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InsuranceEmploye pooed membe
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The Product Disclosure Statement or employer-sponsored members (including members employed
under Police Blue Ribbon and Ambulance Ofcers Super arrangements) comprises a coreMemberBooklet and a number o Member Booklet Supplements. The Member Booklet Supplement Insurance (this document) provides additional inormation that supplements the insurance inormation
contained in the Member Booklet.
DEATH AND TPD COVER
About your automatic cover page 2Thi ectio decibe the automatic cove povided to employe pooed membeof Fit state supe.
Start-up bonus page 7
Transerring cover to First State Super page 8
Additional death and TPD cover page 9
Restrictions on automatic cover page 11
Interim accident cover or death and TPD page 11
Beneft payments page 11
Opting out, reducing, terminating or ceasing cover page 12
INCOME PROTECTION
Applying or income protection page 13
Start up bonus page 14
Transerring cover to First State Super page 15
What income protection covers you or page 15
Interim accident cover or income protection page 18
Claiming a beneft page 18
Limitations and exclusions page 18
The cost o income protection page 19
Termination or cessation o income protection cover page 20
GLOSSARY page 22
Reading this SupplementFit state supe death, total ad pemaet diablemet (TPD) ad icome potectio iuace i offeed toFit state supe membe though TOWEr utalia Limited (Bn 70 050 109 450, FsL 237848) (the Insurer).Thi Member Booklet supplemet povide you with geeal ifomatio about thee iuace aagemet adthe ifomatio doe ot take ito accout you pecic eed. You hould coide the ifomatio havig egadfo you peoal cicumtace. t i ecommeded that you coult a liceed o authoied acial advie if youequie acial advice which take ito accout you peoal cicumtace.
ll iuace cove povided by Fit state supe i ubject to the tem ad coditio cotaied i the iuacepolicie iued by the ue ad the tem ad coditio of the policie pevail ove ay icoitecy i thisupplemet. The iuace ifomatio povided i thi Membe Booklet supplemet i baed o the policieiued to the Tutee by the ue, ad ifomatio povided by the ue about the opeatio of thoe policie.
The ue ha give ad ot withdaw it coet fo thi ifomatio to be icluded i thi Member Bookletsupplemet i the fom ad cotext i which it appea. The ue take o epoibility fo ay othe ifomatiocotaied i the Member Booklet o thi Membe Booklet supplemet. Whe eadig thi upplemet, pleae otethat udelied wod have a paticula meaig ude the iuace policie. Thee wod o expeio aeexplaied i the Glossaryo page 22. refeece to we/u ae efeece to Fit state supe.
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When does cover start?
Povided you ae eligible, you automatic cove will
commece o the date you commece employmet
with a Fit state supe paticipatig employe if we
eceive the t sG cotibutio made fo you by that
employe withi 180 day of commecig employmet.
f you ae eligible, ad we eceive you t sG
cotibutio fom you Fit state supe paticipatig
employe moe tha 180 day afte you commeced
employmet, you cove will commece whe we
eceive you t sG cotibutio.
When does cover cease?
You death ad, if applicable, TPD cove i Fit state
supe will ceae whe ay of the followig occu:
you membehip with Fit state supe ceae;
thee i ot eough moey i you accout to cove
the cot of you cove;
you each age 70 (o 69 i the cae of temial ille
cove);
a death, temial ille o TPD beet i paid o
payable fo you full cove ude the iuace policy
iued by the ue to the Tutee;
if you have ay eidual death cove afte paymet
of a temial ille o TPD beet, the date thi
eidual death cove i paid o payable fo you ude
the iuace policy iued by the ue to the
Tutee;
you commece militay evice (othe tha i the
utalia med Foce reeve if you ae ot o
active duty outide utalia)*; o
the date we eceive you witte equet to cacel
you cove.
additio, cove may ceae with the ue ude
cicumtace outlied ude the ectio Termination of
the policyo page 12.see the ectio Opting out, reducing, terminating or
ceasing covero page 12 fo ifomatio o whe cove
may ecommece o cotiue, if cove ceae becaue:
thee i iufciet moey i you accout; o
you commece militay evice.
* t i impotat that you otify u if you commece militay eviceo, if you ae i the utalia med Foce reeve ad youcommece active duty outide utalia. You ca alo apply at thattime fo you cove to cotiue. The ue may accept (with owithout coditio) o eject you applicatio.
Death ad TPD cove
About your automatic cover a membe of Fit state supe Employe
spooed Diviio, you may automatically eceive
iuace to cove you fo death, (which iclude cove
fo temial ille) ad total ad pemaet diablemet
(thi i efeed to a TPD). utomatic cove i ubject to
eligibility, a explaied below.
The cot of cove (deducted fom you accout) ad
the value of ay iuace beet paid (if you claim
i accepted) ae calculated o a pe uit bai. The
automatic cove i 3 uit of death ad TPD cove. You
ca opt out o educe you uit of automatic cove, o
chage you uit of death ad TPD cove to death oly
cove. refe to page 12 fo futhe ifomatio.
Eligibility
To be eligible fo automatic cove to commece you
mut be a ew membe of Fit state supe, aged
ove 15 ad le tha 70 yea of age, ad you
employe mut be a Fit state supe paticipatig
employe makig you upeauatio guaatee (SG)
cotibutio to Fit state supe.
additio, you automatic cove will be eticted if:
you have peviouly bee paid a total ad pemaet
diablemet type beet fom ay fud (icludigFit state supe) o iue, o
we do ot eceive a sG cotibutio fo you
fom you Fit state supe paticipatig employe
withi 6 moth of you commecig wok with that
employe.
see page 11 fo a explaatio of thee etictio.
Cost o automatic cover
The cot of automatic cove i:
$5.00 pe moth pe uit of death ad TPD cove;
ad
$2.38 pe moth pe uit of death oly cove.
Thi amout i deducted mothly fom you upe
accout.
Fom 1 July 2011, $0.10 of the cot of each uit of
death ad TPD cove, ad $0.05 of the cot of each uit
of death oly cove, will be etaied by Fit state supe
to offet cot i admiiteig TPD ad death beet
ad claim.
Fit state supe eceive a tax deductio fo iuace
pemium. Thi tax deductio i paed o to you afte
the ed of the acial yea.
The cot of automatic cove may iceae i the futue.f thi happe, you will be otied at leat 30 day
befoe the chage i implemeted.
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Category/RatingDescription o employees duties
Public sector Private sector
ducation andpublic service
White Collar Pedomiatly ofce-baed, icludig pofeioal uch a accoutat o lawyead othe occupatio uch a teache o othe tetiay educated people who wok iedetay poitio.
Governentradingnterrie
ight manual not puely ofce-baed ad ot oly i edetay ole. Occupatioal dutie ae ot of amaual atue o withi a hazadou eviomet. some tade upevioy ole alo fallito thi categoy. The Health ecto fall withi thi atig.
ergency
service
manual Motly maual occupatioal dutie icludig occupatio uch a tademe, ecuity
guad ad maufactuig type of occupatio, icludig appetice.
Heavy manual Heavy maual occupatio ad dutie i hazadou eviomet, icludig occupatiouch a cleae.
aic plu You mut apply ad be accepted by the ue to be i the Baic Plu categoy. Youmay be eligible fo the Baic Plu iuace categoy if you wok i a low-ik cleical omaagemet occupatio ad you ea moe tha $80,000 a yea (icludig sG). The$80,000 pe yea may be adjuted o a po-ata bai if you ae a pat-time employee. Toapply fo the Baic Plu iuace categoy cotact utome sevice o go to the webitefo a applicatio fom.
I you change employers
f you chage employe, you iuace atig cabe the moe favouable of you old employe ad
you ew employe. f you chage employe, make
ue that you complete the Insured members change
of employment advice fom available o ou webite
www.ttateupe.com.au o fom utome
sevice by callig 1300 650 873.
What is your insurance rating?
The value of you iuace beet deped o you
iuace atig ad you age. Fo automatic cove, you
iuace atig i you Fit state supe paticipatig
employe categoy it i ot baed o you paticula
occupatio. Each employe i give a employe
categoy by the ue, baed o the aveage dutie of
all employee of that employe. f you ae uue of you
employe categoy fom Table 1 below, check you
membe tatemet o cotact u to d out. see If you
change employers below fo moe ifomatio.
f you have moe tha oe Fit state supe paticipatig
employe, you iuace atig fo automatic cove will
be the moe favouable of you employe categoie.
While you iuace i automatically ated accodig
to you employe categoy, if you ae employed i a
low-ik cleical o maagemet occupatio you ca
apply to be i the Baic Plu iuace categoy. f you
applicatio to be i the Baic Plu categoy i accepted
by the ue, you may be eligible to eceive a lage
beet.
You ca apply to be occupatioally ated fo all cove.
You applicatio will eed to be aeed ad accepted
by the ue. TheApplication to change insurance
category rating fom i available o ou webite at
www.ttateupe.com.au ude Publications and
forms o by callig utome sevice o 1300 650 873.
Table 1: Category/Rating Description o employees duties
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How much is the beneft?
Table 2 below how the beet payable fo each iuace atig fo each uit of cove. remembe, if you aeeligible, you will automatically eceive 3 uit of death ad TPD cove. You ca educe you uit of automatic
cove, o chage you uit of death ad TPD cove to death oly cove. refe to page 12 fo futhe ifomatio.
Table 2: $ cover per unit per Insurance Rating
ating/Category(Public sector)
Education andPublic Service
Government TradingEnterprise and Health Emergency Services
Basic Plusating/Category(Private sector)
WhiteCollar
LightManual
Manual / HeavyManual
Age o member (years)* $ cover per unit $ cover per unit $ cover per unit $ cover per unit15 127,911 83,629 69,072 129,190
16 127,911 83,629 69,072 129,190
17 127,911 83,629 69,072 129,190
18 127,911 83,629 69,072 129,190
19 127,911 83,629 69,072 129,19020 127,911 83,629 69,072 129,190
21 127,911 83,629 69,072 129,190
22 127,911 83,629 69,072 129,190
23 127,911 83,629 69,072 129,190
24 127,911 83,629 69,072 129,190
25 127,911 84,786 69,072 129,190
26 127,911 85,641 69,072 129,190
27 127,911 86,979 69,072 129,190
28 127,911 86,979 69,072 129,190
29 127,911 86,979 69,072 129,190
30 127,911 86,979 69,072 129,190
31 127,911 86,979 69,072 129,190
32 127,911 86,979 69,072 129,190
33 127,911 86,979 69,072 129,190
34 127,911 86,979 69,072 129,19035 127,911 86,979 69,072 129,190
36 124,865 84,908 67,366 127,143
37 121,820 82,837 65,783 125,992
38 119,992 81,619 64,808 123,562
39 112,074 76,259 60,544 120,875
40 102,328 71,500 55,306 112,561
41 100,812 68,579 54,518 105,296
42 91,527 65,191 49,478 91,527
43 82,242 56,166 44,437 82,242
44 72,956 49,610 39,529 72,956
45 63,671 43,243 34,488 63,671
46 55,712 37,135 30,244 55,712
47 47,753 32,499 25,866 47,753
48 41,121 27,989 22,152 41,366
49 35,815 24,407 19,499 39,556
50 31,172 21,091 16,780 37,606
51 30,861 19,624 16,588 41,963
52 26,232 17,611 14,196 39,209
53 22,374 15,276 12,190 35,968
54 20,060 13,502 10,801 32,890
55 17,745 12,036 9,567 29,650
56 15,430 10,570 8,410 26,247
57 13,347 9,104 7,175 22,845
58 11,033 8,149 6,018 18,632
59 8,950 6,309 4,706 14,906
60 7,870 5,433 4,243 12,476
61 6,712 4,556 3,626 10,369
62 6,095 4,162 3,240 8,101
63 5,555 3,780 2,932 7,615
64 4,706 3,286 2,469 5,995
65 4,706 3,286 2,469 5,99566 4,706 3,286 2,469 5,995
67 4,706 3,286 2,469 5,995
68 4,706 3,286 2,469 5,995
69 4,706 3,286 2,469 5,995
Death ad TPD cove (cot.)
* eticted deitio of total ad pemaet diablemet applie fom age 65
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Circumstance Eect on your beneft amount
f you have eight o moe yea of cotiuou cove You death (ad temial ille) beet amout fo each
uit of automatic cove will iceae by 5% (fo a maximum
of 3 uit).
f you pemaetly loe:
the ue of two limb (whee a limb i a whole
had o foot), o
the ight of both eye, o
the ue of oe limb ad the ight of oe eye.
You TPD beet amout fo each uit of automatic death
ad TPD cove will iceae by 25% (fo a maximum of
3 uit).
Increased beneft payments
ome cicumtace, you may eceive a iceaed beet paymet. Thee cicumtace ae et out i Table 3 below.
Table 3: Increased Beneft
When will you receive a beneft?
f you have automatic cove, you will be etitled to
eceive a beet paymet if you die, you ae diagoed
with a temial ille o, if you have TPD cove, you
become totally ad pemaetly diabled while you
iuace cove i i foce. Temial ille ad totally
ad pemaetly diabled ae tem deed i the
iuace policy ad you mut meet cetai coditio
to be etitled to thee beet. Both thee tem ae
explaied i Table 4 o page 6. Befoe a paymet of aclaim ca be made it mut be appoved by the ue
ad the Tutee.
You ae epoible fo ay cot aociated with
completig ad povidig the claim fom (icludig
ogoig claim fom) ad ay aociated documet
that the ue eaoably equie fo the aemet
of you claim. You may alo be aked, at you expee,
to povide othe evidece that the ue eaoably
equie to ubtatiate you claim.
The ue may equie you to atted (at it expee)
ay medical examiatio by a medical pactitioe
o othe health pofeioal that it omiate, ad/
o to udego tet, that it coide eceay to
ubtatiate you claim.
uace beet ae paid to Fit state supe o
you behalf. f a temial ille o TPD beet i paid,
you will eed to atify a coditio of eleae ude
upeauatio law to eable Fit state supe to pay
you upe accout balace ad you iued beet to
you. pplicable tax will be deducted fom a TPD beet.
f you do ot atify a coditio of eleae, Fit state
supe i ot able to eleae the beet to you but will hold
it a pat of you upe accout balace. The coditio
of eleae ude upeauatio law ae decibed i
the Member Booklet Supplement: Accessing your super
available o ou webite www.ttateupe.com.au o
fom utome sevice by callig 1300 650 873.
Death beet paymet ae paid to you Fit state
supe accout ad ditibuted togethe with you
upeauatio accout balace.
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Table 4: Defnitions o terminal illness and total and permanent disablement
Terminal illness de the iuace policy, temial ille mea:
a) a appopiate pecialit medical pactitioe pecialiig i you ille cetie i witig that,depite eaoable medical teatmet, you ae uffeig a ille that will lead to you deathwithi 12 moth of the date of the ceticatio, ad
b) the ue i atied, o medical o othe evidece, that depite eaoable medicalteatmet, the ille will lead to you death withi 12 moth of the date of ceticatio.
You mut have death cove o the date of the ceticatio ad the ue mut be atied thatthe ceticate i cuet at the time the claim i lodged.
Total and permanent
disablement or totally
and permanently
disabled
de the iuace policy, total ad pemaet diablemet, o totally ad pemaetlydiabled, mea:
1. f, at the icidet date, you ae aged le tha 65 ad employed o elf-employed, o havebee uemployed fo 12 moth o le, you ae eligible to be aeed ude paagaph (i),(ii), (iii), (iv), ad (v) below.
2. f, at the icidet date, you have bee uemployed fo geate tha 12 moth, o you aeaged 65 o moe, you ae eligible to be aeed ude paagaph (i), (iii), (iv), ad (v) below.
3. f, at the icidet date, you ae olely egaged i dometic dutie, you ae eligible to beaeed ude paagaph (i), (iii), (iv), ad (vi) below.
(i) you uffe the pemaet lo of ue of 2 limb o the ight of both eye o the lo of ue ofoe limb ad the ight of oe eye (whee limb i deed a the whole had o the whole foot);
(ii) you have bee abet fom you occupatio though ille o ijuy fo 3 coecutive moth(whee you coditio i uclea, it i eaoable to defe aemet) ad you have povidedpoof to the atifactio of the ue that you have become icapacitated to uch a exteta to ede youelf ulikely eve to egage i o wok fo ewad i ay occupatio o wokfo which you ae eaoably qualied by eao of educatio, taiig o expeiece;
(iii) though ille o ijuy, you ae pemaetly uable to pefom 2 of the followig 6 activitieof daily livig uaided ad you have povided poof of thi to the atifactio of the ue:
1. Bathing to howe o bathe;
2. Dressing to de o ude;
3. Toileting to ue the toilet icludig gettig o ad off;
4. Feeding to eat ad dik;
5. Mobility to get out of bed o chai o wheelchai; o
6. Continence to cotol bladde ad bowel fuctio.
f you ca pefom the activity by uig pecial equipmet, you will be coideed able toudetake that activity uaided.
(iv) though ille o ijuy, you uffe fom the pemaet deteioatio o lo of itellectualcapacity ad poof to the atifactio of the ue ha bee povided that you have beeequied to be ude the cotiuou cae ad upeviio by aothe adult peo fo acotiuou peiod of 6 moth o moe followig the icidet date ad that thi cae i likely tobe o a pemaet daily ad ogoig bai.
(v) you have become o diabled by ille o ijuy that the ue i atied that you ae:
pemaetly uable to pefom at leat 2 of the followig 5 eveyday wokig activitiewithout the phyical aitace of aothe peo, depite the ue of appopiate aitiveaid, ad thi pemaet iability ha lated fo a cotiuou peiod of 6 moth o moefollowig the icidet date; ad
you ae ulikely eve to etu to gaiful employmet.
The eveyday wokig activitie ae Mobility, Communicating, Vision, Lifting ad ManualDexterity, each of which i explaied a follow:
a) uable to pefom Mobilitymea:
. you caot walk moe tha 200m o a level uface without toppig due tobeathlee o evee dicomfot; ad/o
. you caot bed, keel o quat to pick omethig up fom the oo ad taighte upagai afte bedig, keelig o quattig; o ca you get i ad out of a tadadeda ca.
Death ad TPD cove (cot.)
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Claims while you are overseas
f you ae ot i utalia whe you claim total ad pemaet diablemet o temial ille, you may be
equied to etu to utalia at you expee fo aemet of you claim.
Start-up bonus coverStart-up bonus units
You have a limited oppotuity to apply fo up to 3 uit
of exta cove (tat-up bou uit) o top of you
3 uit of automatic cove without povidig the ame
level of detail about health ad lifetyle a i equied i
a odiay applicatio.
Who can apply?
You ca apply fo the tat-up bou uit if:
you have automatic cove ad you have ot
peviouly educed it; ad
we eceive you t sG cotibutio made by you
Fit state supe paticipatig employe withi 6
moth afte you tated wok with that employe;
ad
you ae at wok at the time of applicatio.
The application process
To be coideed, you completed Start-up bonus cover for
new employer-sponsored members fom attached to thi
upplemet (alo available at www.ttateupe.com.au o
fom utome sevice by callig 1300 650 873) mut be
eceived by u withi 180 day of u eceivig you t sG
cotibutio made by you Fit state supe paticipatig
employe. You applicatio may be accepted o ejected
by the ue. Howeve, while you applicatio i beig
coideed, you will be eligible fo iteim accidetcove ee page 11.
I your application is accepted
f you applicatio i accepted, you cove will iceae fom
3 to up to 6 uit, depedig o the umbe of additioal
uit you have applied fo. The exta uit will be at the ame
iuace atig a you automatic cove. The cot of the
exta uit will be the ame a each uit of you automatic
cove i.e. $5 pe moth (o $2.38 pe moth if you apply fo
death oly cove). f you applicatio i accepted, you cove
(i epect of the tat-up bou uit) commece o the
date of acceptace.
Total and permanent
disablement or totally
and permanently
disabled (cont.)
b) uable to pefom Communicating mea:
. you caot peak i you t laguage o that you ae udetood i a quiet oom; oca you hea (with o without a heaig aid o othe aid) a ituctio give i aomal voice i you t laguage i a quiet oom; ad/o
. you caot udetad a imple meage i you t laguage, ad elay thatmeage to aothe peo.
c) uable to pefom Vision mea you caot, with o without glae o cotact lee, eadodiay ewpit, o ca you pa the tadad eyeight tet fo a ca dive licece.
d) uable to pefom Lifting mea you caot lift, cay o move object weighig 5kg uigeithe o both had.
e) uable to pefom Manual Dexteritymea you caot ue eithe o both had o youge to maipulate mall object with peciio (uch a pickig up a coi o fateighoelace o butto, uig cutley, o uig a pe o keyboad to wite a hot ote).
(vi) a a eult of ille o ijuy, you:
ae ude the egula cae of a medical pactitioe; ad ae uable to pefom omal dometic dutie; ad
ae uable to leave you home uaided; ad
have ot egaged i ay employmet fo a peiod of 6 coecutive moth; ad
at the ed of 6 moth, you have povided poof to the atifactio of the ue that you havebecome icapacitated to uch a extet a to ede youelf likely to equie ogoig medicalcae ad be ulikely eve to egage i dometic dutie o ay gaiful employmet.
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Example 1Joh, aged 40 ad with a alay of $105,000,
eceive 3 uit of automatic death ad TPD
cove ad i accepted fo 3 tat-up bou uit.
Joh alo applie ad i accepted fo the baic
plu occupatio atig. Joh 6 uit of cove
would be woth 6 time $112,561 pe uit o a
total of $675,366. t the ame time a applyig
fo the tat-up bou uit, Joh ca alo apply
fo $324,634 additioal cove ($1,000,000 miu
$675,366 a maximum of 10 time alay o
$1,000,000, whicheve i le, applie) uig a
implied applicatio.
Note: The above example i illutative oly ad i baed othe facto tated. t hould ot be take to cotai o povidea etimate of the pemium payable by you.
Death ad TPD cove (cot.)
Start-up additional bonus cover
Whe applyig fo the tat-up bou cove, ad
uig the ame fom, you may alo apply fo additioal
tat-up bou cove (above the total of 6 uit, but
ubject to a maximum of 10 t ime alay o $1,000,000,
whicheve i le) without povidig the ame level of
detail about health ad lifetyle a i equied i a
odiay applicatio.
f you ae eligible to apply fo the tat-up bou uit,
you ca apply fo additioal tat-up bou cove if you:
have ot had death o total ad pemaet
diablemet type cove declied o excluded i the
pat fom ay fud (icludig Fit state supe) oiue; ad
have ot had a total ad pemaet diablemet
type beet fom ay fud (icludig Fit state
supe) o iue accepted o declied.
You applicatio may be accepted o ejected by the
ue. While you applicatio i beig coideed, you
will be eligible fo iteim accidet cove ee page 11.
f you applicatio i accepted, you additioal bou
cove commece o the date of acceptace.
Transferring cover toFirst State SuperYou may, afte joiig the Fud, apply to have up to
$10 millio i death ad up to $5 millio i TPD cove
that you may have i aothe life policy i you ame
(previous insurance), tafeed to Fit state supe.
You ca oly tafe cove if:
you ae at wok o the day immediately pecedig
the day that the tafe, if accepted by the ue,
i due to tat i the Fud; ad
you have ot had a applicatio fo life, total ad
pemaet diablemet type beet, o icome
potectio iuace declied; ad
you ae ot eligible, have ot eceived, o ae
applyig fo a total ad pemaet diablemet
type beet, a pemaet o tempoay icapacity
beet, temial ille beet o a icome
potectio beet fom woke compeatio, ay
upeauatio fud o life iuace policy; ad
you have ot bee diagoed with a temial ille;
ad
you have ageed ot to execie ay cotiuatio
optio ude the peviou iuace o had cove
eitated ude that iuace; ad you agee that you cove ude the peviou
iuace will ceae o acceptace of you tafe
cove by the ue; ad
the ue ha bee povided with atifactoy
evidece of ay coditio o etictio which
applied ude the peviou iuace.
f ay idividual etictio, coditio, pemium
loadig o excluio wee impoed ude the peviou
iuace, they may alo apply to the tafeed cove.
Thi tafe amout i i additio to you exitig Fit
state supe automatic cove ad the total i ubject to
the maximum cove limit.
To apply to tafe you cove, you oly have to
povide limited ifomatio about you health, icome,
occupatio, lifetyle ad patime. You applicatio
will the be aeed by the ue. The cot o the
value of uit tafeed will deped o you iuace
atig; i.e. you employe employe categoy, o you
occupatio categoy, whicheve i the moe favouable.
The applicatio fom to tafe cove ca be foud
at the back of thi upplemet ad i alo available at
www.ttateupe.com.au o fom utome sevice
by callig 1300 650 873.
Note: You hould wait fo ou witte comatio of the tafe ofcove befoe cacellig ay peviou iuace.
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Additional death and TPD coverFuthe additioal cove fo death ad TPD o death oly
(ot icludig tat up bou cove) ca be eithe:
Unit based cover (whee the beet amout
deped o you age ad you iuace atig); o
Fixed cover (whee the beet amout i xed,
egadle of you age).
What is the maximum cover?
The maximum amout of iuace cove i:
ulimited cove fo death; ad
$5 millio fo temial ille, ad
$5 millio fo TPD.
What is the cost?
Table 5: Cost o Additional Cover
Type o cover Death & TPD Death only
it baed $5 pe uitpe moth
$2.38 pe uitpe moth
Fixed cove Deped o you age, the amout of cove, ad the applicable iuaceatig (you employe categoy ooccupatio categoy).
The cot of you iuace i deducted fom you Fitstate supe accout each moth i aea. f you otify
u that you wih to educe o opt out of cove, the
amout deducted will be educed o ceae o the day
afte the ext paymet i due.
The cot of uit baed o xed cove may iceae i
the futue. f thi happe, you will be otied at leat
30 day befoe the chage i implemeted.
e the calculato o ou webite to calculate the cot
of xed cove. example of calculatig the cot of xed
cove i icluded o page 11.
The application processThe applicatio fom fo additioal cove i attached
to thi upplemet (ad i alo available at
www.ttateupe.com.au o fom utome
sevice by callig 1300 650 873).
Whe you apply fo additioal cove, you will eed to
povide ifomatio about you health, occupatio,
icome ad lifetyle. The ue may, at it dicetio,
accept you applicatio (with o without coditio) o
eject it. While you applicatio i beig coideed, you
will be eligible fo iteim accidet cove (ee page 11).
When does cover start?
f you applicatio i accepted, you additioal cove
commece o the date of acceptace.
When does cover cease?
You additioal cove will ceae ude the ame
cicumtace a you automatic cove (ee page 12).
Your insurance rating
like automatic cove, you iuace atig fo
additioal cove ca be baed o eithe you employe
categoy (ee page 3) o you paticula occupatio.
You iuace atig fo you additioal cove will be
whicheve i moe favouable to you.
moe favouable iuace atig could mea you
pay le i pemium (if you have xed cove) o you
will be eligible fo a highe iuace beet (if you
cove i uit baed).
f you do ot apply to have you cove occupatioally
ated ad if you occupatio categoy i moe favouable
tha you employe iuace categoy, (ad you
have ot bee accepted fo the baic plu iuace
categoy) the beet that you would eceive fo each uit
of additioal cove may be highe tha the beet you
would eceive fo each uit of automatic cove.
f you chage you employe o you occupatio, you
may be able to apply to impove you iuace atig.
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Death ad TPD cove (cot.)
Calculating the cost o fxed cover
ig Table 6 below:
1. Wok out you aual pemium pe $1,000 of cove,
takig ito accout you age, you iuace atig
ad whethe the cove i death ad TPD, o death
oly.
Table 6: Annual premium per $1000 o cover
2. Multiply by the umbe of $1,000 of cove you
wih to apply fo (you xed cove amout divided
by $1,000)
3. Divide the aual pemium by 12 fo you mothly
pemium.
Rating/Category(Public sector)
Education andPublic Service
Government TradingEnterprise and Health
Emergency Services Basic Plus
Rating/Category(Private sector)
White Light manual Manual/Heavy manual Basic Plus
Age Attained* Death Only Death & TPD Death Only Death & TPD Death Only Death & TPD Death Only Death & TPD
15 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4616 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4617 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4618 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4619 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4620 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4621 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4622 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4623 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4624 0.22 0.46 0.33 0.70 0.40 0.85 0.22 0.4625 0.22 0.46 0.33 0.69 0.40 0.85 0.22 0.4626 0.22 0.46 0.33 0.69 0.40 0.85 0.22 0.4627 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4628 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4629 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4630 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.46
31 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4632 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4633 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4634 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4635 0.22 0.46 0.32 0.68 0.40 0.85 0.22 0.4636 0.22 0.47 0.33 0.69 0.42 0.87 0.22 0.4637 0.23 0.48 0.34 0.71 0.43 0.89 0.22 0.4738 0.23 0.49 0.34 0.72 0.43 0.91 0.23 0.4839 0.25 0.52 0.37 0.77 0.46 0.97 0.23 0.4940 0.27 0.57 0.39 0.82 0.51 1.06 0.25 0.5241 0.28 0.58 0.41 0.86 0.51 1.08 0.27 0.5642 0.31 0.64 0.43 0.90 0.57 1.19 0.31 0.6443 0.34 0.71 0.50 1.05 0.63 1.32 0.34 0.7144 0.38 0.81 0.56 1.19 0.71 1.49 0.38 0.8145 0.44 0.92 0.65 1.36 0.81 1.70 0.44 0.9246 0.50 1.06 0.75 1.58 0.92 1.94 0.50 1.0647 0.59 1.23 0.86 1.81 1.08 2.27 0.59 1.23
48 0.68 1.43 1.00 2.10 1.26 2.65 0.68 1.4249 0.78 1.64 1.15 2.41 1.43 3.02 0.71 1.4950 0.90 1.89 1.33 2.79 1.67 3.50 0.74 1.5651 0.91 1.91 1.42 3.00 1.69 3.54 0.67 1.4052 1.07 2.24 1.59 3.34 1.97 4.14 0.71 1.5053 1.25 2.63 1.83 3.85 2.29 4.82 0.78 1.6354 1.39 2.93 2.07 4.35 2.59 5.44 0.85 1.7955 1.58 3.31 2.32 4.89 2.92 6.15 0.94 1.9856 1.81 3.81 2.65 5.56 3.32 6.99 1.07 2.2457 2.09 4.41 3.07 6.46 3.90 8.20 1.22 2.5758 2.53 5.33 3.43 7.22 4.65 9.77 1.50 3.1659 3.12 6.57 4.43 9.32 5.94 12.49 1.88 3.9460 3.55 7.47 5.15 10.82 6.59 13.86 2.24 4.7161 4.17 8.76 6.14 12.91 7.71 16.22 2.70 5.6762 4.59 9.65 6.72 14.13 8.63 18.15 3.45 7.2663 5.03 10.59 7.40 15.56 9.54 20.05 3.67 7.7264 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.8165 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.8166 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.8167 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.8168 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.8169 5.94 12.49 8.51 17.89 11.32 23.82 4.66 9.81
* eticted deitio of total ad pemaet diablemet applie fom age 65
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Restrictions on automatic cover ome cicumtace, you automatic cove will be eticted, a explaied i Table 7 below.
Table 7: Restrictions on Cover
Circutance How cover i affected
f we do ot eceive yout sG cotibutio fomyou Fit state supepaticipatig employewithi 6 moth of youcommecig wok with thatemploye
1. You cove will commece o the date that we eceive you t sG cotibutio, ad:
2. For the frst 12 months ater cover commences you ae oly eligible fo limited cove.
3. Ater 12 months rom the date cover commences: f o the date 12 moth afte youcove commece you ae:
at wok, you will be eligible fo full cove ude the policy fom that date;
ot at wok, you will oly be eligible fo limited cove util the date you meet the at wokequiemet, at which time you will be eligible fo ulimited cove ude the policy.
f you have peviouly bee
paid a total ad pemaetdiablemet type beetfom ay fud (icludigFit state supe) o iue
You will oly eve be eligible fo limited cove i the Fud.
Example 2
Fo a additioal $50,000 death ad TPD cove fo sue, a 39-yea old employed by a Govemet Tadig
Etepie, the pemium i calculated a follow:
Level o fxedadditional cover
$1,000s o cover(divide $50,000 by 1,000)
Multiply by the annualpremium per $1,000 o cover
Annual/monthly premium
$50,000 50 X $0.77 = $38.50(o $3.21 pe moth)
Note: The above example i illutative oly ad i baed o the facto tated. t hould ot be take to cotai o povide aetimate of the pemium payable by you.
Interim accident cover fordeath and TPDf you ae eligible to apply fo tat-up bou o additioal
death ad TPD o death-oly cove, you eceive
iteim accidet cove fo death ad/o TPD while you
applicatio i beig aeed by the ue. You iteim
accidet cove tat fom the time that the ue
eceive a popely completed applicatio fom adceae at the ealiet of:
whe you applicatio i accepted (o ay tem),
ejected o withdaw; o;
whe the ue otie you that you iteim
accidet cove ha ceaed; o
you ceae to be a membe of the Fud.
The iteim accidet cove i
(a) fo Death cove, the lee of
i) the amout applied fo; ad
ii) $2,000,000; ad
(b) fo TPD cove, the lee of
i) the amout applied fo; ad
ii) $1,000,000 educed by ay exitig TPD cove.
teim accidet cove cove you whee you death
o total ad pemaet diablemet, a applicable,
i caued olely, diectly ad idepedetly of ay
othe caue, by accidet a log a death o total
ad pemaet diablemet, a applicable, occu
withi 365 day of the accidet.
Benet paymentsll beet paymet (fo the total amout of youautomatic cove, tat-up bou cove, additioal cove
ad tafeed cove) ae ubject to a maximum amout
of $5 millio fo temial ille ad $5 millio fo total
ad pemaet diablemet. Thee i o maximum death
beet.
f you have xed cove, the iuace beet will be the
amout of xed cove accepted by the ue, plu a
amout fo each uit of cove that you have.
The beet amout fo additioal uit-baed cove deped
o the iuace atig that applie to you additioal cove,
which could be diffeet fom you automatic cove uleyou apply, ad ae accepted, to be occupatioally ated fo
all cove. Table 2, o page 4, how the beet amout fo
each uit of cove, fo each iuace atig.
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Death ad TPD cove (cot.)
Opting out, reducing, terminatingor ceasing coverReducing or opting out o automatic cover
You ca educe you automatic cove to oe o 2 uit of
death ad TPD cove (the cot of death ad TPD cove
i till $5 pe uit pe moth) o you ca opt out of cove
altogethe.
lteatively, you ca educe you automatic cove to oe,
2 o 3 uit of death oly cove (o that you ae coveed
fo death ad temial ille, but ot TPD). The cot of
each uit of death oly cove i $2.38 pe uit pe moth.
To educe you cove, complete the Application to reduceor cancel insurance coverfom icluded at the back of thi
upplemet, o available at www.ttateupe.com.au o
fom utome sevice by callig 1300 650 873.
f you educe o opt out of cove, you cove ca eve
be automatically eitated. You ca e-apply fo cove
by povidig detailed ifomatio about you health,
icome, occupatio ad lifetyle, but cove i ubject to
acceptace by the ue.
I you wish to reduce your automatic cover
without costs being incurred, you must do so
within 30 days o being notifed that you have
received automatic cover by completing the
Application to reduce or cancel insurance cover
included at the back o this supplement, or
available at www.ttateupe.com.au o fom
utome sevice by callig 1300 650 873.
Insufcient money in your super to pay
the cost o your insurance
f you cove ceae becaue you do ot have eough
moey i you accout to pay the cot of you iuace,
but you emai a membe of Fit state supe, you cove
may be eitated (a log a you have ot educed o
opted out of cove) i the followig cicumtace:
f a cotibutio ufciet to cove the cot of you
iuace i made to you accout withi 28 day of
the Tutee otifyig you i witig that you cove ha
ceaed, you cove will be eitated a at the date
that it peviouly ceaed.
f we do ot eceive a cotibutio ufciet to
cove the cot of you iuace withi thi 28-day
peiod, cove will be eitated whe we eceive a
sG cotibutio ufciet to cove the cot of you
iuace o you behalf fom a Fit state supe
paticipatig employe, but you eitated cove will
the be the lowe of:
(a) the level of cove you had pio to it ceaig;
ad
(b) 3 uit of death ad TPD automatic cove, ad
if, o the date cove i eitated, you ae ot at
wok, the you will have oly limited cove util you
have bee at wok fo 2 coecutive moth.
f you have educed o opted out of cove, you cove
ca eve be automatically eitated, but you ca e-
apply fo cove by povidig detailed ifomatio about
you health, icome, occupatio ad lifetyle. f you
applicatio i accepted, cove commece o the date
of acceptace by the ue.
Termination o the policy
f the policy iued to the Tutee by the uetemiate ad you ae at wok, the Tutee may eplace
you cove with ubtatially equivalet cove ude a
ew policy.
f the policy iued to the Tutee by the ue
temiate ad you ae ot at wok o the temiatio
date, you will cotiue to have total ad pemaet
diablemet cove with the ue util the ealiet of
the followig:
you etu to wok ad actively pefom all you
omal dutie ad wok you uual hou fee fom
ay limitatio due to ille o ijuy ad you ae ot
etitled to eceive icome uppot beet of aykid; o
you 70th bithday; o
the date the ue accept o declie a claim fo
total ad pemaet diablemet beet claimed by
o fo you.
I you are in the Australian Armed
Forces Reserve on active duty overseas
You ca apply to cotiue you cove if you ae
i the utalia med Foce reeve o active
duty outide utalia. f you do ot apply, o you
applicatio i ejected, you cove that ceaed will
automatically e-commece:
at your previous level immediately afte you
etu fom active duty outide utalia, povidig
you peiod of active duty i le tha 12 moth
ad you ae at wok at the ed of that peiod;
othewie
at the lower o your previous level o cover
and 3 units o automatic cover immediately
o eceipt of the ext sG cotibutio fom you
Fit state supe paticipatig employe afte you
peiod of active duty outide utalia.f you ae ot at wok o the date cove e-commece,
you will oly have limited cove util you have bee
at wok fo 2 coecutive moth.
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You do ot eceive automatic icome potectio cove whe you become a membe of Fit state supe.You ca apply howeve, fo icome potectio cove ude the policy iued to the Tutee by the ue.
You do ot eed to have death o TPD cove to apply fo icome potectio cove.
Applying for income protectionWhat can you apply or?
You ca apply to be iued fo a eplacemet icome (paid to you mothly i aea). You ca apply fo the beet
tuctue fom the optio how i the Table 8 below, a log a you do ot exceed the maximum cove.
Table 8: Beneft options
Beneft Periods 2 years 5 years or age 65
come replacemet ratio 50% o 75% 50% o 75%
Waitig Peiod 14, 30, 60 o 90 day 30, 60 o 90 day
ove fo upeauatio cotibutio beet* 10% of mothly icome 10% of mothly icome
*The upeauatio cotibutio beet i paid diectly ito you accout i Fit state supe ad will attact cotibutio tax.
What is the maximum cover?
The maximum iued mothly beet that you ca have
ude the policy deped o the beet peiod.
2 year beneft period up to $50,000 pe moth
(icludig the upeauatio cotibutio beet,
if applicable).
5 year beneft period or beneft period to age 65
up to $40,000 pe moth (icludig the upeauatio
cotibutio beet, if applicable).
Who can apply?
You ca apply if you ae:
(a) a Fit state supe membe o applyig fo
membehip of the Fud; ad
(b) a utalia reidet; ad
(c) olde tha 15 yea of age ad ot olde tha 65
yea of age; ad
(d) gaifully employed fo at leat 15 hou pe week.
What is the cost?
pemium i deducted fom you Fit state supe
accout mothly, i aea. The pemium amout i
calculated by takig ito accout:
you age; ad
you iuace atig (baed o you employe
categoy o you occupatioal categoy); ad
you icome eplacemet atio (50% o 75%) of you
mothly icome; ad
whethe you ae iued fo the upeauatio
cotibutio beet; ad
you waitig peiod; ad
you beet peiod.
come potectio
see The cost of income protection o page 19 o
go to the iuace calculato o ou
www.ttateupe.com.au.
The application process
You applicatio mut cotai ifomatio about you
health, mothly icome, occupatio ad lifetyle.
Depedig o the evidece upplied, you applicatio
may be accepted o declied by the ue, o pecial
coditio may be impoed o you cove.
f you applicatio fo icome potectio i accepted
by the ue, you will be otied of you iued
mothly beet, you icome eplacemet atio, you
beet peiod, you waitig peiod, the date you cove
commece, whethe the upeauatio cotibutio
beet i icluded ad ay pecial coditio that apply
to you cove.
Changes to your fnancial circumstances
fte you applicatio i accepted, you hould tell u
if you mothly icome deceae, a you may ot be
eligible to eceive you full iued mothly beet ad
you may be able to pay a lowe pemium.
f you mothly icome iceae, you ca apply to
iceae you iued mothly beet (ubject to the
maximum level of cove). y iceae i cove i
ubject to acceptace by the ue. f the iceae
i accepted, you will be otied of you ew iued
mothly beet.
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Start-up bonusstat-up bou i a limited amout of icome potectio
that you ca apply fo without povidig the ame level
of detail about you health ad lifetyle a i equied i
a odiay applicatio fo icome potectio.
Who can apply?
f you ae employed by a Fit state supe paticipatig
employe, you ca apply fo tat-up bou icome
potectio withi 180 day afte the date we eceive you
t sG cotibutio fom that employe. To apply, you
mut:
be employed fo at leat 15 hou pe week; ad
joi Fit state supe withi 6 moth of
commecig employmet with a Fit state supe
paticipatig employe.
Your insurance rating
le you apply to be occupatioally ated, o you
apply to be i the baic plu iuace categoy,
you iuace atig fo the tat-up bou i you
employe categoy. Fo a explaatio of iuace
atig, ee page 3.
You iuace atig affect:
you iued mothly beet ude the tat-upbou, ad
you icome potectio cove pemium.
Table 9 below how the maximum iued mothlybeet (you icome eplacemet atio (50% o 75%)
of you mothly icome) that you ca be iued fo
ude the tat-up bou, depedig o you employe
categoy.
Table 9
come potectio (cot.)
Employer category
MaximumStart up BonusInsured Monthly
Benefts#
Public sector Private sector
Baic Plu* Baic Plu $10,000
Educatio ad Publicsevice
White olla $6,000
Govemet TadigEtepie (icludigHealth secto employee)
Light Maual $6,000
Emegecy seviceMaual $5,000
Heavy Maual $3,000
* Baic Plu mut be applied fo ad accepted by the ue.
# You ca elect the upeauatio cotibutio beet to applyto you tat up bou cove. The upeauatio cotibutiobeet i ubject to the maximum tat up bou iued mothlybeet.
Applying or the start-up bonus
you applicatio, you ae oly equied to povide
limited ifomatio about you health, icome, occupatio
ad lifetyle (compaed to a odiay applicatio fo
icome potectio). t may be accepted (with o without
coditio) o ejected by the ue. While you
applicatio i beig aeed, you will be eligible fo
iteim accidet cove (ee page 18).
f you applicatio fo tat-up bou cove i accepted
by the ue, you will be otied of you iued mothly
beet, you beet peiod, you icome eplacemet
atio, if the upeauatio cotibutio beet iicluded, you waitig peiod ad the date you cove
commece.
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What is the beneft period?The beet peiod i the maximum peiod fo which
the ue will pay a mothly diability beet ad/
o patial diability beet fo a claim i elatio to
total diability ad patial diability fo the ame
o elated ille o ijuy. The beet peiod i
omiated by you i you applicatio ad accepted
by the ue.
f you ae etitled to a ecuet diability beet
(efe page 17) thi will be coideed to be a
cotiuatio of the iitial claim ad, while the
waitig peiod will ot be eapplied, all peiod of
claim will be added togethe fo the pupoe of
aeig the beet peiod.
Transferring cover to FirstState SuperYou may, afte joiig the Fit state supe, apply to
tafe up to $40,000 pe moth icome potectio
cove that you may have i aothe life policy i you
ame (previous insurance) to Fit state supe.
You ca oly tafe cove if:
you ae at wok o the day immediately pecedig
you tafeig cove commecig i the Fud; ad
you have ot had a applicatio fo life, total ad
pemaet diablemet o icome potectio
iuace declied; ad
you ae ot eligible, have ot eceived o ae
applyig fo a total ad pemaet diablemet
type beet, a pemaet o tempoay icapacity
beet, temial ille beet o a icome
potectio beet fom woke compeatio, ay
upeauatio fud o life iuace policy; ad
you have ot bee diagoed with a temial ille;
ad
you have ageed ot to execie ay cotiuatio
optio ude the peviou iuace o had cove
eitated ude that iuace; ad
you agee that you cove ude the peviouiuace will ceae o acceptace of you tafe
cove by the ue; ad
the ue ha bee povided with atifactoy
evidece of ay coditio o etictio which
applied ude the peviou iuace.
f ay idividual etictio, coditio, pemium
loadig o excluio wee impoed ude the peviou
iuace they may alo apply to the tafeed cove.
Thi tafe amout i i additio to ay icome
potectio cove you may have ude Fit state supe
ad the total i ubject to the maximum cove limit.
To apply to tafe you cove, you oly have to
povide limited ifomatio about you health, icome,
occupatio, lifetyle ad patime. You applicatio
will the be aeed by the ue. The pemium
cot will deped o you iuace atig. The
applicatio fom to tafe cove ad ca be foud at
www.ttateupe.com.au o obtaied fom utome
sevice by callig 1300 650 873
Note: You hould wait fo ou witte comatio of the tafeof cove befoe cacellig ay peviou iuace.
What income protection coversyou forMonthly disability beneft
When are you eligible or a monthly disability beneft?
You will be eligible to eceive a mothly diability beet if:
you have bee totally diabled o patially diabled fo
the waitig peiod (ad totally diabled fo at leat 7 outof 12 coecutive day duig the waitig peiod); ad
you ae totally diabled at the ed of the waitig peiod,
o immediately followig a peiod duig which the
patial diability beet ha bee payable; ad
you pe-diability icome i educed due to you total
diability.
The mothly diability beet will be paid mothly i
aea ad the amout of you beet accue daily o a
po-ata bai.
Paymet of the mothly diability beet i ubject to the
limitatio ad excluio outlied o page 18 ad mutbe appoved by the ue ad the Tutee.
Totally diabled o total diability mea that, i the
ue opiio, while coveed fo come Potectio,
olely a a eult of a ille o ijuy, you ae:
uable to pefom at leat oe icome poducig
duty of you egula occupatio; ad
ot wokig i ay capacity, gaiful employmet o
othewie; ad
ude the egula cae of a medical pactitioe
ad, i the ue eaoable opiio, you ae
complyig with the advice ad teatmet give bythat medical pactitioe.
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come Potectio (cotiued)come potectio (cot.)
How much is the monthly disability beneft?
You mothly diability beet paymet will be thelee of:
you iued mothly beet, ad
you icome eplacemet atio (50% o 75%) of you
pe-diability icome.
The upeauatio cotibutio beet, if you ae
coveed fo thi beet, may alo be payable.
y beet payable i limited to the maximum cove
ad ubect to the limitatio ad excluio outlied o
page 18.
When do the monthly disability beneft
payments cease?
You mothly diability beet paymet will ceae to be
paid o the ealiet of:
the date you ae o loge totally diabled; o
the date of you death; o
you 65th bithday; o
the expiy of the beet peiod.
Partial disability beneft
You will be eligible to eceive a patial diability beet if;
you have bee totally diabled fo at leat 7 out of
12 coecutive day duig the waitig peiod;
you ae patially diabled at the ed of the waitig
peiod, o immediately followig a peiod duig
which the mothly diability beet ha bee
payable.
Patially diabled o patial diability mea that,
i the ue opiio, while coveed fo come
Potectio, olely a a eult of a ille o ijuy that
caued you to be totally diabled, you:
do ot have the capacity to wok i you
occupatio at the ame level you wee wokig at
pio to commecemet of total diability; ad
ae eaig etu to employmet icome that i
le tha you pe-diability icome; ad
ae ude the egula cae of a medical pactitioe
ad, i the ue eaoable opiio, you ae
complyig with the advice ad teatmet give by
that medical pactitioe.
When do partial disability beneft payments cease?
Mothly patial diability beet paymet will ceae to
be paid o the ealiet of:
the date you ae o loge patially diabled, o
the date of you death, o
you 65th bithday, o
the expiy of the beet peiod.
patial diability beet i equal to:
pe-diability icome etu to employmet icome x iued mothly beet
pe-diability icome
How much is the partial disability beneft?The patial diability beet payable i calculated a follow:
The upeauatio cotibutio beet, if you ae coveed fo thi beet, may alo be payable ad will alo be
educed by ay upeauatio guaatee cotibutio made i elatio to you etu to employmet icome.
y beet payable i ubject to the maximum cove ad ubject to the limitatio ad excluio outlied o
page 18.
Indexation
f you beet peiod i 2 yea, at the ed of 12
moth duig which you eceived a mothly diability
beet o patial diability beet, you iued
mothly beet will be iceaed by 5%. f you
beet peiod i 5 yea o to age 65, at the ed of
each 12 moth peiod duig which you eceive a
mothly diability beet o patial diability beet,
you iued mothly beet will be iceaed by the
lee of 5% ad P.f you ae coveed fo the upeauatio
cotibutio beet, it will be idexed o the ame
bai a you iued mothly beet.
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Recurrent disability beneft
f you etued to wok afte eceivig a mothly diability
beet o patial diability beet ad become totally
diabled o patially diabled agai withi 6 moth
(fom the ame o a elated ille o ijuy) the ue
will teat ay ecuece of that diablemet fom the
ame o elated caue a a cotiuatio of the ame
beet peiod ad o waitig peiod will apply. Howeve,
becaue the beet will be teated a a cotiuatio of
the ame beet peiod, it will oly be payable fo the
emaide, if ay, of the beet peiod.
Rehabilitation expense beneft
f you ae totally diabled o patially diabled, the uemay pay fo the cot of a appoved ehabilitatio
pogam if the ue eaoably coide the pogam
i likely to ait i you ehabilitatio. Thi i i additio
to the beet othewie payable to you fo icome
potectio. The ehabilitatio expee beet will be
payable if:
the ue appove the ehabilitatio expee i
witig befoe they ae icued, ad
the ehabilitatio expee ae icued to diectly
ait you to etu to wok o udetake a vocatioal
etaiig pogam.
The amout of the ehabilitatio expee beet will be
educed by ay amout that ca be claimed fo the
ehabilitatio expee fom ay othe ouce.
ehabilitatio expee beet will be paid diectly to
the povide of the ehabilitatio evice.
Income protection cover during leave
without pay
log a pemium cotiue to be paid, you will
cotiue to be coveed duig a peiod of leave without
pay o the followig bai.
f you make a claim duig the peiod of leave withoutpay, you pe-diability icome will be aveaged ove
the 12 moth immediately pio to you goig o leave
without pay (athe tha the 12 moth immediately pio
to you becomig totally diabled) a log a:
if you ae employed, you employe ha appoved the
peiod of leave i witig pio to you goig o leave
ad the peiod of leave doe ot exceed 24 moth;
o
if you ae elf-employed, you have made
aagemet fo the cotiuatio of you buie
duig you abece o leave (though the uppot
of othe paticipat i the buie o though theevice of a locum o equivalet eplacemet o
a tempoay bai), you deive o icome duig
you abece ad you abece o leave doe ot
exceed 24 moth.
all othe cicumtace, pe-diability icome will be
calculated ove the 12 moth immediately pio to youbecomig totally diabled.
the evet you uffe ille o ijuy while o leave
without pay, the occupatio you followed befoe you
commeced the leave will be you occupatio fo the
pupoe of detemiig total diability.
f you ae coveed duig a peiod of leave without pay
ad eligible to eceive a icome potectio beet, o
beet will be paid util the lat to occu of:
if you ae employed, the date you leave without pay
i cheduled to ceae i accodace with the peiod
of employe appoved leave, o if you ae elf-employed, the expiatio of the peiod
of abece aaged befoe the tat of you leave, o
the expiy of the waitig peiod.
I you are taking leave without pay
f you ae takig leave without pay, you hould coide
whethe to etai you icome potectio cove. The
amout of you beet deped o you pe-diability
icome. Except i the cicumtace explaied i the
peviou ectio Income protection cover during leave
without pay whe you pe-diability icome will be
aveaged ove the 12 moth immediately pio to you
goig o leave without pay, you pe-diability icomewill be calculated ove the 12 moth immediately pio
to you becomig totally diabled. Thi mea that, if you
become totally diabled, you pe-diability icome will
be aveaged ove a peiod which iclude time whe you
wee o upaid leave ad ay beet that you would
be etitled to will be educed. lo, if you leave without
pay cotiue fo moe tha oe yea ad you the
become totally diabled, you pe-diability icome will
be aveaged ove the 12 moth you wee o leave ad
ay beet that you would be etitled to will be educed
to zeo.
While you hould have egad fo you owcicumtace, a membe might wih to cotiue the
cove, eve if ay beet payable i educed i thi
way, if he o he ited to eume gaiful employmet.
lteatively, a membe may coide it i pefeable
to cacel icome potectio cove if itedig to take
exteded upaid leave, depedig o whethe o ot
the upaid leave i appoved ad the duatio of the
upaid leave. Pleae ote, howeve, that if you cacel
icome potectio iuace, you mut e-apply (if you
ae eligible) ad you applicatio may be accepted o
declied by the ue, o pecial coditio may be
impoed o you cove.t i ecommeded that you coult a liceed o
authoied acial advie if you ae i thi ituatio.
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come potectio (cot.)
Interim accident cover forincome protectionf you apply fo icome potectio cove, o a iceae
i you iued mothly beet, the ue will povide
you with iteim accidet cove fo total diability o
patial diability while coideig you applicatio.
teim accidet cove commece o the date that the
ue eceive you popely completed applicatio
fom ad cotiue util the ealiet of:
the day o which you applicatio i accepted (o
ay tem), ejected o withdaw; o
the day 90 day afte the date the ue eceive
you popely completed applicatio fom; o
whe the ue otie you that you iteim
accidet cove ha ceaed; o
you ceae to be a membe of the Fud.
f total diability o patial diability occu by accidet
while you have iteim accidet cove, the iued
mothly beet will be the lowet of:
the amout omiated a the iued mothly
beet ad upeauatio cotibutio beet i
the applicatio; o
$10,000 pe moth (icludig ay upeauatio
cotibutio beet) educed by ay exitig
icome potectio cove; ad
the maximum level of cove.
y beet payable will be ubject to the limitatio ad
excluio outlied i the ext colum.
f a iteim accidet cove beet i payable, it will oly
be payable util the ealiet of:
the date you ae o loge total diabled o patially
diabled; o,
the date of you death; o
you 65th bithday; o the expiy of the beet peiod omiated i the
applicatio.
Claiming a benetPayment o a claim
Paymet of a claim mut be appoved by the ue
ad Fit state supe.
You will eed to atify a coditio of eleae ude
upeauatio law to eable u to pay a beet to
you ad ay applicable tax will be deducted fom
the beet pio to paymet. f you do ot atify acoditio of eleae, Fit state supe i ot able to
eleae the beet to you. The coditio of eleae
ude upeauatio law ae decibed i the MemberBooklet Supplement: Accessing your supero ou
webite at www.ttateupe.com.au.
You ae epoible fo ay cot aociated with
completig ad povidig the claim fom (icludig
ogoig claim fom) ad ay aociated documet
that the ue eaoably equie fo the iitial ad
ogoig aemet of you claim. You may alo be
aked, at you expee, to povide othe evidece that
the ue eaoably equie to ubtatiate you
claim.
The ue may equie you to atted (at it expee)
ay medical examiatio by a medical pactitioe o
othe health pofeioal that it omiate, ad/o to
udego tet, that it coide eceay to eable it to
ubtatiate you claim.
Claims while you are overseas
f you ae outide utalia ad o claim fo total
diability o patial diability fo moe tha 12 moth,
the ue may efue to cotiue payig beet ule
you have, at you expee, etued to utalia.
lo, you may be equied to etu to utalia at you
expee fo iitial ad ogoig aemet of ay claim.
Limitations and exclusionsReduction o monthly beneft payment
The amout of ay beet payable to you fo a moth
will be educed by ay othe diability icome which
accue to you duig that moth.
When benefts are not payable
Beet ae ot payable i the followig cicumtace:
itetioal elf-iicted ijuy o ay attempt to
commit uicide; o
omal pegacy o childbith; o
wa, which iclude ay act of wa (whethe declaed
o ot), evolutio, ivaio, ebellio o civil uet.
Futhe, o beet will be payable ude icome
potectio cove if the paymet of the beet would
cotavee ay poviio i the Private Health Insurance
Act 2007 (Cth) o othe elated legilatio.
One disability beneft payment at any time?
The ue will oly pay you oe mothly diability
beet o patial diability beet at a time duig the
beet peiod.
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The cost of income protection
Step 1 Work out your level o cover per annum
seeApplying for income protection you iued mothly beet (thi i the icome eplacemet atio of you
mothly icome) multiplied by 12. dd 10% of mothly icome if the upeauatio cotibutio beet i
icluded. Make ue that you do ot exceed the maximum cove.
Step 2 Work out your insurance rating and premium actor
le you apply ad ae accepted to be occupatioally ated you iuace atig fo icome potectio
(icludig the tat-up bou) i you employe categoy. see page 3 fo a deciptio of the iuace
atig. e you iuace atig to wok out you pemium facto fom Table 10.
Table 10: Premium actor
Occupation rating actors
Private sector Public sector Factor
Baic Plu Baic Plu 0.90
White olla Educatio ad Public sevice 1.00
Light Maual Govemet Tadig Etepie 1.30
MaualEmegecy sevice
1.90
Heavy Maual 2.30
Step 3 Work out your basic income protection premium
ig Table 11, Table 12 o Table 13 o page 2021 (depedig o you beet peiod) to wok out you
baic icome potectio pemium accodig to you age, you level of cove (ee step 1) ad the waitig
peiod applyig.
Follow the tep below to calculate the cot of icome potectio. lteatively, go to www.ttateupe.com.au
ad ue the uace cove ad pemium calculato to detemie how much iuace cove may be uitable
fo you ad how much it may cot you. Pemium fo icome potectio may iceae i the futue. f thi
happe you will be otied at leat 30 day befoe the chage i implemeted.
Step 4 Calculate your premium
Divide you level of cove (step 1) by $1,000 to give you you umbe of $1,000 of iued cove. Multiply
thi umbe by you baic icome potectio pemium (step 3) ad you pemium facto (step 2). Thi will
give you you aual pemium. Divide you aual pemium by 12 fo you mothly pemium.
Example 3
Joh i 39 yea old, employed by a Govemet Tadig Etepie, ha a mothly icome of
$10,000, a beet peiod of 2 yea, a 90-day waitig peiod ad a icome eplacemet atio of
50% of mothly icome. The pemium i calculated a follow:
evel of coverer annu
$1,000 of cover
(divide $60,000 by$1,000)
aic incoerotection reiuer annu(fom Table 11)
preiu factor(fom Table 10)
Annual/onthlyreiu
$60,000 ($5,000mothly icome)
60 X $1.13 X 1.30= $88.14 pe yea o$7.35 pe moth
Note: The above example i illutative oly ad i baed o the facto tated. t hould ot be take to cotai o povidea etimate of the pemium payable by you.
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Table 11
2 Year Beneft
AgeAttained
Waiting Period
14 days$
30 days$
60 days$
90 days$
15 3.05 1.50 0.96 0.71
16 3.14 1.54 0.98 0.72
17 3.23 1.58 1.02 0.75
18 3.28 1.60 1.03 0.76
19 3.32 1.62 1.04 0.76
20 3.46 1.70 1.08 0.79
21 3.41 1.67 1.06 0.75
22 3.45 1.69 1.06 0.73
23 3.44 1.69 1.05 0.7124 3.45 1.69 1.05 0.70
25 3.46 1.70 1.05 0.68
26 3.54 1.74 1.07 0.68
27 3.63 1.78 1.09 0.70
28 3.73 1.82 1.12 0.71
29 3.89 1.90 1.16 0.71
30 4.01 1.96 1.19 0.72
31 4.19 2.05 1.23 0.74
32 4.42 2.16 1.30 0.77
33 4.67 2.29 1.37 0.81
34 4.96 2.42 1.44 0.83
35 5.17 2.53 1.52 0.88
36 5.64 2.76 1.64 0.94
37 5.91 2.90 1.73 1.01
38 6.15 3.01 1.81 1.06
39 6.41 3.14 1.89 1.13
40 6.69 3.27 1.98 1.21
41 6.87 3.36 2.05 1.30
42 7.14 3.49 2.15 1.39
43 7.51 3.67 2.28 1.52
44 7.71 3.77 2.37 1.64
45 8.23 4.03 2.55 1.79
46 8.73 4.27 2.72 1.97
47 9.26 4.53 2.92 2.16
48 9.86 4.83 3.15 2.41
49 10.73 5.25 3.44 2.68
50 11.58 5.66 3.75 2.99
51 12.66 6.20 4.13 3.36
52 13.88 6.80 4.56 3.78
53 15.23 7.45 5.03 4.24
54 16.78 8.21 5.59 4.79
55 18.61 9.11 6.23 5.40
56 20.80 10.18 6.99 6.11
57 23.34 11.42 7.87 6.93
58 26.34 12.89 8.89 7.86
59 29.63 14.49 10.01 8.86
60 33.31 16.29 11.27 10.00
61 37.62 18.41 12.72 11.27
62 42.35 20.71 14.32 12.68
63 40.95 20.03 13.45 11.13
64 22.36 10.94 6.61 4.01
Termination or cessation ofincome protection coverWhen does your income protection
cover cease?
You icome potectio cove i Fit state supe will
ceae whe ay of the followig occu:
you membehip with Fit state supe ceae; o
thee i ot eough moey i you accout to
cove the cot of you cove; o
the date of you death; o
you each age 65; o
you commece militay evice (othe tha the
utalia med Foce reeve if you ae ot o
active duty outide utalia); o
the date we eceive you witte equet to cacel
you cove.
additio, cove may ceae with the ue ude
cicumtace outlied i the followig ectio
Termination of the policy.
Termination o the policy
f the policy iued to the Tutee by the ue
temiate ad you ae actively pefomig all thedutie of you occupatio ad wokig you uual
hou fee fom ay limitatio due to ille o ijuy,
you cove may be eplaced with ubtatially
equivalet cove ude a ew policy.
f the policy iued to the Tutee by the ue
temiate ad you ae ot actively pefomig all the
dutie of you occupatio ad ae ot wokig you
uual hou fee fom ay limitatio due to ille o
ijuy o the temiatio date, you will cotiue to
have icome potectio cove util the ealiet of the
followig:
you etu to wok ad actively pefom all youomal dutie ad wok you uual hou fee fom
ay limitatio due to ille o ijuy ad you ae
ot etitled to eceive icome uppot beet of
ay kid; o
you 65th bithday; o
the date the ue accept o declie a claim fo
icome potectio beet claimed by you.
come Potectio (cot.)
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Table 12
5 Year Beneft
AgeAttained
Waiting Period
30 days$
60 days$
90 days$
15 2.54 1.58 1.15
16 2.55 1.60 1.17
17 2.56 1.62 1.18
18 2.56 1.62 1.17
19 2.55 1.61 1.16
20 2.59 1.63 1.17
21 2.60 1.63 1.14
22 2.64 1.63 1.15
23 2.67 1.65 1.1324 2.70 1.65 1.14
25 2.73 1.67 1.14
26 2.82 1.73 1.17
27 2.92 1.78 1.24
28 3.02 1.85 1.26
29 3.17 1.93 1.30
30 3.31 2.00 1.35
31 3.49 2.08 1.39
32 3.69 2.19 1.43
33 3.92 2.30 1.50
34 4.15 2.42 1.56
35 4.39 2.57 1.64
36 4.69 2.74 1.75
37 4.98 2.91 1.88
38 5.24 3.09 2.03
39 5.37 3.28 2.19
40 5.52 3.50 2.37
41 5.70 3.72 2.57
42 6.00 3.97 2.80
43 6.35 4.27 3.06
44 6.65 4.55 3.35
45 7.06 4.90 3.69
46 7.46 5.27 4.07
47 7.89 5.67 4.45
48 8.35 6.11 4.91
49 8.90 6.60 5.44
50 9.45 7.12 6.03
51 10.10 7.72 6.64
52 10.80 8.35 7.30
53 11.56 9.02 8.01
54 12.39 9.77 8.80
55 13.86 11.04 9.65
56 14.94 11.99 10.59
57 16.10 12.99 12.24
58 17.37 14.04 13.33
59 18.76 15.05 14.29
60 19.26 15.43 14.47
61 19.12 15.01 13.94
62 20.91 14.85 13.34
63 20.05 14.34 11.64
64 10.98 6.97 4.31
Table 13
To age 65 Beneft
AgeAttained
Waiting Period
30 days$
60 days$
90 days$
15 5.34 3.45 2.64
16 5.34 3.45 2.64
17 5.34 3.45 2.64
18 5.34 3.45 2.64
19 5.34 3.45 2.64
20 5.34 3.45 2.64
21 5.48 3.51 2.66
22 5.61 3.57 2.69
23 5.75 3.64 2.7324 5.90 3.71 2.77
25 6.05 3.78 2.81
26 6.29 3.97 2.97
27 6.59 4.16 3.12
28 6.93 4.36 3.25
29 7.33 4.57 3.38
30 7.77 4.79 3.52
31 8.26 5.04 3.66
32 8.80 5.31 3.81
33 9.39 5.61 3.99
34 10.01 5.94 4.20
35 10.68 6.32 4.45
36 11.38 6.73 4.73
37 12.12 7.19 5.07
38 12.89 7.69 5.46
39 13.70 8.24 5.91
40 14.53 8.85 6.42
41 15.38 9.50 6.99
42 16.25 10.21 7.62
43 17.14 10.97 8.32
44 18.04 11.77 9.08
45 18.96 12.62 9.91
46 19.87 13.51 10.78
47 20.79 14.43 11.70
48 21.69 15.37 12.66
49 22.59 16.33 13.65
50 23.46 17.29 14.65
51 24.30 18.24 15.65
52 25.11 19.17 16.62
53 25.86 20.04 17.55
54 26.55 20.85 18.41
55 27.15 21.57 19.18
56 27.58 22.12 19.77
57 27.79 22.43 20.13
58 27.69 22.42 20.17
59 27.18 22.01 19.79
60 26.12 21.06 18.89
61 24.29 19.39 17.29
62 21.33 16.69 14.70
63 16.23 12.16 10.41
64 7.11 4.45 3.30
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come Potectio (cotiued)
Phrase Meaning
ccidet Mea a ufoeee, violet, exteal ad viible evet that occu accidetally duig thepeiod of cove.
t Wok Mea you ae gaifully employed ad, i the ue opiio, capable of pefomig youidetiable wok dutie without etictio by ille o ijuy fo at leat 15 hou pe week(whethe o ot you ae actually wokig thoe hou).
utalia reidet Mea a utalia citize o a peo who i the holde of a utalia pemaet via withithe meaig of sectio 30 of the Migration Act 1958 o eide i utalia o a 457 wokigvia.
Beet Peiod Pleae efe to the explaatio o page 15
P Mea oume Pice dex (all goup weighted aveage fo eight capital citie) iued by theutalia Bueau of statitic fo the mot ecet 12 moth befoe the date of calculatio.
Dometic Dutie Mea beig olely egaged i maitaiig the family home. Fo example:
ookig of meal fo you family
leaig of the family home;
shoppig fo you family food;
Doig you family laudy; ad
Takig cae of depedet childe (if applicable);
but excludig ay tak pefomed fo alay, ewad o pot.
Employed Mea beig employed fo emueatio o ewad.
Gaiful Employmet o
Gaifully Employed
Mea the pefomace of wok fo ewad o i the expectatio of ecoomic beet to you, oa peo o etity coected with you. You ca be eithe employed o elf-employed.
lle Mea icke, dieae o diode.
cidet Date Mea i epect of TPD cove, the late of the ceticatio date of the ijuy o ille which
caued total ad pemaet diablemet, o the date o which you ceaed employmet due tothe ijuy o ille that caued total ad pemaet diablemet.
come Poducig Duty Mea a duty that geeate at leat 20% of you pe-diability icome.
juy Mea bodily ijuy which i caued olely ad diectly by exteal, violet ad accidetal meaad i idepedet of ay othe caue.
ued mothly beet Mea the mothly beet amout accepted by the ue.
Limited cove (fo death ad
TPD cove)
Mea that you ae oly coveed fo claim aiig fom a ille which t became appaet,o a ijuy which t occued, o o afte the date the cove tated o, if the cove waeitated, o o afte the date the cove wa eitated. Fo detail about how ad whe youcove ca be eitated, efe page 12.
Maximum level of cove o
maximum cove
Death ulimited
Temial lle $5 millio
TPD $5 millio
come Potectio:
2 yea beet peiod - $50,000 pe moth (icludig the upeauatio cotibutiobeet);
5 yea ad to age 65 beet peiod - $40,000 pe moth (icludig the upeauatiocotibutio beet)
Medical pactitioe Mea, ule the ue agee othewie, a medical pactitioe legally qualied adegiteed to pactice i utalia, who i ot you, you poue, a elative, a buie pate, ahaeholde o you employee.
hiopacto, phyiotheapit ad alteative health povide ae ot egaded a medicalpactitioe.
Gloay
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Phrase Meaning
Mothly come You go mothly icome eaed fom peoal exetio fom you mai occupatio, ooccupatio, aveaged ove the 12 moth immediately pio to applyig fo icome potectiocove, aide fom boue which ae to be aveaged ove the 3 yea pio to applyig foicome potectio cove. f you have bee employed o elf-employed fo le tha 12 mothbefoe applyig fo icome potectio cove, you go mothly icome will be aveaged ovethe peiod ice you lat tated employmet o elf-employmet.
Note:
Fo the pupoe of calculatig you mothly icome:
1. you employe upeauatio cotibutio ae ot icluded; ad
2. if you ae elf-employed, you hae of buie expee ae ot icluded.
Occupatio Mea the employmet o activity i which you ae picipally employed o elf-employed.
Othe Diability come Mea ay icome (othe tha etu to employmet icome) which you may deive duig amoth fo which the mothly diability beet o patial diability beet i payable ad iclude:
a) ay beet payable ude othe icome potectio iuace policie;
b) ay beet ude ay woke compeatio, tatutoy compeatio, peio, ocialecuity o imila cheme o othe imila state, Fedeal o Teitoy legilatio; ad
c) ay beet paid ude tate o fedeal legilatio uch a the Depatmet of Vetea ffai;ad
d) ay claimed employe fuded ick leave etitlemet ad othe icome paymet.
y Othe Diability come which i i the fom of a lump um, o i commuted fo a lump um,ha a mothly equivalet of oe ixtieth (1/60th) of the lump um ove a peiod of ixty (60)moth.
f it ca be how that a potio of the lump um epeet compeatio fo pai ad
uffeig, o the lo of ue of a pat of the body, the ue will ot take that potio itoaccout a Othe Diability come.
Patially diabled o patial
diablemet
Pleae efe to the deitio o page 16.
Pe-diability come You mothly go icome eaed fom peoal exetio fom you mai occupatio, ooccupatio, aveaged ove the 12 moth immediately pio to becomig totally diabled, aidefom boue which ae to be aveaged ove the 3 yea pio to becomig totally diabled.f you have bee employed o elf-employed fo le tha 12 moth befoe becomig totallydiabled, you mothly go icome will be aveaged ove the peiod ice you lat tatedemploymet o elf-employmet.
Note:
Fo the pupoe of calculatig you pe-diability icome:
1. you employe upeauatio cotibutio ae ot icluded; ad
2. if you ae elf-employed, you hae of buie expee ae ot icluded.
rehabilitatio expee The cot of a ehabilitatio pogam (othe tha a pogam which would cotitute healthiuace buie ude the Private Health Insurance Act 2007 (Cth)) which a medicalpactitioe cetie i eceay fo you ehabilitatio.
retu to employmet
icome (fo icome
potectio pupoe)
Mea the go icome eceived by you duig a moth i epect of which a patial diabilitybeet may be payable, ad which i eaed a a coequece of you peoal exetio(icludig commiio, bou ad othe paymet that the ue eaoably coide fompat of you emueatio package), le all expee icued by you i coectio with eaigthat icome duig that moth (if you ae elf-employed, le you hae of buie expee).
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Phrase Meaning
salay f you ae employed you aual emueatio eceived fom peoal exetio, icludigbae alay, boue, fee, egula ovetime, commiio ad fige beet, but oticludig ivetmet icome, icome eceived fom defeed compeatio pla, diabilityicome policie o etiemet pla ad icome ot deived fom peoal exetio. Employeupeauatio cotibutio made fo you ae alo ot icluded.
f you ae elf-employed the amout eaed by the buie diectly due to you ow wok,le you hae of buie expee fo the buie, but befoe the deductio of icome taxfo the buie (o the elevat potio fo pat of a acial yea).
self-employed mea you ae pefomig activitie fo emueatio o ewad i a buie of which youdiectly o idiectly ow all o pat.
supeauatio cotibutio
beet (fo icome potectiopupoe)
if you have applied ad bee accepted fo a upeauatio cotibutio beet, aupeauatio cotibutio equal to:
10% of you pe-diability icome will be paid to you Fit state supe accout while youeceive a mothly diability beet;
10% of you pe-diability icome will be paid to you Fit state supe accout le ayupeauatio guaatee cotibutio made i elatio to you etu to employmeticome, while you eceive a patial diability beet.
Temial lle Pleae efe to Table 4 o page 6.
Total ad Pemaet
Diablemet/Totally ad
Pemaetly Diabled
Pleae efe to Table 4 o page 6.
Totally Diabled o Total
Diability (fo icomepotectio pupoe)
Pleae efe to the deitio o page 15.
Waitig peiod (fo icome
potectio pupoe)
Mea the cotiuou peiod (14, 30, 60 o 90 day, whicheve i applicable) commecig fomthe date a medical pactitioe cetie you a totally diabled ad fo which you have to betotally diabled o patially diabled befoe the mothly diability beet o patial diability beeti payable. f, duig the waitig peiod, you etu to gaiful employmet, the waitig peiod willtill be egaded a cotiuou if you etu to wok i fo 5 day o le ad you agai becometotally diabled o patially diabled a a eult of the ame ijuy o ille. The day fo whichyou wee i gaiful employmet will be added to the waitig peiod. f you etu to gaifulemploymet fo moe tha 5 day, the a ew waitig peiod will commece.
Gloay (cotiued)Gloay (cot.)
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If you need help with this form: Contact Customer Service between8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 014 04/11 p1
A. Your personal details
Member number Title (Mr Mrs Ms Miss Dr) Male Female Birth date (DD-MM-YYYY)
- -Family name
Given name/s
Postal address
Suburb State Postcode
Daytime contact telephone number Mobile number
Can the insurer contact you directly to clarif y or gather information relation to this application? Yes NoEmail address
FSS Trustee Corporation ABN 11 118 202 672 AFSL 293340 as the trustee of First State Super Scheme ABN 53 226 460 365
Refer to the Explanatory notes on page 8 for important information about completing this form.
Please print clearly in black ink.
You should use this form if you are:
A new employer-sponsored member of First State Super and you would like to apply for additional cover over and above the Basiccover to which you are automatically entitled. You should also use this form to apply for income protection cover. Premiums foradditional cover are payable in addition to the premiums payable for automatic cover.
A new personal member of First State Super and you would like to apply for death and total and permanent disablement (TPD) cover,death only cover or income protection cover.
An existing member and you wish to increase your existing insurance cover or apply for an increase to your additional cover.
B. Occupation statement
1. Are you employed? If not, you may only apply for additional death and TPD cover. Yes No
2. Are you employed as a casual worker? Yes No
3. Are you in paid employment for more than 15 hours per week? Yes No
4. What is your occupation?
5. Name of employer or government department you work for
6. Annual salary (includes packaged items but not bonuses/commissions) OFFICE USE ONLY Employer Code
$
7. What duties do you perform at work? Please be as specic as possible as this information is used to assign an occupational rating if applicable.
Application or insurance (or to increase your current insurance beneft)
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If you need help with this form: Contact Customer Service between8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 014 04/11 p2
I currently have: 0 units 1 unit 2 units
and I would like to apply for: 1 unit 2 units 3 units
Please7 cross the relevant box:
I would like to change my additional death only cover to additional death and TPD cover
I would like to increase my additional death and TPD cover to either a xed dollar amount or a number of units as shown below*, OR
I would like to increase my additional death only cover to either a xed dollar amount or a number of units as shown below*
I would like to nominate the following xed dollar amount:$
OR
I would like to nominate the following number of units:
*NOTE: You can only select one of the above two options ie. xed dollar amount OR number of units
Please7 cross the relevant box:
I would like to change my death only cover to death and TPD cover
I would like to apply for/increase my death and TPD cover to either a xed dollar amount or a number of units as shown below*, OR
I would like to apply for/increase my death only cover to either a xed dollar amount or a number of units as shown below*
I would like to nominate the following xed dollar amount:$
OR
I would like to nominate the following number of units:
*NOTE: You can only select one of the above two options ie. xed dollar amount OR number of units
See the glossary of insurance terms for the denition ofmonthly income.
Complete this section if you DO NOT currently have income protection cover (you must also complete Section H)
i) I would like to apply for a benet of 75% OR 50% of my current monthly income
ii) In addition to the % of monthly income indicated at i), I would like a 10% superannuation contributions benet
paid to my First State Super account Yes No
iii) I would like a benet period of 2 years 5 years to age 65
Please7 cross the relevant box:
I would like to change my automatic death only cover to automatic death and TPD cover
I would like to increase my automatic death and TPD cover, OR automatic death only cover (delete one) as follows:
If your application for automatic death and TPD cover is not accepted for TPD insurance, you may be offered death only cover by theinsurer.
C. Employer-sponsored members automatic cover
D. Employer-sponsored members additional cover
E. Personal members death and TPD or death only cover
F. All members income protection cover (you must be employed and working to apply)
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If you need help with this form: Contact Customer Service between8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 014 04/11 p3
iv) My current gross monthly income is $
v) The effective date of my current gross monthly income is - - (DD-MM-YYYY)
vi) I would like a waiting period of
*Note: 14 day waiting period is only available for a two-year benet period.
Complete this section if you DO currently have income protection cover (you must also complete Section H)
i) I would like to increase the percentage of my current gross monthly income paid as a benet from 50% to 75%
ii) My monthly income has increased to $
iii) The effective date of my current gross monthly income is - -(DD-MM-YYYY)
iv) I would like to reduce my waiting period from:
to:
v) In addition to the % of monthly income indicated at i), I would like a 10% superannuation contributions benet
paid to my First State Super account Yes No
vi) I would like a benet period of 2 years 5 years to age 65
*NOTE: 14 day waiting period is only available for a two-year benet period.
Please answer the following questions if you wish to apply to be rated for the Basic Plus insurance category. You must be able to answeryes to each of the following questions to be eligible for the Basic Plus insurance category . If you are accepted for this category, itwill apply to all your insurance cover. Your health information will also be taken into account to determine your eligibility for this category.
1. Are the duties of your occupation limited to professional, managerial, administrative, clerical, secretaria l or similarwhite collar-type tasks which are of a sedentary nature and do not involve manual work and are undertakenentirely within an ofce environment (excluding travel time from one ofce environment to another)? Yes No
2. Are you earning in excess of $80,000 (including superannuation) per annum from this occupation? Yes No
3. Do you hold a tertiar y qualication relevant to your current occupation OR are you a member of a professionalinstitute or registered member of a government body OR are you engaged as a senior member of your employersmanagement/executive team? Yes No
1. Please state your: Height (cm) Weight (kg)
2. Name and address of your usual doctor or medical centre:
Surname
Given name
Address
State Postcode
3. a. Are you applying to increase your current level of cover? Yes No
b. Have you ever held or applied for any life, disability, accident & sickness or trauma insurance, that wasdeclined, postponed, premium increased or modied, or had a current policy cancelled or renewal refused? Yes No
c. Have you claimed on any type of disability, trauma, accident and sickness or such benets as WorkersCompensation or Motor Vehicle Third Party? Yes No
d. Do you have, or are you applying for, any other life or disabil ity cover? Yes No
14 days* 30 days 60 days 90 days
30 days 60 days 90 days
14 days* 30 days 60 days
F. All members income protection cover (cont.)
G. Basic Plus insurance category application
H. Personal statement
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If you need help with this form: Contact Customer Service between8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 014 04/11 p4
If Yes to b, c and/or d, please provide full details below.
Name of
companyCover type
Sum
insured
Date of
applicationAccepted Loaded Exclusion Declined
Is this
cover to be
replaced?
Yes or no
$
$
4. Habits and activities
a. Do you drink alcohol? Yes No
If Yes, state type and daily quantity.
b. Have you smoked in the past 12 months? Yes No
If Yes, state form and daily quantity.
c. Have you ever used or injected yourself with any drug not prescribed by a doctor, or received Yes Nocounseling or treatment for the use of alcohol or drugs?
If Yes, please note that the insurer may ask you to complete an additional questionnaire.
d. Do you currently, or do you intend to engage in any hazardous pastime and / or sporting activity Yes Nosuch as aviation (other than as a fare paying passenger travelling over recognised routes), motorracing, diving, football, parachuting, hang-gliding or any other extreme sport?
If Yes, please note that the insurer may ask you to complete an additional questionnaire.
e. Do you intend travelling outside Australia within the next 2 years? Yes No
If Yes, please provide details below (where, when, duration and reasons).
5.