PDSsupp Insurance Apr11 FINAL

8/3/2019 PDSsupp Insurance Apr11 FINAL

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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.



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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.


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.


9/489

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.


10/4810


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


11/4811

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.


12/4812


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.


13/4813

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.


14/4814

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.


15/4815

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.


16/4816

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.


17/4817

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.


18/4818

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,


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.


19/4819

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.


20/4820

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


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


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.


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.)


21/4821

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


22/4822

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


23/4823

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).


24/4824

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.)


25/48

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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)


26/48


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


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


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)


27/48

CONTINUES ON NEXT PAGE >


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


28/48


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.

PDSsupp Insurance Apr11 FINAL

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