostplus, then we’ll deduct the usual weekly premium, but you will not be covered for TPD. In the event of an insurance claim you will only be covered for a Death benefit. Any insured benefit paid is in addition to your account balance.

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8.8 Understanding Unitised & Fixed Benefit Insurance Cover

8.8.1 Choosing unitised or fixed insurance cover

When applying for Death Only, TPD Only or Death & Total & Permanent Disability cover, you can choose either unitised cover or fixed benefit cover. You cannot have a combination of unitised and fixed cover.

8.8.2 Unitised insurance cover

With unitised cover, you pay a set price for each unit of cover you hold. The benefit value of each unit changes depending on your age. The benefit value of each unit decreases as your age increases, and the number of units you hold may change, however the amount you pay per unit remains the same.

8.8.3 Fixed insurance cover

With fixed insurance cover your insured benefit value stays the same. However, from age 61 your TPD benefit will reduce each year by 20% of the cover held at age 60, and from age 64 will remain fixed at 20% (of your cover held at age 60) until you turn 70 when your cover ends. The cost of your fixed insurance cover will vary depending on your age which means you may pay higher fees as you get older.

The below example highlights how your insurance cover is reduced:

Your age	TPD benefit	Example, $100,000 sum insured Fixed benefit cover
60	100%	$100,000
61	80%	$80,000
62	60%	$60,000
63	40%	$40,000
64	20%	$20,000
65	20%	$20,000
66	20%	$20,000
67	20%	$20,000
68	20%	$20,000
69	20%	$20,000
70	0	0

 

See 8.18 Death Only and Total & Permanent Disability (TPD) Only insurance: Fixed benefit cover table

 

8.8.4 Switching between units of cover and fixed cover

You can switch from unitised to fixed cover or from fixed to unitised cover at any time, provided you meet he eligibility requirements. If you do this, your level of cover and premiums may change.

8.8.5 When does Death and Total & Permanent Disability insurance cover start? (Industry and Personal Super Plan Members)

For Eligible Persons, your automatic default insurance cover commences on the Cover Commencement Date as defined in section 8.13 Definitions, provided there are sufficient funds in your account to pay for premiums.

Applications to increase cover: If you have applied to increase your insurance cover via an application, your increased cover will commence on the date your application is accepted by the Insurer and you have sufficient funds to pay the required insurance premiums. Acceptance is subject to underwriting. We will advise you in writing of the outcome of your application.

8.8.6 Duplicate accounts

You are only eligible to retain insurance in one account. Where you have multiple accounts, you will retain cover in the account with the highest level of insurance and the account with lower insured amount will be closed. If you have an account with default Automatic Income Protection insurance cover (as defined in 8.17) and a separate account with non-default Income Protection insurance cover (as defined in 8.16), Hostplus will contact you to discuss your options. Any overpaid premiums will be refunded to you. Your insurance cover will automatically be transferred once your accounts have been merged unless you tell us otherwise. You must inform us immediately if you have more than one account with Hostplus. 

Please note that if you are an existing member and have a duplicate account or have joined another division of Hostplus you are not entitled to the 8.4 Special insurance offer on joining for new members.

8.8.7 Exclusions

In the event of a War involving Australia or your country of residence the insurer may offer increased premium rates. No benefit is payable if the event giving rise to the claim is caused directly or indirectly by War (as defined in 8.13 Definitions).

8.8.8 Going overseas?

If you travel or reside overseas, you are covered for claims, provided your insurance premiums continue to be paid from your account and you have sufficient funds in your super account to pay the premiums. In the event of a Total and Permanent Disability or Income Protection claim you may be required to return to Australia at your own expense to be assessed for a benefit.

8.8.9 When your Death and TPD insurance cover ends

Your insurance cover will cease, without the need for us to notify you, on the earliest of the following events: 

• the date you commence Active Duty with the military services of any country (other than the Australian Armed Force Reserve where you are not on Active Duty outside Australia),
• the date you cease to be a member of Hostplus,
• the date you reach age 70 for Death and TPD cover,
• the date we receive your written request to cancel your insurance (or where the request specifies a later date, the later date specified),
• in the event of your death,
• the date you are paid a benefit which is equal to the amount of your Death benefit,
• the end of the month in which your account balance has insufficient funds to pay the premium,
• by opting out of your insurance cover online via Member Online at hostplus.com.au,
• the date the insurance policy ends,
• the date your account becomes inactive, or
• your account is transferred to the Australian Tax Office or an Eligible Rollover Fund.

8.8.10 If your cover starts again (Death and TPD)

Recommencement of Cover – Insufficient account balance, inactive accounts and low balance members

If your cover has ceased, it may in certain circumstances (explained in the table below) start again from the Recommencement Date provided you are an Eligible Person on the Recommencement Date and have been a Member of Hostplus at all times since the Cover End Date and provided there are sufficient funds in your account to pay for premiums.  A recommencement may change the level of insurance you previously held and / or your occupation rating, so this may affect your premium.

Recommencement of Cover - Active Duty outside Australia with the Australian Armed Forces Reserve

If your cover has ceased as a result of you having commenced Active Duty outside Australia with the Australian Armed Forces Reserve, you may have your cover recommenced up to the automatic default level of cover provided the period of that Active Duty did not exceed 12 consecutive months and your cover would not have otherwise ceased due to any other reason.

Upon recommencement, New Events Cover will apply for 12 consecutive months commencing on the later of you ceasing Active Duty outside Australia with the Australian Armed Forces Reserve, and the date you are first At Work with your Participating Employer. New Events Cover will continue to apply if you are not At Work after this 12 month period until you return to being At Work, unless you are accepted by the insurer for Full Cover. Acceptance remains subject to underwriting.

Note: If the period of Active Duty (referred to under this section) exceeded 12 consecutive months, acceptance will remain subject to underwriting and approval by the insurer.

8.8.11 Manage your Insurance online

To make it easy for you the Hostplus online insurance tool allows you to manage all your insurance needs all year round. You have the flexibility to change your level of insurance cover when your circumstances change.

Simply apply online now

8.8.12 How much insurance cover can I apply for?

You can apply for unlimited Death cover which includes Terminal Illness cover.  Underwriting conditions may apply.

You can apply for up to a maximum of $5 million in Total & Permanent Disability (TPD) cover.

If you have Death and TPD cover, the amount of TPD cover cannot exceed your Death cover.

Underwriting conditions may apply. 

8.8.13 Calculating how much insurance cover you need and cost of cover

To calculate the type and level of insurance cover you need click here to use our online insurance calculator.

8.8.14 Apply for your insurance premiums to be waived when you take parental leave

You can apply for your insurance premiums to be waived during employer approved parental leave, provided you have been a member of Hostplus for at least 12 months at the time you apply.

To make an application, please arrange for your employer to complete the Notification of Parental Leave form and return to us.

If all the requirements are satisfied, your insurance premiums will be waived during any maternity leave period for the duration of your leave up to a maximum period of up to 12 months’ leave. This option is not available if you are self-employed.

You may still apply to change your cover during this period.

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8.9 Understanding occupational ratings

Some members will be eligible to pay a lower premium based on their occupation and associated occupational rating set by the insurer.

The table below is a description of occupational ratings. If you require assistance determining your occupational rating you can contact Hostplus.

Please note: Depending on your occupation and the type of cover you select, you may be assessed on different occupation ratings. For example, a hospitality worker will be considered as Standard for Death and TPD but Heavy blue for Income Protection cover.

If you do not provide your occupational details and you are electing to take up fixed cover, you will automatically default to the Heavy Blue collar occupational rating for Death and TPD insurance cover. 

Occupational Rating

To change your insurance scale you can apply online at hostplus.com.au by clicking here.

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8.10 Changing your level of cover after you have joined

You can change your level of cover and tailor it to suit your needs, at any time during your membership by applying online. You can take advantage of the following options to increase your cover.

8.10.1 Transferring your insurance cover into Hostplus

If you have insurance cover through another superannuation fund or otherwise for Death Only, TPD Only or Death and Total & Permanent Disability (TPD) cover (“Transferred Cover”) you may be able to transfer up to $1,500,000 of Death Only, TPD Only or Death and TPD insurance cover into Hostplus provided that:

• your Transferred Cover is of a similar nature to the cover provided under Hostplus,
• your Transferred Cover is still in force (if you intend to transfer cover, you must not cancel your cover with the previous insurer/fund or transfer your full superannuation account balance to Hostplus until your transfer application has been accepted),
• any loadings, restrictions and exclusions which apply on your Transferred Cover will also apply to your cover transferred to Hostplus, and
• you cancel your Transferred Cover with the previous insurer once the transfer to Hostplus has occurred – if you do not cancel your previous cover, in the event of a claim, any benefit payable to you will be reduced by the amount payable under the previous cover.

To apply to transfer your existing cover to Hostplus, please apply online by clicking here.  

Please note that any Death and/or TPD cover transferred to Hostplus will be in addition to the same insurance cover you hold under Hostplus. (subject to a limit of $5m for TPD cover). If you have TPD Cover, the TPD cover amount cannot exceed your Death Cover. If you have fixed TPD cover, from age 61 your TPD benefit will reduce each year by 20% of the cover held at age 60, and from age 64 will remain fixed at 20% of your cover held at age 60 until  you turn 70 when your cover ends.

 

8.10.2 Specific life events cover - cover that keeps up with you

To help ensure your Death and Total & Permanent Disability (TPD) cover keeps up with you whenever you take a big step forward – like buying a new home or starting a family, you have the opportunity to take advantage of our life events cover. This feature, which is only accessible to Industry members, allows you to increase your unitised cover by four additional units or under fixed benefit cover, by 25% of your current sum insured up to a maximum of $200,000, without the need to complete lengthy paperwork or supply medical information.

To obtain the additional cover under this feature, you must apply within 6 months of: 

• getting married,
• the birth or adoption of a child/children,
• divorce,
• taking on a mortgage or negotiating an increase to your existing mortgage (principle place of residence),
• a dependent child starting secondary school,
• taking out a business loan in excess of $100,000,
• increasing an existing business loan, by at least $100,000 (excluding re-draw and refinancing).

You will need to provide proof that the event has occurred. If you have Death Only cover, the increase will be for Death Only cover. If you have TPD Only cover, the increase will be for TPD Only cover. If you have Death and TPD cover, the increase will apply to both types of cover. You can take up one life event cover increase every 12 months and three increases in total in the lifetime of your membership. The same loadings, exclusions and limitations will apply to your life events cover that applied immediately before your life events application. 

If you have been previously declined in your application for insurance by the insurer you will not be eligible for the specific life events cover.

You can apply online by clicking here

8.10.3 Converting your unitised insurance cover to fixed benefit insurance cover

You have the option to replace your unitised cover with 8.8.3 Fixed insurance cover at any time by applying online by clicking here. You must be 60 years of age or less to be eligible for this offer. Where an application is made, you will have your unitised cover converted to an equivalent amount of fixed benefit cover, rounded up to the next $1,000.

You cannot have a combination of unitised cover and fixed benefit cover.

You can revert back to unitised cover by clicking here. You must be 60 years of age or less to be eligible for this offer.
Where an application is made, you will have your fixed cover converted to an equivalent amount of units, rounded down to the next whole unit.

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8.11 Interim Accident Cover

While the insurer is assessing your application for Death and TPD insurance cover, or an increase in your existing Death and TPD cover, or to amend your Death & TPD insurance cover, you are provided with Interim Accident Cover. If you die or suffer total and permanent disablement as a result of an accident during the period in which the Interim Accident Cover applies, the interim benefit will be at the same level as the cover applied for or in the case of increasing your cover, the difference between the level of increased cover applied for and the level of current cover, up to the maximum benefit level limit as below:

Interim Accident Cover commences when we receive your application and will continue until the earlier of: 

• the date the insurer accepts or rejects your application,
• 90 days after the date Interim Accident Cover starts, 
• the date that you withdraw your application for additional cover; or
• the date your cover otherwise ends as set out under 8.10.5 When your Death and TPD insurance cover ends.

‘Accident’ means a fortuitous, external event that occurs by chance causing death or total and permanent disablement. It does not refer to an event which results in sickness, disease, allergy or infirmity of the insured member, such that they would qualify for a Death or Total & Permanent Disability (TPD) benefit (as applicable) to be paid under the policy.

Whether the death or total and permanent disablement was caused by an unintended and unexpected characteristic or consequence of an intended act (such as the application of unintentionally excessive force, or the creation of unintended or excessive force, or the creation of unintended excessive pressure or strain) is irrelevant in determining whether death or total and permanent disablement has arisen as a result of an accident.

An accident must result in the death or total and permanent disablement of the insured member within 365 days of the accident for a benefit to be payable where liability is contingent on an event being caused by an accident or by accidental injury.

For the avoidance of doubt, an accident shall specifically exclude death or total and permanent disablement (if it applies):

• arising out of, or contributed to in any way by, any pre-existing sickness, disease, injury, gradual physical or mental deformity, or infirmity known to the insured member when their insurance cover commenced, or
• arising in circumstances where the insured member deliberately assumed the risk or courted disaster, irrespective of whether he or she intended or contemplated the results of his or her actions.

Where there is any doubt as to the cause of death or total and permanent disablement sustained as a result of an accident, the cause will be characterised as being the result of a sickness. See 8.13 Definitions.

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8.12 When should I make a claim for a benefit Death and Total and Permanent Disablement

You should advise us of a claim as soon as reasonably possible. If you don’t notify us within a reasonable time, the insurer may reduce or refuse to pay the insured benefit to the extent their assessment of your claim is prejudiced. 

If you make a claim, the insurer reserves the right to investigate the claim including but not limited to the use of investigative agents, conducting surveillance and requesting information and medical examinations.

It is important to note that if you make a claim, you will only be entitled to an insured benefit if you meet the eligible criteria (see section 8.10) under the terms of the fund’s insurance policy. The insured benefit is determined as at the date of the event occurring (e.g. for death event, date of death) and the level of insurance cover at that time. In circumstances where you are in the process of applying for additional cover but have not yet been accepted by the insurer, you will only be entitled to the lesser amount of cover applicable prior to the increase, in the event of a successful claim.

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8.13 Definitions

Total and Permanent Disablement (TPD):

“Totally and Permanently Disabled”, “Total and Permanent Disablement”, “Total and Permanent Disability” or “TPD” means:

1. Unlikely to do a suited occupation ever again

If you are:

• aged less than 65 years as at the Date of Disablement; and
• employed or engaged in a gainful occupation, business, profession or employment within 12 months of the date you cease to be so employed or engaged:

1.1. you have suffered an injury or illness and, as a result of that injury or illness:

1.1.1. are totally unable to be employed or engaged in that occupation, business, profession or employment for a period of six consecutive months, and

1.1.2. are determined by the insurer that at the end of that six month period (or such later time as agreed with the trustee), to be permanently incapacitated to such an extent as to render you unlikely ever to be employed or engaged in any gainful occupation, business, profession or employment for you are reasonably suited by education, training or experience.

NOTE: For the avoidance of doubt, the six month periods referred to in part 1 above does not apply to parts 2 to 5 below.

OR

2. Significant impairment to whole body

You suffered an injury or illness and, as a result of that injury or illness you:

2.1. suffered a permanent impairment of at least 25% of whole person function as defined in the American Medical Association publication ‘Guides to the Evaluation of Permanent Impairment’, 4th edition, or an equivalent guide to impairment approved by the insurer, and

2.2. are disabled to such an extent, as a result of this impairment, that you unlikely ever again to be able to be employed or engaged in any gainful occupation, business, profession or employment for which you are reasonably suited by education, training or experience.

OR

3. Loss of limbs and/or sight

As a result of illness or injury, you suffered the total and permanent loss of the use of: 

• two limbs (where ‘limb’ is defined as the whole hand or the whole foot), or 
• the sight in both eyes, or 
• one limb and the sight in one eye

and are disabled to such an extent, as a result of this impairment, that you are unlikely ever again to be able to be employed or engaged in any gainful occupation, business, profession or employment for which you are reasonably suited by education, training or experience.

OR

4.Unable to look after oneself ever again

As a result of illness or injury, you suffered loss of independent existence and are disabled to such an extent, as a result of this impairment, that you are unlikely ever again to be able to be employed or engaged in any gainful occupation, business, profession or employment for which you are reasonably suited by education, training or experience.

‘Loss of independent existence’ means the insurer has determined you are totally and irreversibly unable to perform at least two of the following five ‘activities of daily living’ without the assistance of another adult person: 

• bathing and/or showering. 
• dressing and undressing. 
• eating and drinking. 
• using a toilet to maintain personal hygiene. 
• getting in and out of bed, a chair or wheelchair, or moving from place to place by walking, wheelchair or with assistance of a walking aid.

OR

5. Permanent loss of intellectual capacity

As a result of illness or injury, you suffered cognitive loss and are disabled to such an extent, as a result of this impairment, that you are unlikely ever again to be able to be employed or engaged in any gainful occupation, business, profession or employment for which you are reasonably suited by education, training or experience.

‘Cognitive loss’ means the insurer has determined that a total and permanent deterioration or loss of intellectual capacity has required you to be under continuous care and supervision by another adult person for at least six consecutive months and, at the end of those six consecutive months, you are likely to require permanent ongoing continuous care and supervision by another adult person.

Other Definitions

Active Duty

Full-time occupation as part of a military force, as opposed to reserve duty.

Active Employment or Actively Employed means the Member is:
(a) Gainfully Employed and not absent from work or on leave, due to illness or injury;
(b) actively performing or capable of performing all the duties of all the occupations held by the Member for at least 35 hours per week (even if not working 35 hours per week), free from any limitation due to Illness or Injury; and
(c) not in receipt of, or entitled to claim, Income Support Benefits from any source including but not limited to workers’ compensation benefits, statutory motor accident benefits or disability income benefits (including government Income Support Benefits of any kind).

At Work
Actively performing all the duties of your occupation, working your usual hours free from any limitation due to illness or injury and not entitled to or receiving Income Support Benefits of any kind.

Where you own all or part of the business from which you earn your regular income, At Work means you are capable of, and in fact performing without restriction due to injury or illness, all of the usual identifiable duties of the occupation for which you earn your regular income.

Contribution
A contribution from any source or a transfer or rollover of a superannuation benefit received on your behalf.

Cover Commencement Date
(a) If you Opt-in to Default Cover, the later of the following:
    (i) the date we receive your Opt-in; and
    (ii) The date you become an Eligible Person.
(b) for Members who do not Opt-in to Default Cover, the date the Eligible Person first meets all the following criteria:
    (i) is aged at least 25 years (where applicable); and
    (ii) the Member’s account has a balance of at least $6,000 on or after 1 November 2019.

Cover End Date
Where cover ends because:
(a) of insufficient funds in your account, the last calendar day of the month in which your account balance has insufficient funds to pay premiums;
(b) your account becomes Inactive, the date your account becomes Inactive; or
(c) as at 31 March 2020 you are a Low Balance Member (and not an Exempt Person), cover ends at 11:59pm on 31 March 2020.

Degenerative Condition means any of the following conditions:

• Parkinson’s Disease
• Dementia
• Arthritis including Rheumatoid Arthritis
• Osteoporosis
• Motor Neurone Disease
• Multiple Sclerosis
• Muscular Dystrophy

Election means a written request or positive election from the Member to always maintain all their cover provided under the Hostplus policy even if no Contribution has been received from any source into the Member’s account for a continuous period of 16 months.

To avoid doubt, a written request or positive election made after 8 May 2018 and before 1 April 2019 to be provided with cover under the Hostplus policy will qualify as a valid Election without having to specify for the cover to be maintained even if no Contribution has been received from any source into the member’s account for a continuous period of 16 months.

Eligible Person
You are an Employer Sponsored or Personal Super Plan Member who is: 

(a) a member of the industry Division of the Fund;
(b) at least 11 years old and under 70 years of age for Death (including Terminal Illness) and TPD Cover;
(c) an Australian resident or a lawful non-citizen, within the meaning of the Migration Act 1958 (Cth) for whom your employer is required to make employer contributions,
(d) not an Excluded Member; and
(e) not an insured member of the Executive Division of the Fund.

An Excluded Member is a member who satisfies one or more of the following:

• has reached the maximum expiry age, being age 70 for Death and TPD cover;
• has previously declined default cover, opted out of or cancelled all cover under this or any previous Hostplus policy; or
• a Hostplus Personal Super Plan member whose occupation excludes them from being eligible for insurance.

Excluded members are ineligible for cover under the Hostplus policy except where accepted by the insurer at its absolute discretion. Acceptance remains subject to underwriting. We will notify you of the outcome of any application made.

Exempt Person means a Member to whom we are permitted, under the Superannuation Industry (Supervision) Act 1993 (Cth), to provide cover under the Hostplus policy because:

(i.)   the Member has made a written request or positive election to be provided with cover under the Hostplus policy even where:
   (a.)   their account has not had a balance of at least $6,000 on or after 1 November 2019; or
   (b.)    they are aged less than 25 years (where applicable); or
(ii.)    the Member has made an Election.

For the avoidance of doubt a Member can be an Exempt Person in respect of the PMIF Laws but not an Exempt Person in respect of a period of Inactivity and vice versa.

Full Cover
Cover that is neither New Events Cover nor Restricted Cover.

Gainfully Employed
Employed or self-employed for gain or reward in any business, trade, profession, vocation, calling, occupation or employment.

Inactive or Inactivity means:
(a)  no Contribution has been received from any source into your Member account for a continuous period of 16 months ending on or after 1 July 2019;
(b)  we have not received an Election from you.

Income Support Benefit
Monetary benefits which are paid or entitled to be paid to replace a person’s loss of income or income earning capacity as a result of Illness or Injury.

Industry Members/Employer Sponsored Member(s)
A member who is an employee of a Participating Registered Hostplus Employer and has been registered/joined with Hostplus through this employer. The Participating Employer is attached your account within the Fund, at the Cover Commencement Date.

Low Balance Member
A Member whose account has not had a balance of at least $6,000 at any time within the applicable timeframes set out in the table below:

New Events Cover
You are only covered for an illness that first becomes apparent, or an injury that first occurs, on or after the date cover commenced.

Opt-in means an Eligible Person makes a written request or positive election to be provided with default cover for the first time even where their account has not had a balance of at least $6,000 on or after 1 November 2019 or they are aged less than 25 years (where applicable).

Participating Registered Hostplus Employer (Participating Employer)
An employer who has completed an employer application form to register with Hostplus and makes Superannuation Guarantee Contribution on behalf of employees through the Industry product.

Personal Super Plan Member
you are a member who has chosen to become a member of Hostplus and has completed a personal super plan application form.

Pre-existing Condition
Any injury or illness, condition or related symptom which you, or any reasonable person in your position:

• was aware of, or should have been aware of; or
• had, or was intending to have, or would have had a medical consultation for,

in the two years prior to the date your cover commenced or recommenced under the Policy or the previous policy.

Putting Members’ Interests First Laws or PMIF Laws refers to the Treasury Laws Amendment (Putting Members’ Interests First) Act 2019 and associated amendments to the Superannuation Industry (Supervision) Act 1993 (SIS Act).

Recommencement Date
Where cover recommences due to the receipt of:

(a) an election or request from a person to recommence their cover, (including an Election), the date we receive the person’s election or request; 
(b) a Contribution for a person, the date the Contribution for the person is received by us unless (c) applies;
(c) a Contribution for a person where the person may not have met the legislative requirements for cover to recommence, the later of the following:
   (i.) the date the Contribution for the person is received by us;
   (ii.) the date the person makes a written request or positive election to be provided with cover under the Hostplus Policy even where their Account has not had a balance of at least $6,000 on or after 1 November 2019 or they are aged less than 25 years (where applicable);
   (iii.) the date the person first meets all the following criteria:
      • is aged at least 25 years (where applicable); and
      • the Member’s Account has a balance of at least $6,000 on or after 1 November 2019.

Restricted Cover

You are only covered for an illness that first becomes apparent, or an injury that first occurs, on or after the date cover commenced or recommenced and provided the Injury or Illness is not a Pre-Existing Condition.

OR

Where you directly or indirectly own all or part of the business from which you earn your income, the total amount earned by the business over the financial year as a direct result of your personal exertion or activities through your usual occupation, less your share of business expenses, but before the deduction of income tax, for that business (or the relevant proportion for part of a financial year).

Terminal Illness

(a) Two Medical Practitioners, one of whom specialises in your illness, certifies in writing that despite reasonable medical treatment the illness will lead to your death within 24 months of the date of the certification, and
(b) The insurer is satisfied, on medical or other evidence that despite reasonable medical treatment the illness will lead to your death within 24 months of the date of the certification referred to in paragraph (a).

The illness which you suffer, must occur and the date of the first and second certifications referred to in paragraph
(a) must be made while you are covered for death cover with Hostplus.

See 2.13.9 Types of benefits

Tertiary education

Tertiary education includes but is not limited to mean diplomas, undergraduate and graduate certificates, and associate's, bachelor's, master's and doctoral degrees obtained at any type of education pursued beyond the high school level.

War

War includes an act of war (whether declared or not), revolution, invasion, rebellion or civil unrest.

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8.14 Industry Member Automatic Death & TPD Default Unitised Cover Table

The table below shows the level of default Death and TPD cover eligible Industry (employee) members receive upon joining Hostplus. The level of default cover applied is based on your age next birthday.

Cost Of Unitised Death & TPD Cover

The rates shown have been rounded up to two decimal places for ease of use, the actual premium rates applied to your account are to four decimal places.

Your unitised cover premiums will be calculated based on your applicable occupational rating, number of units held and type of cover. 

Please note the ‘Standard’ occupational rating classification will apply to you until such time as you vary this under the terms of the policy, in writing with Hostplus.

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8.15 Death Only and Total and Permanent Disability Only insurance Fixed benefit cover table

Management/Clerical (White collar) premium rates are shown per $1,000 sum insured.

The rates shown have been rounded up to two decimal places for ease of use, the actual premium rates applied to your account are to four decimal places.

Fixed Death and TPD Cover is calculated by adding the Death Only and TPD Only premium rates together.

Your Fixed Cover premiums will be calculated based on your age next birthday, your applicable Occupation Rating Factor, type of cover and the dollar value of your cover. 

If you do not provide your occupational details and you take up fixed cover, you will automatically default to the Heavy Blue collar occupational rating for Death and TPD insurance cover, until such time as you vary this under the terms of the policy, in writing with Hostplus. 

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8.16 Non-default MetLife Income Protection insurance cover

This section 8.16 discloses the terms and conditions of non-default Income Protection insurance cover .

If you are joining Hostplus through an employer who was previously a default employer of Club Super you receive Automatic Income Protection insurance cover when you become eligible. The terms and conditions of that cover are disclosed in section 8.17 of this document.

Income Protection insurance helps to protect your income if you can’t work because of illness or injury by providing regular monthly payments to help you meet your living expenses.

You can apply for cover of up to 90% of your monthly pre-disability salary (where, in the event of a successful claim, 75% of your monthly pre-disability salary is paid to you and 15% of your monthly pre-disability salary is paid into your account with Hostplus*), capped at $30,000 per month, with a waiting period of either 30, 60 or 90 days and you can choose to receive monthly benefits for either up to two years, five years or up to the age of 65.

*The contribution to your account is a concessional contribution and subject to the concessional contributions cap. See 2.14.10 Contribution limits.

You can apply for Income Protection cover via Member Online at hostplus.com.au.

8.16.1 When your non-default Income Protection cover starts

Your non-default Income Protection insurance cover commences on the date your application is accepted by the insurer and your insurance premium is paid. Acceptance is subject to underwriting. We will advise you, in writing, of the outcome of your application.

8.16.2 When your non-default Income Protection cover ends

Your non-default Income Protection insurance cover will cease on the earliest of the following events:

• the date you commence Active Duty with the military service of any country (other than the Australian Armed Forces Reserves and are not on Active Duty outside Australia).
• the date you cease to be a member of Hostplus.
• the date you reach age 65.
• the date we receive your written request to cancel your insurance (or where the request specifies a later date, the later date specified).
• the date that you permanently retire from the workforce.
• in the event of your death.
• the end of the month in which your account balance has insufficient funds to pay the premium.
• the date the insurance policy ends
• the date your account becomes inactive, or
• your account is transferred to the Australian Tax Office or an Eligible Rollover Fund. 
  
  
  
  
  

8.16.3 Who’s eligible for non-default Income Protection insurance cover with Hostplus?

You are eligible for non-default Income Protection insurance cover if you are:

• a member of the Industry Division of the Fund;
• at least 15 years old and under 65 years of age;
• an Australian resident or a lawful non-citizen, within the meaning of the Migration Act 1958 (Cth) for whom the employer is required to make employer contributions;
• not an Excluded Member;
• not an insured member of the Executive Division of the Fund; and
• not eligible to receive, and you have not had a claim admitted, for a total and permanent disablement benefit from any source (including a superannuation fund or otherwise ) prior to commencement of cover under the Hostplus policy. Please note, if you are not eligible for Income Protection insurance cover due to this clause, your cover will be deemed to have never commenced and any premium deducted for any cover that you have been given in error will be refunded to your account.

In addition, you must meet the following requirements under the Putting Members’ Interests First Laws:

• You must be aged at least 25 years (where applicable); and
• Your account has had a balance of at least $6,000 on or after 1 November 2019; and
• Your account is not Inactive; or
• You are an Exempt Person.

An Excluded Member is a member who satisfies one or more of the following:

•  has reached the maximum expiry age, being age 65; 
• works in an excluded occupation; or
• has previously declined default cover, opted out of or cancelled all cover under this or any previous Hostplus policy; or 
• is eligible to receive or has received a lump sum benefit for total and permanent disability from any source.

Excluded members are ineligible for cover under the Hostplus policy except where accepted by the insurer at their absolute discretion. Acceptance remains subject to underwriting.  We will notify you of the outcome of any application made. 

8.16.4 Excluded occupations

An excluded occupation is an occupation that the Fund’s insurer will not cover for non-default Income Protection insurance. Refer to Excluded occupations.

8.16.5 Non-default Income Protection Cover Exclusions

No benefit will be payable if the injury or illness is caused directly or indirectly by one of the following: 

• your intentional, self-inflicted act, or any attempt to commit suicide,
• pregnancy unless you are disabled for more than three months after the end of the pregnancy, in which case the waiting period is deemed to start on the later of the date disablement begins and the end of the pregnancy, or
• war or act of war.

In addition to the above, the insurer may refuse to pay any benefits:

• while you are imprisoned.
• if the premium has not been paid in respect of all members insured under the insurer’s policy.
• if you do not comply with the requirements made of you by the insurer in the course of considering your claim.
• where the insurer’s assessment of the claim is prejudiced.

No Partial Disability Benefit will be payable where you cease to be employed for reasons other than illness or injury.

8.16.6 Non-default Income Protection cover how your benefit is calculated

With non-default Income Protection cover, you first decide how much of your pre-disability salary you would like to insure. You can apply for up to a maximum of 90% of your pre-disability salary. If insured for that amount, in the event of a successful claim, 75% of your monthly pre-disability salary is paid to you and 15% of your monthly pre-disability salary is paid into your Hostplus account. You may, of course, choose to have Income Protection insurance cover that is less than 90% of your pre-disability salary.

Where your non-default  Income Protection benefit is up to 75% of your pre-disability salary, we will pay that benefit to you. Where your Income Protection benefit is from 75% to 90% of your pre-disability salary, we will pay a maximum of 75% of your pre-disability salary to you and the remained is paid into your Hostplus account. 

Click here to calculate the level of insurance cover you need

8.16.7 Your choice of waiting periods and benefit periods for non-default Income Protection

Hostplus offers three waiting periods: 30, 60 or 90 days. A waiting period is the period during which you must be disabled or partially disabled before any non-default Income Protection benefit is payable. You do not receive a monthly benefit for the waiting period.

The benefit period is the maximum period of time that a benefit will be paid for any one illness or injury while you are disabled or partially disabled. You can choose a benefit period of two years, five years or up to age 65.

Premiums vary depending on which waiting period or benefit period you choose. Generally, the longer the waiting period and the shorter the benefit period, the lower the premium. See section 8.16.26 Income Protection insurance annual premiums table.

If you want to reduce the waiting period  (e.g. from 90 days to 60 days) or increase the benefit period (e.g. ‘two years’ to ‘up to age 65'), you will need to complete a new online insurance application.

 During the waiting period, you can return to work once, for up to 10 consecutive days, without having to start a new waiting period. If this occurs, the number of days you have worked will be added to the waiting period.

8.16.8 Special Insurance Offer – non-default Income Protection insurance

Eligible Industry members who have obtained automatic death and TPD cover, have a once off opportunity to obtain non-default Income Protection insurance up to $4,000 per month for a benefit period of two years, and a default waiting period of 90 days (unless you nominate otherwise) with limited health questions.

You can apply for the special offer via Member Online at hostplus.com.au if you Opt-in to automatic death and TPD cover within 60 days of the date the Hostplus Welcome Letter is issued to you.

See 8.4 Special insurance offer for Industry members

Important Note:
If you are not Actively Employed on the date we receive your application, your Income Protection Insurance will be Restricted Cover until you are Actively Employed for 30 consecutive days at which time Full Cover will replace your Restricted Cover.
Any restrictions that apply to your automatic death and TPD cover will also apply to any Income Protection obtained under the special insurance offer and will continue to apply until it expires under the relevant terms.

See section 8.16.9 Restricted Cover – Income Protection for more information.

Where you are provided with cover under this section, your cover will commence on the date your application is accepted.

8.16.9 Restricted Cover – non-default Income Protection

 Restricted Cover covers you for an illness which became apparent to you or an injury that first occurs on or after the date your cover commences. It will not provide a benefit if you suffered from a Pre-Existing Condition i.e. illness or injury known to you for 2 years prior to your cover commencing.

This Restricted Cover will generally be replaced with Full Cover when you resume your normal duties with your employer for 30 consecutive days.

Special rules apply to recommencement of insurance cover. Please see 8.16.12 If your Income Protection cover starts again

8.16.10 Maximum monthly benefit payable for non-default Income Protection

The maximum monthly benefit that will be paid by the insurer in the event of a claim is the lower of:

• the benefit represented by the number of units of cover for which the insurer has agreed to cover you.
• 90% of your monthly pre-disability salary, a maximum of 75% is payable to you and the balance as a contribution to your Hostplus super account up to a maximum of $30,000 per month.

8.16.11 Non-default Income Protection Interim Accident Cover

While the insurer is assessing your application for non-default Income Protection insurance cover, or an increase in your existing non-default Income Protection cover or to amend your non-default Income Protection insurance cover, you are provided with Interim Accident Cover. In the event that you suffer Disability or Partial disability as a result of an accident during the period in which the interim accident cover applies, the interim accident benefit will be for the same level as the cover applied for or in the case of increasing your cover, the difference between the level of increased cover applied for and the level of current cover, up to a maximum monthly benefit limit of $20,000 for the benefit period selected in the application.

The interim accident cover commences when we receive your application and will continue until the earlier of:

• the date the insurer accepts or rejects your application;
• you withdraw your application;
• 90 days after the date interim accident cover starts; or
• the date your cover otherwise ends as set out under the heading 8.19.2 When your Income Protection cover ends.

‘Accident’ means a fortuitous, external event that occurs by chance causing total or partial disability. It does not refer to an event which results in sickness, disease, allergy or infirmity of the insured member, such that they would qualify for a total or partial disability benefit (as applicable) to be paid under the insurer’s policy.

Whether the total or partial disability was caused by an unintended and unexpected characteristic or consequence of an intended act (such as the application of unintentionally excessive force, or the creation of unintended or excessive force, or the creation of unintended excessive pressure or strain) is irrelevant in determining whether total or partial disability has arisen as a result of an accident.

An accident must result in the total or partial disability of the insured member for a benefit to be payable where liability is contingent on an event being caused by an accident or by accidental injury.

For the avoidance of doubt, an accident specifically excludes total or partial disability:

• arising out of, or contributed to in any way by, any pre-existing sickness, disease, injury, gradual physical or mental deformity, or infirmity known to the insured member when their insurance cover commenced.
• arising in circumstances where the insured member deliberately assumed the risk or courted disaster, irrespective of whether he or she intended or contemplated the results of his or her actions.

Where there is any doubt as to the cause of death or total and permanent or partial disability sustained as a result of an accident, the cause will be characterised as being the result of a sickness.

8.16.12 If your non-default Income Protection cover starts again

Recommencement of Cover - Active Duty outside Australia with the Australian Armed Forces Reserve 

If your Income Protection cover has ceased as a result of you having commenced Active Duty outside Australia with the Australian Armed Forces Reserve, you may have your cover recommenced up to the Special Offer cover provided the period of that Active Duty did not exceed 12 consecutive months and your cover would not have otherwise ceased due to any other reason.

Upon recommencement, New Events Cover will apply for 12 consecutive months commencing on the later of you ceasing Active Duty outside Australia with the Australian Armed Forces Reserve, and the date you are first At Work with your Participating Employer.  New Events Cover will continue to apply if you are not At Work after this 12 month period until you return to being At Work, unless you are accepted by the insurer for Full Cover. Acceptance remains subject to underwriting. 

 

 

8.16.13 Non-default Income Protection disability benefit

The insurer will pay a disability benefit if you are disabled (see 8.19.27 Income Protection cover definitions) after the end of the waiting period that is applicable to you and provided that the insurer has admitted your claim. The monthly benefit starts to accrue from the day after the end of the waiting period.

The monthly benefit is payable in arrears and stops at the earlier of:

• the end of the benefit period.
• the date you attain age 65.
• the date of your death.
• the date you are no longer disabled.
• the date that you fail to comply with the insurer’s request to return to Australian for ongoing assessment - See 8.16.20 - Travelling overseas?

   

8.16.14 Non-default Income Protection Partial disability benefit

The insurer will pay a partial disability benefit (a proportion of the Disablement benefit) if you are partially disabled (see 8.19.27 Income Protection cover definitions) except where you had ceased to be employed for reasons other than illness or injury.

The partial disability benefit will be calculated as follows:

   (A – B)              
________        x disability monthly benefit
        A

Where

A is your monthly pre-disability salary (see 8.16.28 Income Protection cover definitions)

B means any income earned by you from personal exertion while disabled or partially disabled when the income is from your occupation, or any other occupation. 

Disability monthly benefit means the lesser of: 

• the benefit you are covered for, 
• 75% of your pre-monthly disability income, 
• the level of cover agreed to between the insurer and you, and 
• $30,000. 

The partial disability benefit begins to accrue from the day after you are no longer disabled or after the waiting period, as the case may be.

The partial disability benefit is payable in arrears and stops at the earliest of:

• the end of the benefit period.
• the date you attain age 65.
• the date you cease to be partially disabled.
• the date you are earning, or are capable of earning, monthly salary or wages equal to or greater than your pre-disability salary, or engaging in any occupation on a full-time basis (if working full-time prior to disability) or part-time basis (if working part-time prior to disability) or casual basis (if working casually prior to disability).
• the date that you fail to comply with the insurer’s request to return to Australian for ongoing assessment - See 8.16.20 - Travelling overseas?
• the date of your death.

8.16.15 Death benefit while claiming non-default Income Protection

If you die while a disability or partial disability benefit is being paid, the insurer will pay an amount equal to the monthly benefit you were receiving at the date of your death, for one month.

8.16.16 Non-default Income Protection Recurring disability

If you suffer a recurrence of disability in respect of the same or a related cause of an earlier claim, within six months of that earlier claim ending, the insurer will treat this subsequent claim as a continuation of the first claim and will waive the waiting period if for the same hours per week as you were engaged in. The payment of benefits over all periods for the same or related Illness or Injury shall not exceed the length of the benefit period.

8.16.17 How do payments work?

Non-default Income Protection benefits are payable monthly in arrears once your claim has been accepted.

Once payment of your Income Protection benefit begins, your benefit will be adjusted annually in line with the increase in the CPI to protect your payments from the effects of inflation. However, the benefit will not increase by more than 5% in any year.

When you return to work and your Income Protection benefit has ceased, the monthly benefit that you are covered for will revert to the pre-disability monthly benefit level.

8.16.18 Retraining Expense Benefit

Whilst you are in receipt of a non-default Income Protection benefit, the insurer may pay all or some of the expenses incurred in relation to you participating in a return to work program if the insurer is of the opinion that the program may help you return to work. Any payments will be made to the service provider and at the insurer’s discretion and must be approved before incurred.

8.16.19 What happens if you are suffering from more than one injury or illness?

You can only claim one non-default Income Protection benefit if you suffer from different types of injuries or illness that exist at the same time. For example, if you receive a monthly benefit for the benefit period due to a broken arm, you cannot also claim a monthly benefit during the same period if you suffer from another injury.

8.16.20 Travelling overseas?

Non-default Income Protection cover provided insures you while you are overseas. However, if you are overseas for more than 6 months after you commence to receive Income Protection benefits, the insurer may require you to return to Australia for claim assessment. If you fail to do so, the insurer may, in its discretion, refuse to continue payments.

8.16.21 Reduction of benefits

Your  non-default Income Protection payments may also be reduced by other payments (including settlement or commutation amounts) as set out below, where such benefits combined with the benefit payable under the policy would exceed 75% of your pre-disability salary:

• by way of workers’ compensation, similar legislation or any settlement in common law.
• under any statutory accident compensation scheme.
• any amounts payable in respect of loss of income (whether legislated or otherwise). 
• paid sick leave.
• as benefits under any other disability, injury or sickness insurance policy (except for lump sum benefits received from total and permanent disablement under a policy).

Any lump sum payment (such as settlement or commutation amounts) will be converted to an equivalent monthly amount by dividing the lump sum payment by 60 (i.e. the lump sum is paid out monthly over a period of 60 months ).

If your monthly benefit is reduced because you are in receipt of other payments, as set out above, or where you are entitled to a partial disability benefit, the 15% of your pre-disability salary which is paid into your Hostplus account, will also be reduced proportionally.

8.16.22 When should I make a non-default Income Protection claim?

You should advise us of a claim as soon as reasonably possible. If you don’t notify us within a reasonable time, the insurer may reduce or refuse to pay the insured benefit to the extent their assessment of your claim is prejudiced. 

If you make a claim, the insurer reserves the right to investigate the claim including but not limited to the use of investigative agents, conducting surveillance and requesting information and medical examinations. 

It is important to note that if you make a claim, you will only be entitled to an insured benefit if you meet the eligible criteria (see section 8.16.3) under the terms of the fund’s insurance policy. The insured benefit is determined as at the date of the event occurring (e.g. for partial disability, date of injury or illness occurred) and the level of insurance cover at that time. In circumstances where you are in the process of applying for additional cover but have not yet been accepted by the insurer, you will only be entitled to the lesser amount of cover applicable prior to the increase, in the event of a successful claim. See also interim accident cover in section 8.16.11.

8.16.23 Transfer your Income Protection insurance cover into Hostplus

You have the opportunity to transfer your existing Income Protection cover into Hostplus if it is of a similar nature to the cover provided under Hostplus, without underwriting (“Transferred Cover”). The total amount that a person may transfer from all sources is the lesser of: 

• the number of units to cover 90% of your pre-disability salary (of which a maximum of 75% is payable to you and the balance paid as a contribution to Hostplus), or
• the maximum cover of $10,000 per month.

provided that:

• Your Transferred Cover is of a similar nature to the cover provided via Hostplus
• your Transferred Cover is still in force (if you intend to transfer cover, you must not cancel your cover with the previous insurer/fund or transfer your full superannuation account balance to Hostplus until your transfer application has been accepted),
• any loadings, restrictions and exclusions which apply on your Transferred Cover will also apply to your cover transferred to Hostplus, and
  you cancel your Transferred Cover with the previous insurer once the transfer to Hostplus has occurred – if you do not cancel your previous cover, in the event of a claim, any benefit payable to you will be reduced by the amount payable under the previous cover.

Transferred Cover will replace any Income Protection cover that you already have at Hostplus.

Any amount above $10,000 will be assessed by the insurer. Generally, Income Protection insurance cover will be matched on the same waiting period and benefit period to that which was previously provided under the transferred cover. If the waiting period is not available, the next longest waiting period will be provided. Your transferred cover will replace any existing Income Protection cover you have with Hostplus (as long as any monthly benefit does not exceed 90% of your salary).

You cannot transfer cover that is subject to a waiting period that is greater than 90 days.

Conditions and other limitations apply. All applications are subject to the approval of the insurer and for your application to be considered you must provide proof of your external cover and the terms upon which it was granted.

To transfer your existing Income Protection cover to Hostplus, please apply online by clicking here.

8.16.24 Update your non-default Income Protection insurance online

To make it easy for you and to ensure you have adequate insurance cover when your circumstances change, you can also apply to increase or take out other forms of insurance cover online.

8.16.25 Calculating your non-default Income Protection insurance cover

To calculate the type and level of insurance cover you need click here to use our online insurance calculator.

8.16.26 Non-default Income Protection insurance annual premiums table

Rates are shown per $100 monthly cover Management/Clerical (White collar) scale. Premium rates include estimated 9% stamp duty.

The rates shown have been rounded up to two decimal places for ease of use.  The actual premium rates applied to your account are rounded to four decimal places.

Your Income Protection premiums will be calculated based on your age next birthday, your applicable Occupational Rating Factor, type of cover and the dollar value of your cover.

If you are electing to take up Income Protection cover under the Special insurance offer (see Section 8.16.8) and do not provide full occupational information you will not be eligible for this cover.

8.16.27 Apply for your insurance premiums to be waived when you take parental leave

 

8.16.28 Non-default Income Protection cover definitions

Definitions

Pre-disability salary

Where you are employed, the total monthly gross income from an employer for personal exertion you receive from your usual occupation, averaged over the most recent 12 month period (that may include any period of unemployment since you last worked or the actual period of work if less) before the deduction of income tax, and includes: 

• cash salary, 
• regular overtime (averaged over the previous three years, or since you started your current occupation, if less), 
• the monetary value of non-cash benefits or fringe benefits provided by your employer in direct substitution of salary (as long as the fringe benefits continue to be provided to you after disability benefit payments have commenced), 
• performance related commissions, bonuses and other monetary benefits, averaged over the previous three years, or since you started your current occupation (if less), or

Where you directly or indirectly own all or part of the business from which you earn your income, the total amount earned by the business over the financial year as a direct result of your personal exertion or activities through your usual occupation, less your share of business expenses, but before the deduction of income tax, for that business (or the relevant proportion for part of a financial year).

Employed persons who have been absent from employment due to being on employer approved leave for up to 24 months. 

Where you have been on employer approved leave for up to 24 months (for example maternity or study leave) it is the total monthly regular gross income you received from an employer for personal exertion for your usual occupation before the employer approved leave commenced and averaged over the 12 month period before the employer approved leave commenced. 

If you have been on employer approved leave for a period of more than 24 months you are not eligible to receive an Income Protection benefit. 

Disabled

Members who are employed or have been unemployed for fewer than six months.

In the opinion of the insurer after consideration of medical evidence, that solely as a result of injury or illness, you are:

• unable to perform at least one Income Producing Duty of your occupation;
• not working in any occupation, whether or not for reward; and
• under the regular care and following the advice of a medical practitioner.

Members who have been unemployed for six months or more.

In the opinion of the insurer after consideration of medical evidence, that solely as a result of Illness or Injury occurring whilst the policy is in force, you are:

• unable to perform any duties of any occupation, business, profession or employment, for which you are reasonably suited by education, training or experience ;
• not working in any occupation, whether or not for reward; and
• under the regular care and following the advice of a medical practitioner.

For all members

Partially disabled :

You:
a) have been disabled:
i. for a period during which a disability benefit has been paid, or
ii. for at least 7 days out of 12 consecutive days during the waiting period, and
b) are unable to work in  your occupation at full capacity  as a result of  the  illness or injury resulting in Disability or are working in an occupation  but only in a limited capacity, and
c) are earning a monthly income that is less than your monthly pre-disability salary due illness or the injury and
d) are under the regular care and following the advice of a Medical Practitioner. 

War

War includes an act of war(whether declared or not), revolution, invasion, rebellion or civil unrest.

Other Definitions:  

Cover End Date
Where cover ends because:
(a) of insufficient funds in your account, the last calendar day of the month in which your account balance has insufficient funds to pay premiums;
(b) your account becomes inactive, the date your account has been inactive for a continuous period of 16 months;
(c) as at 31 March 2020 you are a Low Balance Member (and not an Exempt Person), cover ends at 11:59PM on 31 March 2020.

Election means a written request or positive election from the Member to always maintain all their cover provided under the Hostplus policy even if no Contribution has been received from any source into the Member’s account for a continuous period of 16 months.

To avoid doubt, a written request or positive election made after 8 May 2018 and before 1 April 2019 to be provided with cover under the Hostplus policy will qualify as a valid Election without having to specify for the cover to be maintained even if no Contribution has been received from any source into the member’s account for a continuous period of 16 months.

Exempt Person means a Member to whom we are permitted, under the Superannuation Industry (Supervision) Act 1993 (Cth), to provide cover under the Hostplus policy because:

(i.)   the Member has made a written request or positive election to be provided with cover under the Hostplus policy even where:
   (a.)   their account has not had a balance of at least $6,000 on or after 1 November 2019; or
   (b.)   they are aged less than 25 years (where applicable); or
(ii.)    the Member has made an Election.

For the avoidance of doubt a Member can be an Exempt Person in respect of the PMIF Laws but not an Exempt Person in respect of a period of Inactivity and vice versa.

Inactive or Inactivity means:
(a) no Contribution has been received from any source into your Member account for a continuous period of 16 months ending on or after 1 July 2019;
(b) we have not received an Election from you.

Income Producing Duty
A duty of your occupation that generates at least 20% of your monthly Pre-Disability Salary.  

Low Balance Member means a Member whose account has not had a balance of at least $6,000 at any time within the applicable timeframes set out in the table below:

Participating Registered Hostplus Employer (Participating Employer)

An employer who has completed an employer application form to register with Hostplus and makes Superannuation Guarantee Contribution on behalf of employees through the Industry product.

Pre-existing Condition 

Any injury or illness, condition or related symptom which you, or any reasonable person in your position:

• was aware of, or should have been aware of; or
• had, or was intending to have, or would have had a medical consultation for,

in the two years prior to the date your cover commenced or recommenced under the Policy or the previous policy. 

Restricted Cover: 
You are only covered for an illness that first becomes apparent or an injury that first occurs, on or after the date cover commenced or recommenced and provided the injury or illness is not a Pre-Existing Condition. 

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8.17 Automatic Income Protection Insurance (SalarySafe)

This section 8.17 discloses the terms and conditions of default Income Protection (SalarySafe) Insurance cover that only applies to members who join  Hostplus through an employer who was previously a default employer of Club Super (Club Super Default Employer).The terms and conditions of that cover are disclosed in this section 8.17 of the document. 

SalarySafe Income Protection cover will be provided if you are an employee of a Club Super Default Employer. It provides you with 24 hours, 7 days a week income protection cover. It pays a benefit of up to 90% of your income, for the first 26 weeks of your claim (tapering applies thereafter) if you are unable to work in your usual occupation due to sickness or injury. 

In addition, a 10% Superannuation Guarantee contribution on the income protection benefit payable is paid into your super account, calculated on the amount of benefit you receive when you are on claim. The default waiting period is 28 days (the "Waiting Period") after you are injured or sick and cannot work for a period of time. Variable waiting periods are also available. 

You will automatically receive Income Protection cover when you become Eligible for Cover. You are not required to provide any evidence of health to receive this insurance cover. 

8.17.1 How is your premium calculated?

SalarySafe premiums are based on your employer SG contribution, multiplied by a premium rate of 11.83%. Your premium rate is tied to the relevant waiting period that applies; the longer your waiting period, the lower the premium rate – see section 8.17.6 What is the Waiting Period for further information.

Premium rates include stamp duty.

You automatically receive a 28 day waiting period unless you elect another waiting period.

8.17.2 When does SalarySafe cover start?

Cover for new members of Hostplus who are Eligible For Cover will commence from the first date of the relevant period that the first employer superannuation contribution after the member became Eligible For Cover represents and for which premiums are paid to the insurer or the date that the member became Eligible For Cover, whichever is the later, provided that this payment is made by the first quarterly deadline outlined in the superannuation guarantee (SG) legislation and:

1. the member has instructed their employer to have Hostplus as their superannuation fund for receiving SG payments on the commencement of new employment and the member is Actively At Work; or
2. the employer has nominated Hostplus as the default Fund for the purpose of complying with the SG legislation and for receiving SG payments on the commencement of new employment and the member is Actively At Work.

Where all the above conditions are not met, cover will commence from the first date of the relevant period that the first employer superannuation contribution payment made by a Hostplus Participating Employer after the member became Eligible For Cover represents and for which premiums are paid to the insurer or the date that the member became Eligible For Cover, whichever is the later, but will be limited to New Events cover only.

Recommencement of Cover

For those members of Hostplus where cover has ceased due to the member no longer being employed by a Club Super Default Employer and the member later recommences employment with a Club Super Default Employer and is Eligible For Cover, cover will recommence from the first date of the relevant period that the first employer superannuation payment made by the most recent Club Super Default Employer after the member recommences employment with the Club Super Default Employer represents or the date that the member became Eligible For Cover, whichever is the later, provided that this payment is made by the first quarterly deadline outlined in the SG legislation and the member is Actively At Work on their first day of employment.

For those members where the payment was not received by the first quarterly deadline, cover will recommence from the first date of the relevant period that the first employer superannuation contribution payment made by a Club Super Default Employer after the member recommences employment with the Club Super Default Employer represents or the date that the member became Eligible For Cover, whichever is the later, but will be limited to New Events cover only.

For those members where insurance ceased because
they ceased to be Eligible For Cover (due to PMIF) on 31 March 2020, or the member’s account becomes Inactive, cover will recommence either:

1. automatically if the member becomes Eligible For Cover. Cover will commence on the date Hostplus receives the superannuation contribution payment after the member became Eligible For Cover, but shall be limited to New Events cover only; or
2. if the member reapplies for coverage under this Policy by writing to Hostplus and requests to opt in for this insurance coverage. Cover will commence on the date Hostplus received the request to opt in for this insurance coverage, but shall be limited to New Events cover only.

Where an existing member cancels their cover under this Policy and the member later wishes to re-apply for cover under this Policy, their application for cover will be subject to acceptance by the insurer. If the insurer accepts the member’s application for cover, any cover will exclude Pre-Existing Sickness.

8.17.3 How much will my benefit be?

The maximum benefit payable is up to 90% of your income, for the first 26 weeks of your claim (tapering applies thereafter), plus a Superannuation Guarantee contribution of 10% of the value of the benefit payable. Benefit amounts will taper over the maximum 104 week period. You are only covered for the income earned from your Club Super Default Employer; this means that if you cease employment with a Club Super Default Employer you lose your SalarySafe cover, even if you commence employment with a non-Club Super Default Employer.

Please refer to 8.17.13 Can the SalarySafe benefit be reduced? and 8.17.8 Tapering for further information about your benefit.

8.17.4 How are SalarySafe benefits paid?

SalarySafe benefits are calculated weekly and paid fortnightly in arrears. You will receive one seventh (1/7th) of the weekly benefit for each day that you are unable to work due to sickness or injury.

Superannuation Guarantee contributions, received as part of your SalarySafe benefit, are paid to your Hostplus account quarterly.

8.17.5 When are SalarySafe benefits paid?

Your first benefit will be paid at the end of the first fortnight after the waiting period.

SalarySafe benefits are payable if you suffer Disablement.

Important definitions

The following terms are important. The insurance policy defines them as follows:

Actively At Work means you are employed by a Club Super Default Employer and, in the Insurer’s opinion, are genuinely performing all the duties of your usual occupation and capable of working your usual hours without restriction. A member who is on paid leave (including annual leave, sick leave, long service leave, parental leave) and all employer-approved unpaid leave shall also be considered to be actively at work provided:

• that leave is not in connection with an Injury or a Sickness; and
• they were Actively At Work for their usual hours without restriction the week prior to that leave.

A member who has a permanent impairment/Disablement prior to being an insured member will not be considered Actively At Work for that condition.

Club Super Default Employer means a Participating Employer registered as a ‘standard employer-sponsor’ of the Club Super superannuation fund (ABN 12 737 334 298) immediately prior to 1 November 2019.

Degenerative Condition means any condition that has gradually developed over time affecting your musculoskeletal system (muscles, bones, ligaments and joints, including vertebral discs and cartilage).

Disablement means Total Disablement or Partial Disablement.

Election means that the member has made a written request or positive election to Hostplus to be covered under the policy.

Eligible For Cover means a person who is a member of Hostplus and is currently not opted out for the SalarySafe insurance, is not Inactive and who satisfies sub-section ‘a.’ or ‘b.’ as applicable below:

1. For a person who became a member of Hostplus before 1 April 2020, a person who has had an account balance with Hostplus that was equal to or greater than $6,000 on or after 1 November 2019 or who has made an Election to receive cover even if the member has not had an account balance with Hostplus that was equal to or greater than $6,000 on or after 1 November 2019.
2. For a person who became a member of Hostplus on or after 1 April 2020, a person who is over the age of 25 and has an account balance with Hostplus that is equal to or greater than $6,000, or who has made an Election to receive cover even if the member is under the age of 25 or does not have an account balance with Hostplus that is equal to or greater than $6,000

Inactive means Hostplus has not received a contribution from any source into the member's account for a continuous period of 16 months ending on or after 1 July 2019, and the member has not made an Election to receive cover even if Hostplus has not received a contribution from any source into the member's account for a continuous period of 16 months ending on or after 1 July 2019.

Income means your average weekly income before personal deductions and income tax for the number of weeks you are employed during the 52 week period immediately preceding Injury or Sickness resulting in any events insured under this policy. “Income” includes all overtime and all allowances actually paid to you that have been earned from personal exertion at your usual employment from which you are a member of Hostplus.

Injury means a physical injury which occurs fortuitously whilst continuous cover is in force and which results in Disablement, within 12 calendar months from the date of its occurrence and which injury occurs prior to cover ceasing. Such Disablement must continue for a period of not less than the waiting period but does not include any condition which is also a Sickness. 

If a member suffers disablement through an aggravation of an injury which occurred prior to cover, a benefit will only be payable for the duration of the aggravation and not for the underlying injury. 

New Events means an Injury that first occurs or a Sickness that first becomes apparent on or after the date that cover commences or recommences (as applicable).

Partial Disablement means that as a result of an Injury or Sickness, the insured member is prevented from engaging in a substantial part of his or her usual occupation with the Club Super Default Employer in Australia. The insured member must be Actively At Work at the time the Injury or Sickness occurs and must be under the regular care, medically certified and acting in accordance with the instructions or professional advice of a medical practitioner.

Pre-Existing Sickness means any pre-existing sickness that an insured person is having or has had treatment for, or advice for treatment for in the 6 calendar months prior to the commencement of your income protection cover under the policy. However, such a condition will be covered provided that:

(a) the insured person, with the agreement of a legally qualified medical practitioner, ceased all treatment or advice for at least 6 months during continuous cover; or
(b) the insured person has had 2 years of continuous cover under SalarySafe prior to the time of Disablement and has been actively at work prior to the Disablement which leads to the claim.

Sickness means a state of being ill, including a Degenerative Condition resulting in disablement, which is first contracted or which the insured member first becomes aware of while continuous cover is in force and which continues for a period of not less than the waiting period and excludes any Pre-Existing Sickness and any injury.

Total Disablement means that as a result of Injury or Sickness the insured member is prevented from engaging in his or her usual occupation with the Club Super Default  Employer in Australia for which they are a member of Hostplus. The insured member must be Actively At Work at the time the Injury or Sickness occurs, and must be under the regular care, medically certified and acting in accordance with the instructions or professional advice of a medical practitioner.  

8.17.6 What is the Waiting Period?

The waiting period is the period of time (in consecutive days) that you have to be Disabled before you become eligible to receive a fortnightly income benefit. The waiting period commences from the date a medical practitioner certifies that you are Disabled. Hostplus’ default waiting period is 28 days if you do not make a choice. Variable waiting periods are available (see following table) and the longer the waiting period, the lower the fee.

Your first benefit will be paid at the end of the first fortnight after the waiting period ends.

Premium rates for Variable Waiting Periods

^The premium you pay is calculated by multiplying the premium rate by your total monthly (or total monthly equivalent) compulsory employer superannuation contribution.
*You automatically receive a 28 day waiting period unless you elect another waiting period.

Premium rates include stamp duty.

8.17.7 Loyalty Bonus

After 5 years continuous cover with no claims, your benefit will be backdated to commence 7 days prior to the last day of the waiting period). The maximum benefit payment period of 104 weeks still applies.

8.17.8 Tapering

Tapering applies to the Total Disablement benefit and Partial Disablement benefit, which means that the value of your Total Disablement and/or Partial Disablement benefit will reduce over time, as follows:
(i)  90%¹ of your income for the first 26 weeks of claim;
(ii) 75%¹ of your income for weeks 27 to 52; and
(iii) 65%¹ of your income for weeks 53 to 104.

1 Plus 10% of that benefit value as SG Contributions into your superannuation

For Partial Disablement the tapering applies in addition to any further reduction of benefit payable (see paragraph 8.17.20).

8.17.9 What is the maximum benefit period?

SalarySafe benefits are payable for a maximum period of two years or to the date you turn 65 years (subject to comments in section 8.17.10 below), whichever occurs first, commencing after the 28 day default waiting period. The waiting period starts on the date your legally qualified medical practitioner certifies you unfit to work for the condition.

If you turn age 65 while in receipt of a SalarySafe benefit, the remaining payment period depends on whether you are off work due to sickness or injury.

• If you are on claim due to sickness, you can receive an additional 12 weeks, to a maximum of 104 weeks total benefit payment period.
• If you are on claim due to injury, you can receive an additional 52 weeks, to a maximum of 104 weeks total benefit.

8.17.10 What if you are aged 65 to 70 when you make a claim?

The maximum benefit period in this case depends on whether your claim is due to sickness or injury:

• If your claim is due to Sickness, your maximum benefit period is 12 weeks, or to the date you turn 70, whichever occurs first; or
• If your claim is due to Injury, your maximum benefit period is 52 weeks, or to the date you turn 70, whichever occurs first.

8.17.11 What if you become self-employed?

As a self-employed member you would no longer be eligible for SalarySafe insurance cover. As a result:

• Your SalarySafe insurance cover will be cancelled;
• You will not be eligible to claim on any SalarySafe insurance cover from Hostplus; and
• If, at a future date, you are in receipt of valid employer contributions and wish to reinstate SalarySafe insurance cover you will be required to notify Hostplus in writing.

8.17.12 Can you cancel your SalarySafe cover?

If you prefer not to have insurance cover, you can elect to cancel your cover upon joining, or cancel it at any time online or by sending us an email at info@hostplus.com.au or by writing to us at the address below. You can also cancel your insurance by calling us on 1300 467 875.

HOSTPLUS
Locked Bag 5046
Parramatta NSW 2124

If you cancel your insurance cover and subsequently decide that you would like to re-apply for insurance cover down the track, you can do so by completing a new online insurance application online by clicking here. Any application for insurance made at this time will be subject to approval by the insurer and may require underwriting. Any cover accepted by the insurer will exclude Pre-Existing Sickness. We cannot reinstate your original cover once you have decided to cancel it.

If you cancel your insurance we are unable to refund the premiums paid up to the date you cancelled, unless your cancellation is received within 60 days of your cover first commencing.

8.17.13 Can the SalarySafe benefit be reduced?

Yes. Your SalarySafe benefit can be reduced in the following circumstances:

• SalarySafe benefits are reduced by the amount of any statutory benefit (e.g. Workers’ Compensation), sick leave payments or other not at work related payments from your Club Super Default Employer that you receive
• If your statutory benefit ceases but you are medically unable to return to work, your SalarySafe benefit will continue up to the maximum benefit period in respect to the Injury or Sickness for which you were receiving the statutory benefit. The payment will be 75% of the benefit, subject to any tapering – see section 8.17.8), provided you are assessed as unable to return to work by an Independent Medical Officer (arranged by the insurer)
• If you reach an agreement with the relevant Workers Compensation Insurer or Authority to cease weekly statutory benefits and instead receive a lump sum, the insurer will pay you a lump sum instead of future weekly benefits under SalarySafe, calculated as the lesser of:
  1. the Maximum Benefit Period, less any period of payments already made under SalarySafe cover, or
  2. the number of weeks used in the calculation of the lump sum payment by the Workers Compensation Insurer or Authority.
  Once determined, the benefit payable will be that number of weeks multiplied by the last payment made under your  SalarySafe benefit.

• If you are not covered by a Workers Compensation Scheme in the State that you work (for any reason), your SalarySafe benefits can be reduced by the value of the compensation that you would otherwise have been eligible to receive had you been covered by that State’s Workers Compensation Scheme
• If you are entitled to a benefit under SalarySafe through being unable to follow your usual occupation with your Club Super Default Employer but you continue to earn an income from another source or employer – for example you have a second job (provided that you were employed by that other employer prior to your Sickness or Injury) your SalarySafe benefits will not be reduced unless the total of the SalarySafe benefit payable plus the income derived from the other employment exceeds the value of your total income as at the date of Sickness or Injury. Should the total figure exceed the total income as at the date of Sickness or Injury then the excess portion of that income will be deducted from your SalarySafe benefit
• If you suffer an Injury or Sickness whilst you are on employer-approved unpaid leave, any benefits payable will only be paid once the employer-approved unpaid leave is due to cease.
• If you receive payments:
  • from your Club Super Default Employer or any person or entity that becomes your new employer after the date of your Sickness or Injury;
  • from a superannuation or pension fund, plan or scheme;
  • from any other insurance policy that covers disability, injury or sickness;
  • from any mortgage, credit card, bill payer or similar insurance policy;
  • from any workers compensation insurer, compulsory third party motor vehicle insurer or public liability insurer;
  • from any government authority or government instrumentality in the form of a pension or allowance;
  • by way of commission payments or remuneration relating to any period from which you are paid a SalarySafe benefit,
  then your SalarySafe benefit may be reduced by the value of such payment.     

A reduced benefit may be payable if you suffer Partial Disablement. See section 8.17.20 Partial Disablement.

Please contact Hostplus if you have any enquiries concerning these terms and conditions or if you need a copy of the Insurance Policy document.

8.17.14 When does SalarySafe cover cease?

SalarySafe cover will cease when any of the following occurs:

•  When you are no longer employed by a Club Super Default Employer; or
• On your 70th birthday; or
• On your death; or
• When we receive written advice from you that your SalarySafe cover is to be cancelled; or
• When you cease to be a member of Hostplus; or
• When you become self-employed and are no longer in receipt of valid employer contributions; or
• When you are employed as a casual employee with a Hostplus participating employer and your last day at work was greater than 90 consecutive days; or
• When all cover for every member under this Policy ceases, subject to Financial Services Council Guidance Note No. 11 - Group Insurance Takeover Terms; or
• On the date Hostplus terminates or fails to renew the Policy; or
• If premiums on behalf of you are no longer paid by Hostplus to the insurer. For the avoidance of doubt, this includes when premiums cease to be paid because a Club Super Default Employer ceases to make SG contributions to Hostplus in respect of you; or
• From the date insurance is turned off by Hostplus as a result of any legislation, including when you ceased to be Eligible For Cover due to PMIF, or when you become Inactive.

Where SalarySafe cover ceases for you, the insurer is not liable to pay a benefit in respect of you where the waiting period commences after the cover ceases for you.

If the waiting period in relation to you began before cover ceased, the insurer will be liable to pay a benefit in respect of you as a result of only that Injury or Sickness which occurred whilst continuous cover was in force for you, subject to the conditions of the Policy wording as if it were still in force for the period that you remain entitled to be paid a benefit under the conditions of the Policy. 

If the waiting period in relation to you began before cover ceased, as soon as you are Actively At Work the insurer will have no liability to pay any benefit in connection with that Injury or Sickness including any reoccurrence of the Injury or Sickness, subject to Financial Services Council Guidance Note No. 11 – Group Insurance Takeover Terms.

You may be eligible to apply for Non-default Income Protection cover. See Section 8.16.

If the insurer accepts your application for Non-default Income Protection cover, your SalarySafe cover will cease and you will become covered in accordance with the policy terms applicable to Non-default Income Protection cover and you will no longer be eligible to reapply for SalarySafe cover.

8.17.15 When will a benefit not be payable?

A benefit shall not be payable:

a) For the waiting period;
b) If the Sickness or Injury is work-related and the Sickness or Injury occurs whilst the member is working for a non-Club Super Default Employer;
c) In excess of the maximum benefit period in respect of any one injury or sickness;
d) Beyond the date of the member’s death;
e)  If the member fails to provide the requested medical information;
f)  If the member fails to follow medical treatment or advice. Any number of days where the member fails to follow medical treatment or advice will be deducted off the maximum benefit period;
g)   If a fraudulent claim is made in respect of the member;
h)  If the member is serving a prison sentence. Any number of days where the member is incarcerated will be deducted off the maximum benefit period;
i)  If the member agrees to commute their claim;
j)   If the member has previously accepted a TPD settlement for the same or related condition;
k)   If at the time of disablement, the member is not employed by Hostplus participating employer (subject to Continuation of cover upon cessation of employment terms below);
l)  Under more than one of the benefits in respect of the same period of time (i.e. a benefit can only be paid for either an Injury or a Sickness, but not both);
m)   Once the member is deemed fit to return to work by a medical practitioner;
n) For an injury that first occurs or a sickness that first becomes apparent prior to the date the member of the Club Super Default Employer provided an instruction to their employer to have Hostplus as their chosen superannuation fund; or
o)  If the member suffers a work related injury/sickness by another employer who is not a Hostplus participating employer.

8.17.16 Continuation of cover upon cessation of employment

If you are leaving your employer to join another Club Super Default employer, extended cover may be available. In this case, SalarySafe cover continues for no longer than 30 days from the date you cease employment with your current employer, provided you have accepted a position with another Club Super Default employer that contributes to Hostplus within those 30 days.

Cover may also continue for up to 7 days where a member has had medical treatment and advice within 30 days prior to ceasing employment with a Club Super Default Employer. The member will be covered for an injury or sickness whilst continuous cover was in place and suffers a disablement for that condition within that 7 day period.

8.17.17 Continuation of cover for employed members subject to ongoing SG contributions

In practice, your cover will show as current on your Hostplus Member Online account and annual member statement for up to 90 days after the period for which your last employer SG contribution relates to.

However, please note, you will only be actually covered for any period for which your employer makes an SG contribution to your Hostplus account.

8.17.18 Are there any Exclusions?

This Policy shall not apply to any Injury or Sickness  directly caused by or resulting from:

• Any consequence of war, invasion or civil war;
• Intentional self-inflicted injury or sickness, including any attempt at suicide;
• Pregnancy, childbirth or miscarriage other than:
• No benefits shall be payable during any period of parental leave.
• Any Pre-Existing Sickness - (as detailed below);
• Any criminal act committed by an insured member;
• An insured member being a pilot or crew member of any aircraft; or engaging in any aerial activity except as a passenger in a properly licensed aircraft;
• Any professional sporting activities where you earn more than 50% of your annual gross income from that activity; or
• For any claim where the date of Disablement occurs prior to 1 October 2020:
  An insured member suffering from:
  • Any psychological conditions; and/or
  • Stress related conditions; and/or
  • Stress related physical fatigue conditions,
  including but not limited to depression, neurosis, psychosis, mental or emotional stress or anxiety conditions, chronic fatigue or mental disease and associated disorders, unless the insured member is in receipt of Workers' Compensation benefits for that condition.

To avoid doubt, this exclusion will not apply to any claim where the date of Disablement occurs on or after 1 October 2020.

8.17.19 Pre-Existing Sickness

No cover is available in respect of any Pre-Existing Sickness that you have or have had treatment for, or advice for treatment prior to the commencement of your income protection cover under the policy. However, such a condition will still be covered provided that: 

(1) You have, with the agreement of a legally qualified medical practitioner, ceased all treatment or advice for at least 6 months during continuous cover; or
(2) You have had 2 years of continuous cover under SalarySafe prior to the time of your disablement and have been actively at work prior to the disablement which leads to the claim.

For full terms and conditions, refer to the policy document.

If you suffer Disablement through an aggravation of an Injury which occurred prior to cover commencing, the benefit will only be payable for the duration for the aggravation and not for the underlying Injury.

8.17.20 Partial Disablement

If, during the period of disablement, you are able to return to work in a reduced capacity, the SalarySafe benefit will be calculated as the difference between the weekly SalarySafe benefit and the weekly earnings received from the reduced work capacity multiplied by the SalarySafe benefit for total disablement.

If an insured member is able to return to work in a reduced capacity, and work is available but the member declines to do so or the member is no longer employed by a Hostplus participating employer, then the SalarySafe benefit will be reduced to 25% of the SalarySafe benefit for total disablement.

8.17.21 Recurrence of Total or Partial Disablement

If you suffer a recurrence of disablement (or require reconstructive surgery) from the same or related cause, the subsequent period of disablement will be deemed a continuation of the prior period and the waiting period shall be waived.

The Insurer will not liable to pay a benefit relating to any further disablement caused by the same or related injury or sickness once the Maximum Benefit Period expires.

8.17.22 Rehabilitation Benefit

If you have been receiving a SalarySafe benefit, the insurer may improve your ability to return to work by a course of rehabilitation. The insurer may pay the cost of the program. Before the insurer would make such a payment, both they and your treating doctor must first approve the course.

8.17.23 Taxation

The SalarySafe benefit payable to you is regarded as taxable income and attracts Pay-As-You-Go (PAYG) tax, the same as your wages or salary. PAYG tax will be deducted from the benefit before it is paid to you. You cannot claim a tax deduction for the fees because SalarySafe cover is offered through a superannuation fund.

If you receive a SalarySafe benefit, you will be asked to provide your Tax File Number (TFN). If you do not provide your TFN, the insurer will have to deduct tax from your benefit at the maximum marginal tax rate.

These statements in relation to taxation are based on interpretation of present Australian tax law, which may be changed at any time. For advice on your own circumstances, you should always seek professional taxation advice.

8.17.24 Making an insurance claim?

If you or your beneficiaries need to lodge an insurance claim with Hostplus please call us on 1300 467 875. We have a dedicated Claims Team who will assist you every step of the way with your claims enquiry and documentation required - at no cost to you - so there is no need for you to engage a third party person to do this on your behalf.

8.17.25 Duplicate accounts

You are only eligible to retain insurance in one account. Where you have multiple accounts, you will retain cover in the account with the highest level of insurance and the account with lower insured amount will be closed. If you have an account with default Income Protection (SalarySafe) insurance cover (as defined in 8.17) and a separate account with non-default Income Protection insurance cover (as defined in 8.16), Hostplus will contact you to discuss your options. Any overpaid premiums will be refunded to you. Your insurance cover will automatically be transferred once your accounts have been merged unless you tell us otherwise. You must inform us immediately if you have more than one account with Hostplus. 

Please note that if you are an existing member and have a duplicate account or have joined another division of Hostplus you are not entitled to the 8.4 Special insurance offer on joining for new members.

The information in this Section contains general advice only and does not take into account your personal objectives, financial situation or needs. You should consider if this information is appropriate for you in light of your circumstances before acting on it. You may also find it beneficial to obtain advice from a licensed financial adviser. Past performance is not a reliable indicator of future performance.

Host-Plus Pty Limited ABN 79 008 634 704, AFSL No. 244392, RSEL No. L0000093, MySuper No. 68657495890198, Hostplus Superannuation Fund ABN 68 657 495 890, RSE No. R1000054.

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