Please print and/or save this booklet for your records.
Salary Protection Scheme
A guide to your Policy
The Scheme contribution rate as indicated in this booklet does not
include the 1% insurance levy, introduced by the government with
effect from 1st August 2009 and applied by Zurich Life with effect
from July 2010.
contents
A message from Raymond St. John,
Honorary Treasurer, ASTI...................................................................................................................... 1
Introduction. ....................................................................................................................................................2
Why you need the Salary Protection Scheme................................................................. 4
Additional protection for you and your family............................................................. 6
Cost of the Scheme.....................................................................................................................................7
How to join the ASTI Scheme. ......................................................................................................... 8
Frequently asked questions............................................................................................................. 9
Joining the Scheme............................................................................................................................... 10
Terms of employment.......................................................................................................................... 12
Calculation of benefit.......................................................................................................................... 16
Tax relief. .......................................................................................................................................................18
Claiming from the ASTI Scheme...................................................................................................18
Returning to work after making a claim. .............................................................................. 25
Death Benefit............................................................................................................................................26
Other common questions. ............................................................................................................... 27
“Perhaps the greatest threat to your livelihood
is ill health…”
If you fall ill your sick pay provides you with an income for a limited
period only. Once your sick pay runs out, your income will fall
dramatically. In fact most teachers find that they are entitled to
no income whatsoever once their sick pay runs out.
The choice is stark. If you are able to retire on grounds of ill health
you’ll have to try and make ends meet on the small fraction of salary
you’ll receive as a disability pension. Alternatively if you hope to
recover and go back to work you may have no choice but to struggle
on without any income at all.
The ASTI Salary Protection Scheme provides members with the financial
security they deserve. It has grown to become an important benefit of
union membership with over 8,000 members enjoying the protection
the Scheme provides. It is now well placed to provide vital protection for
members at an affordable cost for many years to come.
If you haven’t already joined I would urge you to consider doing so now.
Raymond St. John,
Honorary Treasurer, ASTI
3376 ASTI SPS policy book 12/09
Introduction
Protecting your salary
Cornmarket has been administering the ASTI Salary
Protection Scheme since its launch over 30 years ago.
As an independent financial advisor, Cornmarket’s role is
to act on behalf of members. This includes:
• Negotiating with the insurers (currently Zurich Life)
to obtain the most competitive rates and to secure the
best possible benefits
• Assisting ASTI members who wish to make a claim from
the Scheme by guiding them through every stage of the
claims process and acting as the members’ advocate
• Promoting the Scheme to ASTI members.
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
The Scheme
in action
Through its various Salary Protection Schemes, Cornmarket has helped
protect the financial security of more public sector employees than any
other company in Ireland. But the real testament to the quality of these
Schemes is the amount being paid out to beneficiaries, which is now
counted in hundreds of millions of Euro. Here’s what just two of the people
who’ve already benefited from our Salary Protection Schemes have to say...
“I’m in receipt of benefit from the ASTI Salary
Protection Scheme and it has certainly
made a difference in my life. After I made
the claim, two of my children went down
seriously ill and by having the income from
Cornmarket, it enabled my wife to take time
off completely, to take a year out so that we
could both devote the time to the kids...
John Kelly,
ASTI member and beneficiary
of the ASTI Salary Protection
Scheme.
At that critical period, it meant that there
was an income coming in, it was meeting the
mortgage and I had some sense of security.
I never felt that we were pressurised to
go back to work, either of us, because the
income was coming in… I feel that if I didn’t
have the Salary Protection I would be the
one that would be forced back to work.
I’m happy being around my kids and my kids
don’t feel deprived. They avail of their annual
holiday if circumstances allow. It’s certainly
not determined by financial reasons...
I feel that anybody who is not in the Salary
Protection Scheme today is taking a risk.
Nobody knows when illness is going to strike.
Illness to a 26 year old might be a flu or a
common cold. I think that you’ve got to look
to the broader picture that if the situation
happened tomorrow morning, could you
sustain any type of normal life that you had
become used to…
If you don’t have Salary Protection, it’s
irresponsible. You’ve the responsibility to
meet your debts. You’ve the responsibility to
family and other financial commitments.
Although my circumstances have been
worsened in many ways by having two ill
children, I just can’t imagine what life would
be like for me without that income from the
ASTI Salary Protection Scheme coming in. It’s
a lifeline. It enables me to live with a level of
dignity, to do the things I want to do.
It’s very easy to look at the here and now and
say I’m the picture of health, I’m not going to
get sick. Nobody knows what’s around the
corner and I would say to people that at least
one person in any family should have Salary
Protection.”
“My medication­is €120 a month, it’s very
expensive. But I don’t have to worry about
things like that. Because I’m in the Scheme
it means that what should have become a
luxury, isn’t.
When the bill came in for Euro Languages
college for my daughter or for my son’s halls
of residence at DCU I could just write the
cheque. We didn’t have to worry about it.
It’s great.”
Séamus McAteer,
Scheme Beneficiary, Co. Meath.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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3
Why you need the ASTI Salary Protection Scheme
Although many members feel
What happens to your income if you fall ill?
protection the Scheme provides,
Typically teachers who are contributing to the Superannuation Scheme are
paid full salary for 52 weeks of illness in any 4 year period. After this your pay
stops altogether.
that they will never need the
sadly our experience has been
that even the healthiest person
can suffer unexpected illness or
have a serious accident. This is
why membership of the Scheme
is so vital for every member.
An example* of what
happens when sick pay
runs out
At this point, if you are forced to retire on the grounds of ill health, you may
be entitled to an Early Retirement Pension (ERP). Even if you have many years
of service, your Ill Health Early Retirement Pension will only be a fraction of
your pre-disability salary (see graph below). In addition, those paying PRSI
at the ‘A1’ rate, may be entitled to a State Illness Benefit but at just €10,660
(2009), the State Illness Benefit provides a subsistence income.
The reality is that long-term illness inevitably means a severe drop in living
standards. The need for some kind of additional income is vital.
100%
75%
Salary/Sick pay
€962 p.w.
50%
Early Retirement Pension/
Social Welfare
25%
Plan Benefit
* Example based on benefits for a permanent, full-time teacher who
is a member of the Superannuation Scheme with 15 years’ service,
earning €50,000 p.a. (€962 p.w.) paying PRSI at the lower ‘D1’ rate,
who is now unable to work due to long-term illness or disability.
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ASTI SPS Policy
€260 p.w.
0%
First 52 weeks of illness
After 52 weeks of illness
Salary/Sick pay totals
100% of basic salary
Early Retirement Pension totals
27% of pre-disability salary
3376 ASTI SPS policy book 12/09
In a nutshell, the Scheme aims to
pay you a benefit of up to 75% of
the salary you were earning before
you fell ill, less any Early Retirement
Pension (ERP) and/or State Illness
Benefit to which you are entitled.
How the Scheme works
If you have been taken off the payroll
After 52 weeks of illness in any period of 4 years, the ASTI Scheme pays
you a benefit of 75% of your pre-disability salary less an amount equal
to your Early Retirement Pension (ERP) and/or State Illness Benefit.
If you do not wish to retire (perhaps because you anticipate recovery
of your health) you will obviously not be entitled to claim an Early
Retirement Pension (ERP). In such cases, Zurich Life (the insurer) will
consider paying a benefit equivalent to 75% of salary (less any State
Illness Benefit if applicable) for a maximum of 2 years if there is a
reasonable expectation that you will return to work. This means that
over the 2 year period, no deduction will be made for an Early Retirement
Pension as no Early Retirement Pension is being paid. (See page 23, Q4:
What happens if I do not want to retire? for full details).
If you are on a temporary contract you are entitled to 91 days sick pay in a
12 month period (see page 14, Q8: Are there any special considerations for
part-time/temporary teachers?)
The Scheme goes on paying you until you recover, are deemed fit to return
to work by Zurich, die, or right up to your 60th birthday (see page 11, Q4:
When does my membership end? for details).
An example* of how
the Scheme helps
100%
75%
€962 p.w.
€461 p.w.
50%
25%
€260 p.w.
0%
3376 ASTI SPS policy book 12/09
First 52 weeks of illness
After 52 weeks of illness
Salary/Sick pay totals
100% of basic salary.
Scheme Benefit totals 75%
of pre-disability salary less
Early Retirement Pension.
ASTI SPS Policy
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5
Additional protection for
you and your family
The main purpose of Salary Protection is to provide you and your family with
financial support in the event that you fall ill and find yourself unable to work.
The Scheme provides additional benefit in the form of:
1
Death Benefit of twice salary
The Scheme provides important protection for your family in the form of a Death Benefit
equivalent to twice your annual salary paid to your estate should you die. Some members
may have availed of the option to increase their Death Benefit to a maximum of four times
their salary (from time to time Zurich Life offers this). This is provided up until age 65.
As with your Disability Benefit, this Death Benefit is salary linked – so it rises each year
in line with your salary. Better still, the cost is far lower than that normally charged for an
‘off the shelf ’ Life Assurance Policy. For example, a 45-year-old female earning €50,000 per
annum will pay only €12.92 per month for death benefit of twice salary (€100,000) under
the Scheme. Typically such cover would cost about €18.17* per month outside the ASTI
Scheme.
Terminal Illness Benefit
In the event that a member is diagnosed with a terminal illness with less than 12 months to
live, (and is under age 64) then Zurich Life will pay out the full Death Benefit. This is provided
Zurich’s Chief Medical Officer agrees with the medical evidence provided.
Accidental Death Benefit
In the event of accidental death, a benefit of €15,000 is payable in addition to the normal
Death Benefit of twice annual salary. Accidental Death is defined as ‘death as a direct result
of a bodily injury arising from an external and accidental cause which leaves a visible bruise
or wound.’
Children’s Death Benefit
In the event that a member’s child between the age of 3 months and 18 years of age, or 21
if in full time education dies, an additional Death Benefit of €4,000 will be paid out. Benefit
will not be paid where the claim was a result of a pre-existing or congenital condition.
2
Pension Protection Benefit
Unfortunately, one of the first things to be hit when a member is taken off the payroll is their
pension. In recognition of this fact, if you fall ill and are claiming from the Scheme for more
than 2 years, a further 5% of the salary you were earning before you fell ill will be paid into a
separate Personal Retirement Savings Account (PRSA). This is to make up for the fact that you
will be missing some years of Superannuation contributions. This additional contribution will
continue to be paid until you recover, return to work, die or reach age 60. (See page 11 Q4:
When does my membership end?).
What happens at retirement?
* Source: www.adviserplus.ie
(20 year increasing cover for a
45 year old female non-smoker.
October 2009).
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ASTI SPS Policy
Our experience has been that the vast majority of members still need some element of Life
Cover even after they retire. For this reason, for a contribution of 0.05% of salary (built into
the overall rate of contribution to the Scheme), members are entitled to join the Retired
Members’ Life Cover Plan on retirement without having to undergo any medical underwriting.
This provides for the payment of a tax-free lump sum to your estate on your death. Thereafter,
for a modest monthly contribution, members will benefit from the Death Benefit provided by
the Retired Members’ Life Cover Plan. (see page 26 Q3: Can my death benefit remain in force
after I retire?).
3376 ASTI SPS policy book 12/09
Cost of the Scheme
How much does the Scheme cost?
Very little! As membership is so vital, the Scheme is designed to be affordable
for every member. It's remarkably good value because it’s negotiated on a
special ‘group basis’ for ASTI members. The contribution rate is currently set
at just 2.29% of income and is conveniently deducted from your salary by
your employer. Please bear in mind that it is your responsibility to ensure that
the correct deductions have, in fact, been made by your employer and that
deductions are cancelled where appropriate.
Disability Benefit
1.77%
pension protection benefit
0.16%
Death Benefit
0.31%
Medical Immunity* 0.05%
Total
2.29%
*entitles members to join the Retired Members’
Life Cover Plan without medical underwriting.
A helping hand from the taxman
You are eligible for tax relief at your highest rate of tax on that part of your
contribution going towards Disability Benefit and Pension Protection Benefit
(1.93% of the total contribution of 2.29% of income). This means for most
members the cost of membership is only €11 to €14 a week after tax – a small
price to pay for peace of mind.
Example
Income
Weekly
contribution
‘Real’ weekly contribution
after tax relief
€40,000
€45,000
€17.62
€10.80
€19.82 €12.15
€22.02
€13.50
€50,000 Contribution for a full time teacher who is a member of the Superannuation Scheme,
paying PRSI on a lower ‘D1’ rate, and paying income tax @ 41% (1st October 2009).
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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7
How to join
the ASTI Scheme
Who is eligible to join?
You may apply to join the ASTI Scheme if you are a teacher who is:
1
Under age 60
and
2
A member of the Association of Secondary Teachers of Ireland (ASTI)
and
3
Employed on a permanent full-time basis
or
Employed as a temporary or part-time teacher on a contract of at least
12 months’ duration.
Job/work sharers
Job/work sharing members who satisfy the eligibility conditions
above may also apply to join the ASTI Salary Protection Scheme.
The level of contribution and benefits which apply for them may
differ from those relevant for the full-time members.
Join now!
The ASTI Salary Protection Scheme helps members maintain
the standard of living they deserve. If you haven’t already
joined the Scheme, don’t put it on the long finger.
Apply to join now – simply call (01) 408 4025. Cover begins
as soon as Zurich Life accepts you as a member of the
Scheme.
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
Frequently asked
questions
Joining the Scheme
What medical details must be confirmed
when applying to join?............................................................................ 10
Who is eligible to join?..............................................................................11
When does my membership begin?....................................................11
When does my membership end?........................................................11
Are all applications accepted?...............................................................12
What does it mean if my application is
subject to exclusions, or even refused?.............................................12
Terms of employment
What if I have a second job?..................................................................12
What if I have unearned income?........................................................12
What if I take a career break?................................................................12
What if I change my occupation or leave ASTI?............................. 13
Is my benefit affected by the PRSI contribution I pay?............... 13
What if I am not in the Superannuation Scheme?......................14
Tax relief
Do I have to pay tax on benefits from the ASTI Scheme?.........18
How do I claim my tax relief on contributions?............................18
Claiming from the Scheme
How do I claim from the Scheme?......................................................19
How disabled do I have to be to qualify for benefit
under the Scheme?................................................................................... 23
Who decides whether or not I am fit to work?............................. 23
What happens if I do not want to retire?........................................ 23
Are there any exclusions under the Scheme?................................ 23
Are claims ever turned down by the insurer?................................ 23
When does benefit payment under the Scheme begin?.......... 24
What happens if I become disabled while on
a career break?............................................................................................ 24
For how long will I be paid benefit under the Scheme?........... 24
What happens if I change my terms of employment?...................14
Do I have to pay my contributions if I am
claiming from the Scheme?.................................................................. 24
Are there any special considerations for
part-time teachers?....................................................................................14
What happens if my claim is rejected?............................................ 24
What benefits does the Scheme provide for job sharers
and work sharers?.......................................................................................14
Returning to work after making a claim
What if I take unpaid parental, maternity
or adoptive leave?....................................................................................... 15
What if I take unpaid leave to take care of
a dependant relative?.................................................................................. 15
What if I travel abroad?............................................................................ 15
Calculation of benefit
On what salary is my cover based?.....................................................16
Does it affect my benefit under the Scheme
if my disability is due to an injury at work?....................................16
What if I take out a ‘Critical Illness’ Policy?......................................16
What happens if I return to work only to find that
I become ill again a few months later?............................................ 25
What happens if I return to work but at a reduced
salary or take up a different less well paid job?........................... 25
Death Benefit
What benefit is paid on death?...........................................................26
Can my Death Benefit remain in force if I claim
under the Disability Benefit?................................................................26
Can my Death Benefit remain in force after I retire?.................26
Payment of Death Benefit......................................................................26
Does my cover increase in line with my rising salary?................16
If I am claiming from the ASTI Scheme,
does the amount I receive increase each year?.............................16
What if I already have some form of Salary Protection?...............16
Will I receive money back if I never claim
under the ASTI Scheme?.......................................................................... 17
Other common questions
What happens if I cancel my membership?................................... 27
Under what circumstances can the Scheme be amended?.... 27
Who administers and insures the ASTI Scheme?......................... 27
What are the maximum benefits paid
under the ASTI Scheme?.......................................................................... 17
Pension Protection Benefit..................................................................... 17
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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9
Joining the Scheme
1
1
What medical details must be confirmed when
applying to join?
When completing your application form you must answer
the following questions:
Have you been absent from or unavailable for work through
illness or injury for a continuous period of more than 10
working days in the last 12 months, including periods of
holidays or non-employment (colds or influenza may be
ignored)?
Yes
2
Are you currently unwell or do you suffer from any physical
defect or is there any ailment or disease to which you have a
tendency? Yes
3
No
Are you currently taking prescribed drugs, medicines, tablets
or other treatment or have you done so in the last year (colds
or influenza may be ignored)?
Yes
4
5
No
Have you been referred to a specialist or admitted as an
in-patient to any hospital or clinic in the last four years
(in-patient periods in respect of normal pregnancy and
delivery need not be disclosed)?
Yes
No
Have you ever had any symptoms of, or suffered from any of
the following: Depression, anxiety, stress, nervous breakdown
or mental disorder?
Yes
6
7
No
No
Have you ever been declined, postponed or accepted on
special terms by Zurich Life or any other insurer for life,
serious illness or disability insurance?
Yes
|
Have you ever had any symptoms of, or suffered from any
of the following: Lumbago, slipped disc, whiplash or back
trouble?
Yes
10
No
ASTI SPS Policy
No
Cornmarket makes every effort to ensure that all ASTI
members who wish to join the Scheme are given an
opportunity to do so. With this in mind, rather than preclude
those members who have had health problems in the past
from joining the Scheme (and who therefore typically have
answered yes to one or more of the seven questions listed
opposite) members are instead requested to provide further
details on the application form. On the basis of the details
provided the Scheme’s insurer will then assess the risk
involved. This may include writing to your GP for further
details of your medical history or requesting that you attend
for a medical examination. Alternatively Zurich Life may
contact you to arrange a tele-interview to clarify details of
your medical history. If you answer ‘yes’ to any of the
questions you will be required to provide full details on the
application form.
The insurer may wish to check certain aspects of your
medical health and for this reason you will be expected to
provide the name and address of your current GP and the
number of years you have attended him/her.
The benefits of the ASTI Salary Protection Scheme are being
made available to ASTI members on the basis of certain
conditions. It is important that you appreciate what those
conditions are and are happy to accept those conditions prior
to joining the Scheme. For these reasons when applying to
join the Scheme you must confirm your understanding of
and agreement to a number of conditions. You must confirm
that:
• You wish to join the ASTI Salary Protection Scheme
• You are actively at work on the day you complete
the application form (or capable of being actively at
work on that day)
• The statements you make in your application form
(including any statements written down at your
dictation) are true and complete
• You understand that if you sign the declaration on
the application form untruthfully, or fail to disclose
a material fact, any claim you may make under the
ASTI Scheme may be refused. A material fact is one
which an insurer would regard as likely to influence
the assessment and acceptance of an application
for insurance
• You consent to Zurich Life seeking information
from any doctor who at any time has attended you
concerning anything which affects your physical or mental health or seeking information from any insurance office to which a proposal has been made for insurance on your life and you authorise the
giving of such information
3376 ASTI SPS policy book 12/09
• You agree that the declaration you sign on your
application form and any other declaration you make
in connection with your application to join the ASTI
Scheme, including statements made to any medical examiner on behalf of Zurich Life, shall be the basis for the contract of insurance between you and Zurich Life
2
Who is eligible to join?
You may apply to join the Scheme if you are a teacher who
is:
1 Under age 60 and
2 A member of the Association of Secondary Teachers
of Ireland (ASTI) and
• You are a member of ASTI
3 Employed on a permanent full-time basis or
• You have received and read the Scheme booklet and
understand the conditions of cover
4 Employed as a temporary or part-time teacher on a contract
of at least 12 months’ duration.
Job/work sharers
Job/work sharing members who satisfy the eligibility
conditions above may also apply to join the Salary Protection
Scheme. The level of contribution and benefits which apply
for them will differ from those relevant for the full-time
members.
• You understand cover under the ASTI Scheme will not begin until your application has been accepted by Zurich Life and that you must notify Zurich Life of any changes in your health and/or circumstances which may arise between the date you sign this form and the date Zurich Life accepts you into the ASTI Scheme
• You understand if your application is declined or accepted on special terms, this fact will be noted on a register administered by the Irish Insurance Federation and may be shared with other companies as a
protection against non-disclosure of material facts
3
When does my membership begin?
4
When does my membership end?
• You have received and understand the contract of the Cornmarket Terms of Business document and agree to the terms
• You agree to be bound by the terms and conditions of the ASTI Scheme
• You understand it is a condition of membership that you accept that ASTI may amend the terms of the ASTI Scheme or terminate the ASTI Scheme altogether and that decisions of ASTI in such matters are binding on all members
• Your details may be held on computer or otherwise
and that you may be contacted by Cornmarket
about their services in the future (only applicable
to ASTI members).
From time to time Cornmarket offers a preferential
application form. This form requires you to confirm that:
• You are actively at work or capable of being actively
at work at todays date
and
• You have not been absent from work due to any illness or injury for more than 10 continuous working days in the last 12 months.
The preferential application form is designed to provide
those who can sign the shortened declaration with a ‘fast
track’ application process.
3376 ASTI SPS policy book 12/09
Your cover begins from the date Zurich Life accepts your
application to the Scheme. Members receive a formal
acceptance letter confirming they have been included as
members of the ASTI Salary Protection Scheme. In some
cases medical evidence may be required before membership
of the Scheme can be confirmed. This may involve providing
further details over the telephone or attending a medical
examination at Zurich Life’s expense.
Alternatively Zurich Life may contact you to arrange a teleinterview to clarify details of your medical history.
Membership of the Scheme ends:
• On your 60th birthday as far as the Disability & Pension
Protection Benefit is concerned and on your 65th birthday
as far as the Death Benefit is concerned (assuming you
have not retired)
or
• If you no longer fulfil the eligibility requirements as set out
or
• If your contributions to the Scheme cease (please bear
in mind that the responsibility to ensure that the correct contributions to the Scheme are paid rests with you).
However, you do have the right to carry on an element of
Death Benefit throughout your retirement if, at retirement,
you decide to avail of the Retired Members’ Life Cover Plan
(see page 26 Q2: Can my Death Benefit remain in force after
I retire? for details).
ASTI SPS Policy
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11
Terms of
employment
It is important to remember that Cornmarket may not be
notified by your employer when you retire. It is vital therefore
that you notify Cornmarket at least 10 weeks in advance of
your retirement date so that we can offer you the option
to join the Retired Members’ Life Cover Plan or to stop your
contributions to the Scheme.
5
6
1
Are all applications accepted?
In a small percentage of cases membership of the ASTI
Scheme may be refused. In such cases applicants will receive
a letter confirming that they have not been accepted into
the ASTI Scheme. In other cases, membership may be offered
subject to the condition that certain medical conditions are
excluded from cover.
What does it mean if my application is subject
to exclusions, or even refused?
This means that Zurich Life believe they cannot, because of
your health history, offer you the cover sought, or exclude
certain conditions or restrict the level of cover. Zurich
Life make such decisions only after careful consideration
of the information supplied by you on your application
form together with any details they have received from
doctors you have attended. Applicants may seek additional
clarification from their own doctor who can contact Zurich
Life to request reasons for their decision.
What if I have a second job?
This may be taken into account in calculating any benefit paid
should you make a claim from the Scheme. It is vital, therefore,
that you notify Cornmarket in writing at the time of joining
the Scheme if you have a second job. Likewise, you should
notify Cornmarket in writing if, after joining the Scheme, you
take on a second job. In the event that you have a second job
at the time of joining the Scheme or take on a second job after
joining the Scheme, Zurich Life reserves the right to refuse
cover or withdraw cover in respect of your normal job.
This could happen where, for instance, Zurich Life believes that
your second job involves a greater degree of risk than that
involved in your normal job. The cover provided by the Scheme
does not extend to your second job. If you would like disability
cover on your second job you should contact Cornmarket
about the possibility of insuring yourself against disability
through an individual policy.
2
3
1
What if I have unearned income?
In general, investment and rental income will not be taken
into account when making a claim under the Scheme.
Benefit from any accident or sickness policy will however
be taken into account, except benefits paid under a Critical/
Serious Illness policy (see page 16, Q3: What if I take out a
‘Critical Illness’ Policy? for details and see page 17, Q8: What
are the maximum benefits paid under the ASTI Scheme?).
What if I take a career break?
Generally, members of the Scheme who take a career break
fall into one of the following categories –
Members who wish to continue their full cover under the
Scheme for the duration of their career break because they are
taking up alternative employment.
If you are in this category you may apply within 2 months of
taking a career break to transfer benefits similar to those you
enjoyed under the Scheme to any new job. This is however at
Zurich Life’s discretion and subject to your new job being
acceptable to Zurich Life from an underwriting point of view,
e.g. that your new job does not involve a greater degree of risk
than that in your normal job. Naturally the rate and amount
of your contribution and benefit level will be determined by
your pre-career break salary as you will no longer be an active
member of the Scheme. You should remember to notify
Cornmarket on taking up your normal job at the end of your
career break if you wish to re-activate your membership of the
Scheme. The level of cover applying when you take up your
membership again may be higher than that you enjoyed
while on your career break.
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
2
3
Members who wish to continue the Death Benefit element
of their cover but who do not wish to continue the Disability
Benefit and Pension Protection Benefit element of their
cover and who also wish to re-activate their membership
of the Scheme on completing their career break without
having to undergo any medical underwriting.
4
If you are in this category you may apply within two months
of taking a career break for immunity from medical
underwriting. This will allow you to reactivate your Disability
Benefit and Pension Protection Benefit under the Scheme
before a specified date when your career break is over –
without the need for medical underwriting. To secure
immunity from medical underwriting you must pay a
reduced contribution of 33 ⅓% of the normal contribution
for Disability Benefit. To maintain the Death Benefit in force
you must pay 100% of the contribution for Death Benefit.
These payments are based on your pre-career break salary
and must be paid annually in advance during your career
break. The level of the Death Benefit during the career break
will be based on your salary on the date you started your
career break.
4 Members who simply decide to discontinue membership
of the Scheme.
If you are in this category, or do not notify Cornmarket of
your intention to take a career break, your cover under the
Scheme will cease as soon as your salary stops. Thereafter
you must complete a full medical application form and
undergo medical underwriting should you wish to rejoin
the Scheme upon returning to work.
3376 ASTI SPS policy book 12/09
Disability Benefit Continuation Option
Where a member leaves teaching prior to age 54V they
may, within 30 days of leaving, take out an individual Salary
Protection Policy with Zurich Life for a benefit not exceeding
the Disability Benefit in force under the Scheme at the time
he/she ceased teaching. This is provided that the person
takes up a new occupation acceptable to Zurich Life within
30 days of leaving the ASTI Scheme and that his/her place
of residence is acceptable to Zurich Life. The Policy will be
issued without the need to provide medical evidence. The
premium will depend on the rates applicable to the person’s
age and new occupation and on terms and conditions
applicable to that type of policy at that date.
Death Benefit Continuation Option
Where a member leaves teaching prior to age 59V they may,
within 30 days of leaving, take out an individual Policy with
Zurich Life for a benefit not exceeding the Death Benefit in
force under the Scheme at the time he/she ceased teaching
provided that the person takes up a new occupation
acceptable to Zurich Life within 30 days of leaving the ASTI
Scheme and that his/her place of residence is acceptable
to Zurich Life. The Policy will be issued without the need to
provide medical evidence. The premium will depend on the
rates applicable to the person’s age and new occupation and
on terms and conditions applicable to that type of policy at
that date.
Members who do not wish to continue either the Disability or
Death Benefit or Pension Protection Benefit element of their
cover but who wish to re-activate their membership on
completing their career break without having to undergo any
medical underwriting.
If you are in this category you may apply within two
months of taking a career break for immunity from medical
underwriting. This will allow you to re-activate your
membership of the Scheme before a specified date when
your career break is over without the need for medical
underwriting. To secure immunity from medical underwriting
you must pay a reduced contribution of 33 ⅓% of the
normal contribution for Disability Benefit and 33 ⅓% of
the contribution for Death Benefit and Pension Protection
Benefit. These payments are based on your pre-career break
salary and must be paid annually in advance during your
career break.
What if I change my occupation or leave ASTI?
5
Is my benefit affected by the PRSI contribution
I pay?
Many members are paying PRSI contributions on the lower
‘D1’ PRSI rate and so pay less PRSI than those members on
the ‘A1’ PRSI rate. If a member paying PRSI at the ‘D1’ rate
retires on an Ill Health Early Retirement Pension (ERP) under
the Superannua­ti­ on Scheme, he or she is not entitled to any
State Illness Benefit. On the other hand members paying the
higher ‘A1’ PRSI rate may be entitled to a State Illness Benefit
if they suffer prolonged illness. Members in this situation
may also be entitled to an Ill Health Early Retirement
Pension. The benefit payable under the ASTI Scheme is the
amount needed to ‘top up’ any Ill Health Early Retirement
Pension and any State Illness Benefit to 75% of pre-disability
salary. In effect this means that whether you are a ‘D1’ or an
‘A1’ PRSI contributor, taking both the Ill Health Early
Retirement Pension and the State Illness Benefit into
account, the combined amount you receive in the event of
disability is the same.
ASTI SPS Policy
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13
Terms of employment
6
7
8
14
What if I am not in the Superannuation Scheme?
If you are not contributing to the Superannuation Scheme,
you are not entitled to an Early Retirement Pension should
you become disabled. However, if you are not a member of
the Superannuation Scheme you will be paying full PRSI
contributions and therefore may be entitled to a State Illness
Benefit in the event of disability. Typically, if you are in this
situation you are paid full salary for 52 weeks of illness in
any 4 year period. After this your pay stops altogether and
your only entitlement thereafter is to State Illness Benefit.
Therefore, if you are not a member of the Superannuation
Scheme, any benefit under the ASTI Scheme will be paid
after you have been ill for 52 weeks in any 4 year period. The
amount paid will be 75% of your pre-disability salary less any
State Illness Benefit entitlement, whether paid or not, you
may be receiving from your employer.
under the Scheme may be reduced if, for instance, you spent
some years as a full time teacher. Assuming you were
contributing to the Superannuation Scheme for more than
5 years, you would be entitled to receive an Ill Health Early
Retirement Pension (ERP). If the greater portion of your
Superannuation contributions were made while you were
on a full time salary, it may be the case that your Early
Retirement Pension (which might include many years of
Superannuation contributions based on full-time income) is
in fact very large in relation to your current part-time salary.
As a result you would be eligible for little or no benefit under
the Scheme as you would already be receiving close to or
more than 75% of your pre-disability salary in the form of
an Ill Health Early Retirement Pension. For this reason when
calculating the amount of benefit to be paid under the
Scheme in such cases, Zurich Life may reduce the deduction
in respect of any Early Retirement Pension in order to be fair
to the member. A similar approach is applied for those who
are job sharers.
What happens if I change my terms of employment?
If your terms of employment change, this may affect your
cover under the Scheme. For instance, if you join the
Superannuation Scheme or if you reduce the overall number
of hours you are working each week, your benefits under the
ASTI Scheme may be affected. It is vital therefore that you
notify Cornmarket in writing should you change your terms
of employment.
Are there any special considerations for part-time/
temporary teachers?
Yes. Amongst the issues you should consider:
1
If you are on a temporary contract you are entitled to 91
days sick pay in a 12 month period. Benefit will be paid after
91 days sick leave in a 12 month period.
2
Part-time teachers are eligible to join provided they are
working on a contract of employment of at least 12 months’
duration.
3
Part-time teachers should also bear in mind that in some
cases membership of the Scheme may not be suitable for
them. This could be the case if, for instance, you are on a
relatively low salary and are paying PRSI at the ‘A1’ rate. This
means that if you become disabled you would receive State
Illness Benefit (€10,660 – the 2009 level). If this is more than
75% of your pre-disability salary you would not receive any
benefit from the Scheme. This is due to the fact that you
would already be receiving more than the maximum 75% of
pre-disability salary you are entitled to under the Scheme.
|
4 Part-time teachers should also remember that benefits paid
ASTI SPS Policy
9
What benefits does the Scheme provide for job
sharers and work sharers?
The benefits and contributions for job sharing and work
sharing members are automatically based on job sharing
and work sharing salary i.e. 2.29% of the member’s job
sharing/work sharing salary.
In the event of a claim, Zurich Life may deduct a lesser
amount than the actual Ill Health Early Retirement Pension
(ERP) entitlement from the benefit paid by the Salary
Protection Scheme. This is because, if Zurich Life were to
deduct the actual Early Retirement Pension (which might
include many years of Superannuation contributions based
on full-time salary), the member’s Early Retirement Pension
entitlement could come close to, or actually exceed the
benefit paid under the Scheme. This would mean little or
no benefit would be paid under the Scheme. For this
reason, when calculating the amount of benefit to be paid
under the Scheme, Zurich Life may reduce the deduction in
respect of any Early Retirement Pension in order to be fair
and equitable to the member.
A similar approach is applied for those who take up a
part-time position following a period spent in full-time
employment. This applies to all members who take up
a job sharing or work sharing post and means that
contributions and cover will automatically be based on
your job sharing/work sharing post.
3376 ASTI SPS policy book 12/09
SPECIAL CONCESSION
Option to have cover based on full-time salary:
In recognition of the fact that some members intend to go
job sharing for a limited period of typically one to two years
and would prefer to keep cover based on their full-time
salary, Zurich Life has agreed to provide an option for cover
based on the member’s full-time salary i.e. be treated on the
basis that you are employed full-time and pay a contribution
based on your full-time salary. In this event, the salary for
benefit purposes will be the equivalent to full-time salary.
11
IMPORTANT: If you intend to avail of this option and
have cover based on your full-time salary equivalent, you
must notify Cornmarket in advance of going job sharing
or work sharing. If you do not contact Cornmarket, your
contributions and benefit will automatically default to cover
based on your job sharing or work sharing salary.
10
What if I take unpaid parental, maternity,
or adoptive leave?
If you avail of your entitlement to take unpaid Parental,
Maternity, or Adoptive Leave, and are making your
contributions to the Scheme through salary, no
contributions will be collected in respect of periods for
which you are on leave as you will not be paid a salary while
on leave. Nonetheless your cover will continue unaffected
while you are on leave and no repayment of the ‘skipped’
contributions will be sought. However, this is subject to the
period of unpaid leave being no longer than 18 weeks in
total in any 12 month period. Where the period of leave is
more than 18 weeks in total in any 12 month period,
members should contact Cornmarket for details of their
options. These will be similar to those available to members
who take a career break. You must notify Cornmarket at
least four weeks in advance of the commencement of
unpaid leave.
3376 ASTI SPS policy book 12/09
If you avail of your entitlement to take unpaid Carer’s Leave,
and are making your contributions to the Scheme through
salary, no contributions will be collected in respect of periods
for which you are on leave as you will not be paid a salary
while on leave.
Nonetheless your cover will continue unaffected while you
are on leave and no repayment of the ‘skipped’ contributions
will be sought. However, this is subject to the period of leave
being no longer than 18 weeks in total. Cover for members
who make their contributions by direct debit is likewise
unaffected where such leave is for a period of less than 18
weeks in total. Where the period of leave is more than 18
weeks, members should contact Cornmarket for details of their
options. These will be similar to those available to members
who take a career break.
In order to avail of this option, members must pay 4.58%
i.e. double the normal contribution rate (2.29% x 2). The
first 2.29% of job sharing/work sharing salary will be paid
through salary in the normal way. The second 2.29% must
be paid at the start of each job sharing year by cheque.
Cornmarket will be able to advise you of the extra cost
involved if you avail of this option.
You should note that the option of cover based on full-time
salary is only available to full-time members who are already
members of the Scheme and who subsequently elect to job
share i.e. members who are job sharing at the time they join
the Scheme cannot avail of cover based on full-time salary.
What if I take unpaid leave to take care of
a dependant relative?
You must notify Cornmarket at least 4 weeks in advance of
the commencement of unpaid leave.
12
What if I travel abroad?
As long as you remain resident within Ireland, you are
covered wherever you travel in the world for holiday
purposes. However, should you decide to reside abroad
or work abroad temporarily, you should notify Cornmarket
immediately as Zurich Life reserves the right to vary your
contributions or benefits or cancel membership of the
Scheme in such circumstances. In cases where a non-Irish
national member who, in the opinion of Zurich Life, is
permanently disabled, wishes to move home on a permanent
basis, provided they can get satisfactory medical evidence,
Zurich Life will pay benefit provided the member returns to
a country within the EU and certain other countries: North
America, Australia, New Zealand, Switzerland and Norway.
ASTI SPS Policy
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15
Calculation of benefit
1
On what salary is my cover based?
The vast majority of teachers make their contributions to
the ASTI Scheme through salary. For such teachers,
contributions and cover increase automatically every time
salaries increase. This is because Zurich Life automatically
increases cover in line with salary rises without any need on
the part of the member to complete new application forms
or go for medicals.
Your benefit is based on your salary at the time your sick
leave expires, as confirmed by the Department of Education
and Science. For this purpose salary is defined as: Basic
salary as a teacher plus allowances for teaching
qualifications, posts of responsibility and substitution and
supervision as certified by the Department of Education and
Science or the Vocational Education Committee, but
excluding any other variable payments. If you are paying by
direct debit, your cover and contributions are based on the
last salary you notified to Cornmarket. The level of cover you
enjoy and the amount of contribution you pay will be
increased periodically (see Q4: Does my cover increase with
my rising salary? for details).
2
Members contributing by Direct Debit
For those few teachers who are contributing to the ASTI
Scheme by direct debit from a current account, contributions
and cover will be increased periodically. These increases will
be in line with the period since the last increase was applied.
Again such increases are currently applied without the need
for medical underwriting and members will receive prior
notification.
Does it affect my benefit under the Scheme
if my disability is due to an injury at work?
Yes. If you are injured at work, depending on the circumstances,
Social Welfare benefits, etc., you may be entitled to payments
in excess of 75% of salary. In such cases, as you would already
be receiving a payment greater than 75% of your pre-disability
salary, you would not be entitled to any benefit under the ASTI
Scheme.
3
What if I take out a ‘Critical Illness’ Policy?
4
16
Members contributing by Deduction at Source
‘Critical Illness’ Policies (otherwise known as Serious
Illness/Specified Illness Benefit) pay out a lump sum on
the diagnosis of certain Specified Serious Illnesses. Benefit
paid under such policies are often taken into account
when assessing the level of benefit to be paid under Salary
Protection Schemes. However, Zurich Life has agreed special
preferential arrangements for members of the ASTI Scheme.
This means that currently payments under a ‘Critical Illness’
Policy will not be taken into account when calculating the
benefit to be paid to you under the ASTI Scheme.
5
Does my cover increase in line with my rising salary?
6
One of the great advantages of the ASTI Scheme is that it
allows for your cover to be increased in line with income
rises, promotions etc. This means that the cover you enjoy
under the ASTI Scheme remains realistic over the years
ahead. This is especially so for members contributing by
deduction at source from salary whose benefits under the
ASTI Scheme are based on their recent pre-disability salary.
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As far as additional increases in salary are concerned, for
instance in the case of promotions, currently members
contributing by direct debit may apply to increase their
cover correspondingly. You must apply for such increases
within two months of receiving notification of your salary
increase and you must provide evidence of that salary
increase (such as a recent pay slip).
ASTI SPS Policy
If I am claiming from the ASTI Scheme, does the
amount I receive increase each year?
Yes. The benefit paid to you by the ASTI Scheme increases by
5% each year or the rate of increase in the Consumer Price
Index if lower. This helps ensure the benefit you receive
remains realistic despite the effect of inflation. You should
bear in mind that any Early Retirement Pension you receive
will generally increase each year in line with salary rises
awarded to working members.
What if I already have some form of Salary Protection?
If you already have a Salary Protection or Permanent Health
Insurance policy you should bear in mind that the cover
provided by such a policy may ‘overlap’ with that provided
by the ASTI Scheme, i.e. it will be taken into account when
calculating how much benefit should be paid under the
Scheme to ensure you receive 75% of pre-disability salary. You
should therefore contact your local Cornmarket consultant for
advice before joining the ASTI Scheme.
3376 ASTI SPS policy book 12/09
7
8
Will I receive money back if I never claim under the
ASTI Scheme?
No. As with health or car insurance, your contributions
go to meet the cost of cover for you and your colleagues.
This keeps the cost of membership to a minimum and
means that there is no cash value paid out to those who
never make a claim under the ASTI Scheme.
What are the maximum benefits paid
under the ASTI Scheme?
75% of your salary as paid by your employer less:
(a) any amount of salary, earning, profit, reward, or
remuneration which you are in receipt of from your normal
occupation or any other occupation or business and
9
Pension Protection Benefit
For longer term beneficiaries of the Plan, the issue of
pension is a serious one. In recognition of this fact, if
you fall ill and are claiming from the Plan for more than
2 years, a further 5% of the salary you were earning before
you fell ill will be paid into a separate Personal Retirement
Savings Account (PRSA). This is to make up for the fact that you
will be missing some years of Superannuation contributions.
This additional contribution will continue to be paid until you
recover, return to work, die or reach age 60 (see page 11 Q4:
When does my membership end?).
As this benefit was only introduced after the 2009 review, it
is only applicable to claimants who stared claiming from the
Scheme after June 2009.
(b) the ill-health early retirement pension entitlement calculated on the normal basis as set down by your
employer, irrespective of whether you are receiving this
amount or not* and
(c) an amount equal to the State Illness Benefit payable to
a single person, if entitled and
(d) any benefit you are receiving under the Social Welfare Act
other than sickness, disability or treatment benefits payable
to you under the Social Welfare Acts and
(e) any benefit you are entitled to under any other insurance
against accident or sickness or other similar arrangement
(where appropriate such an amount will be annualised)
except benefits paid under a Critical/Serious Illness policy
(see page 16 Q3: What if I take out a ‘Critical Illness’ Policy?
for details) and
(f) any annualised amount awarded by an arbitration tribunal
or court of law or agreed settlement sum or ex-gratia
payment attributable to loss of earnings arising out of
any action relating to your disablement.
*However, in some cases the insurer may agree to pay
a full 75% of salary without deductions for Early Retirement
Pension if they think there is a reasonable expectation of
you returning to work.
This is for a maximum of 2 years (see page 23 Q3:
What happen if I do not want to retire? for further
details).
Note: The maximum Salary Protection Benefit is
currently €90,000 p.a.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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17
Tax relief
1
Do I have to pay tax on benefits from the ASTI
Scheme?
Disability Benefit paid by the ASTI Scheme will be treated
as normal income and, as such, is liable to income tax, PRSI,
and the health levy. Zurich Life will deduct any tax due from
the payment made to the member in the same way as an
employer deducts PAYE and PRSI from an employee.
Claiming
from the
ASTI Scheme
A step-by-step guide
Death Benefit is paid free of tax to your estate. Thereafter,
beneficiaries of your estate will be subject to whatever taxes
apply at the time of the inheritance.
2
How do I claim my tax relief on contributions?
If you are making your contributions through salary
Tax relief is provided automatically if you are making your
contributions through your salary.
If you are making your contributions through direct debit
Once you have been accepted for membership of the ASTI
Scheme, Cornmarket will forward you a letter confirming
your membership. With this letter you will receive details of
the information your tax inspector needs in order to award
you tax relief on your contributions to the ASTI Scheme.
Simply forward these details to your tax inspector together
with a covering letter. Tax relief is usually granted within a
few weeks of receipt of this information.
Over the years ahead you may need to update your tax
inspector on any increases in your contributions to the ASTI
Scheme as your contributions rise in line with your increasing
salary. To do so you should telephone or write to Cornmarket
who will be happy to forward you up to date details of the
contributions you are making. You should in turn send this on
to your tax inspector who will increase your tax relief
accordingly. Please bear in mind that while tax relief is available
on that part of your contribution relating to Disability Benefit
(currently 1.77% of salary) and Pension Protection Benefit
(currently 0.16% of salary) it is not available on that part of
your contribution relating to Death Benefit (currently 0.31%
of salary), and Medical Immunity Benefit (currently 0.05%
of salary).
18
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
1
How do I claim from the Scheme?
Cornmarket’s role is to help guide members through the
claims procedures and ensure that all legitimate claims are
paid promptly by Zurich Life, the insurers of the Scheme.
Cornmarket has considerable experience in this area and
on behalf of claimants works closely with Zurich Life to
ensure that all legitimate claims are paid.
Cornmarket is not automatically notified of your absence
from work through illness. This means that if you intend
to make a claim under the Scheme you must notify
Cornmarket of this fact. You must contact Cornmarket
(Tel: (01) 477 5130) for a claim form approximately 12 weeks
in advance of the date your salary is due to cease (see page
5: How the Scheme works? for details). Cornmarket will
explain the additional documentation you will need to
submit. Prior to completing your claim form please consult
with Cornmarket. Upon receipt of your claim form,
Cornmarket will process your claim with Zurich Life.
You should note the following:
All evidence reasonably required by Zurich Life must be
provided by the member. The member may be required to
undergo medical examinations (at Zurich Life’s expense) or
an assessment by an occupational therapist. Admittance of
a claim is subject to Zurich Life being satisfied based on
medical evidence received, that you are totally disabled from
following your normal occupation and you are not involved
in another remunerative occupation. You may also be asked
to undergo medical rehabilitation with a view to being
rehabilitated back to your normal occupation.
Zurich Life may also arrange for one of its Health Claims
Advisors to call to you at your home address, either before
any decision is made to admit the claim, or while the claim
is in payment. The purpose of the home visit service is to
explain the claims process, offer advice on social welfare and
re-training if applicable, as well as outlining the various
rehabilitation clauses contained in the policy.
STEP
1
Contact Cornmarket
Cornmarket is not notified
automatically by your employer of
your absence from work through
illness. It can take a number of
weeks to process your claim as
various pieces of information
must be gathered together for
Zurich Life about your health,
salary, etc. This means it is
essential that you contact us at
least 12 weeks in advance of the
date your salary ceases altogether
(see page 4: What happens to your
income if you fall ill? for details).
IMPORTANT – Late notification of claims
It is often not possible to assess retrospectively the
validity of a claim in cases where a significant period
of time has elapsed. For this reason, it is vital you
register your claim promptly in line with the guidelines
given (10 - 12 weeks before sick pay ceases). In the case
of late notification of a claim, cases will be assessed on
individual merit and the insurer reserves
the right to turn down a claim.
It must be emphasised that information required (including
your claim form) by Zurich Life as outlined above must be
dealt with fully and promptly. Undue delay, or failure to
produce such information, may invalidate your claim.
In the event of you failing to follow the advice of your own
or any qualified medical practitioner all benefits payable or
being paid under the policy may cease.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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19
Claiming from the ASTI Scheme
STEP
2
Your Claim Pack
1
2
Once you contact us we will send you a ‘claim pack’
containing 3 forms:
Claim Form – This is the first piece of documentation
you’ll need to return to us. You should return this to us
even before you have gathered together the other
documentation. If you need any help in completing this
form, simply contact our experienced staff on 01 408 4171/
01 477 5130. In some cases Zurich Life may arrange for a
Health Claims Advisor to visit you to assist you in the
completion of the Disability Claim Form.
Checklist Letter – A letter containing a list of the
documents (listed below) you will need to provide in
order for your claim to be processed.
Documents you will need to provide:
• Your original or certified birth certificate
• If you are female and married, your original or certified
marriage certificate (this confirms the link between your
present surname and that on your birth certificate)
• Copy of payslip.
3
Authorisation Form – This authorises us to contact your
employer to request the documentation listed below.
STEP
3
Processing your claim
Once we receive your completed
Claim Form and Medical
Certificate we will send them to
Zurich Life so that an assessment
of your claim may begin
immediately. Thereafter we will
send on any documentation as
we receive it and we will liaise
between you and Zurich Life
throughout the claim process.
Documents we will get from your employer on your behalf:
• Confirmation of your salary details at the date of
disability
•
Confirmation of the date your salary ceased
• Breakdown of your sick leave dates over the last 4 years
• Confirmation of your State Illness Benefit and/or
Early Retirement Pension
• Your PPS Number.
20
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
STEP
4
Medical Examination
Medical evidence will be assessed by Zurich Life’s Chief Medical
Officer. In most cases Zurich Life will request that you attend an
independent medical examination (at Zurich Life’s expense) to
confirm you are indeed disabled from carrying out your normal
job because of your disability. Your medical examination may be
arranged with a doctor locally, however in some cases you may need
to travel to attend for your medical examination (at Zurich Life’s
expense). Zurich Life will pay reasonable and vouched travel and
accommodation expenses for the member and their partner.
STEP
5
Additional Medical Evidence
In some cases Zurich Life’s Chief Medical Officer may require
additional medical evidence from doctors and/or specialists
who have attended to you. You may possibly be requested
to attend a further medical examination (again at Zurich
Life’s expense). Zurich Life will pay reasonable and vouched
travel and accommodation expenses for the member and
their partner.
STEP
6
Note: During the assessment of your claim we will keep you
up to date on medical reports and documentation received.
Decision on your claim
Once all the medical evidence and documentation has been
received, Zurich Life’s Chief Medical Officer will make a
decision on your claim. Should your claim be successful we
will write to you confirming the amount of benefit payable.
Zurich Life will then arrange to pay your benefit directly to
your bank account. If you do not have a bank account your
benefit will be paid by cheque. If your salary ceases by the
time your claim is approved, your benefit will be backdated
to the date your salary ceased (once there has not been an
extreme case of late notification).
Please note: If your claim is unsuccessful and you are unhappy
with the outcome, a series of appeals procedures are available:
1 Direct Appeal
2 Appeal to the Financial Services Ombudsman
3 Arbitration
See page 24, Q 11: What happens if my claim is rejected? We will
of course be happy to help you with any appeal you wish to make.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
| 21
Claiming from the ASTI Scheme
Once a claim is being paid, payment of the benefit is made by Zurich Life
monthly in arrears at the end of each calendar month. Benefit payments
are subject to income tax. Zurich Life will request the Revenue Commissioners
to issue a Tax Credits certificate to Zurich Life (as the employer) in relation to
your claim payment. This will enable Zurich Life to apply the correct tax rate
for future payments. However the first payment may have emergency tax
rates applied (any overpayment of tax will be subsequently paid back).
STEP
7
Your benefit
Your benefit will continue to be paid
for as long as you remain unfit to carry
out your normal job because of illness or
injury. Benefit payments will stop when:
• You recover, i.e. when Zurich Life decides, based on the medical evidence, that you are no longer prevented from doing your normal job because of illness or injury
or
• You return to work
or
• You die
or
• Your 60th birthday
– whichever is earliest.
In certain cases, benefit may be paid where you
return to work at a reduced level of earnings
due to partial disability.
From time to time Zurich Life may require
medical evidence confirming that you remain
unfit to work.
These steps are designed to help you through the claims process
and ensure any benefit you are entitled to is paid out in time.
If you have any questions please do not hesitate to contact us on
(01) 470 8006 or (01) 477 5130.
22
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
2
How disabled do I have to be to qualify for benefit
under the Scheme?
3
Who decides whether or not I’m fit to work?
To qualify for benefit under the Scheme, Zurich Life must be
satisfied that you are totally unable to carry out your duties
under your normal occupation as a Teacher because of illness
or injury and that you are not following any other occupation.
Zurich Life, advised by its Chief Medical Officer (CMO), will
decide whether you are fit to work based on an assessment
of all medical information. To qualify for benefit under the
Scheme, Zurich Life must be satisfied that you are totally
unable to carry out the duties pertaining to your normal
occupation because of illness or injury and that you are not
following any other occupation. In certain cases benefit may
be paid where the member returns to work to take up another
occupation, but at a reduced level of earnings due to partial
disability (see page 25 Q2: What happens if I return to work but
at a reduced salary or take up a different, less well paid job? for
details).
While you are being paid benefit under the Scheme,
Zurich Life will seek regular medical certificates from your
doctor. This is because you must continue to be disabled
and unable to work in order to be entitled to continue to
claim under the ASTI Scheme. Zurich Life may also require
an independent medical examination or specific information
from your doctors. These medical examinations will be at
Zurich Life’s expense. You may also be visited by an Zurich Life
Health Claims Advisor from time to time. In the event of you
failing to follow medical advice during the course of benefit
payments, Zurich Life reserve the right to cease paying
benefits.
Claims which have been in payment for at least 10 years
will no longer be subject to periodical medical reviews and
therefore are guaranteed to be paid, subject to financial
review only, until age 60 or death if earlier.
Please note that the fact you have been granted early
retirement on the grounds of ill health under the rules of
the Superannuation Scheme does not mean that you will
automatically be entitled to a benefit under the Scheme.
This is because Zurich Life reserves the right to undertake its
own medical examinations and its own determination as to
whether you are disabled under the terms of the Scheme.
4
What happens if I do not want to retire?
5
Are there any exclusions under the Scheme?
6
Are claims ever turned down by the Insurer?
If you have exhausted your sick pay entitlement, i.e. been ill for
52 weeks in a 4 year period, but do not wish to retire (perhaps
because you anticipate recovery of your health and returning
to work) you obviously will not be entitled to claim an Early
Retirement Pension (ERP). Therefore in such cases, the Scheme
may pay a benefit equivalent to 75% of your full salary less any
Social Welfare entitlements, i.e. no deduction will be made for
ERP as no ERP has been claimed. This of course assumes that
Zurich Life, the Scheme’s insurer, is satisfied that you are unable
to work due to illness or disability and there is a reasonable
expectation of you returning to work. Benefit will be paid at
this level for up to 2 years. If you subsequently retire within
the 2 years and an ERP is paid retrospectively, the additional
amount paid must naturally be refunded.
There are no general policy exclusions under the ASTI Scheme.
The great majority of claims, typically over 90%, are paid.
However, experience has shown that when difficulties do
arise, they usually arise because:
When joining, the member did not disclose his or her full
medical history.
In such cases Zurich Life reserves the right not to pay a claim.
It is very important that when applying to join the ASTI Scheme
you ensure that you make a full disclosure in relation to any
questions asked on the application form and during any
medical examination you may undergo. If you don’t, any claims
you make may be turned down and cover under the Scheme
may be cancelled.
Medical opinion is that the member is not disabled from
carrying out his or her normal occupation.
Dependent upon the medical condition at issue, specialist
opinion may be required. If ultimately in Zurich Life’s view,
the medical opinion is that you are not disabled as defined
under the ASTI Scheme, benefit will not be paid regardless
of whether you have been retired on grounds of ill health
by your employer. In the event of a dispute you may appeal
to the insurer by providing additional objective specialist
medical evidence.
Should your appeal be unsuccessful you have the right to seek
the assistance of the Financial Services Ombudsman who
may take up your case without cost to you.
Finally, if all other avenues fail, you can take your case to the
courts, using the arbitration procedures provided for under the
ASTI Scheme. Throughout the appeal procedures, Cornmarket
staff will assist you.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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23
7
When does benefit payment under the Scheme begin?
In certain cases benefits may be paid where the member
returns to work but at a reduced level of earnings due to
partial disability (see page 25 Q2: What happens if I return to
Once Zurich Life has accepted your claim, benefit payment
under the Scheme will begin as soon as your salary ceases.
work but at a reduced salary or take up a different, less well-paid
job? for details).
Please remember that it can take a number of weeks to
process your claim as various pieces of information and
medical evidence must be gathered. Therefore it is vital that
you contact Cornmarket at least 12 weeks in advance of the
date your salary ceases.
If your salary has ceased by the time your claim is approved,
your benefit may be backdated to the date your salary ceased.
Zurich Life will arrange to pay your benefit directly to your
bank account. If you do not have a bank account your benefit
will be paid by cheque.
8
What happens if I become disabled while on a career
break?
While on a career break, naturally as you are not in receipt of
salary, no disability benefit is in force. For members who have
taken up another occupation and have who have availed of
the full cover option their cover remains in force. If you have
paid the medical immunity premium to rejoin the Scheme
at the end of your career break but suffer disability while on
your career break, your deferred period will commence at the
end of the career break.
9
10
11
The Scheme will continue to pay benefit as long as your
illness or injury prevents you from doing your normal job
and you are not following any other occupation. Disability
benefit payments will stop when either:
• You receive a significant earned income from some
other source, to a value greater than your annual
benefit (if the earned annual income is less than the
value of your annual benefit your benefit will be
reduced accordingly)
• You are granted an award or an agreed settlement
sum or ex-gratia payment attributable to loss of earnings which if invested would produce an annual income greater than your annual benefit (if the annual income produced is less than your annual benefit your
annual benefit will be reduced accordingly)
• You die
• You reach age 60.
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ASTI SPS Policy
Do I have to pay my contributions if I am claiming from
the Scheme?
No. While you are claiming Disability Benefit from the ASTI
Scheme no contributions are deducted in respect of the Salary
Protection Scheme. The Death Benefit and Medical Immunity
Benefit are maintained free of charge.
What happens if my claim is rejected?
If the claim is rejected, there are a series of appeal procedures.
These are as follows:
1
Direct Appeal
This involves individual claimants making an appeal in which
they should include any additional evidence to support their
claim. Any such evidence is submitted for consideration by
Zurich Life and where relevant by Zurich Life’s Chief Medical
Officer. If the evidence is accepted, the claim is paid.
2
Appeal to the Financial Services Ombudsman
In the event that a direct appeal is not successful and the
claimant is dissatisfied with the outcome, an appeal may be
submitted to the Financial Services Ombudsman. This process
involves obtaining from Zurich Life a “final response letter” and
submitting this letter to the Financial Services Ombudsman
with a request for a complaint form. When the complaint form
is issued, Cornmarket will assist the claimant in completing the
form and returning it together with any relevant
documentation to the Financial Services Ombudsman.
For how long will I be paid benefit under the Scheme?
• You are deemed fit to return to work by Zurich Life
24
Notice period if claim is ended
In the case of claimants who have been in receipt of benefit
for at least one year, where medical evidence indicates that a
member is fit to return to work, Zurich Life will give 3 months’
notice before ending the payment of benefit. This only applies
to those cases where a claim has been in continuous payment
for 12 months.
Once your complaint has been accepted as a matter for
investigation, Zurich Life will be asked to respond to the issue
raised. If your complaint cannot be accepted for investigation
by the Ombudsman you will be informed as to the reason why.
All the circumstances surrounding the complaint will be
examined. Further information or supporting documentation
may be requested from you.
3376 ASTI SPS policy book 12/09
Returning to work
after making a claim
Every case is judged on its individual merits. In some cases
it may be possible to reach a settlement to the satisfaction
of both parties. If this is not possible, the Ombudsman will
adjudicate upon the matter.
1
What happens if I return to work only to find that I
become ill again a few months later?
2
What happens if I return to work but at a reduced
salary or take up a different, less well-paid job?
Following adjudication, the complainant or Zurich Life may
appeal the Ombudsman’s decision to the High Court.
3
Arbitration
In the event that the Ombudsman finds against the
claimant and the claimant is dissatisfied with the
Ombudsman’s decision, the case can be taken to arbitration
by ASTI under the Arbitration Acts. In such an eventuality,
legal counsel are appointed by both parties who jointly
agree on an arbitrator who will act as judge. Normally a
full hearing is held during which the legal teams put their
respective cases to the arbitrator and witnesses are called.
Cross-examination by the other side is a common part of
the process. Following the hearing, the arbitrator will make
a decision. If the arbitrator finds in favour of the claimant,
Zurich Life will make payment in accordance with the policy
terms and conditions.
3376 ASTI SPS policy book 12/09
If you return to work after a period claiming benefit through
the Scheme only to find that you fall ill again, benefit will be
paid immediately by Zurich Life i.e. you will not have to wait
the usual period before your benefit is paid. Naturally this is
subject to Zurich Life being satisfied that you are totally
unable to carry out your duties under your normal
occupation because of illness or injury and that you are not
following any other occupation. This is regardless of whether
or not the illness causing the second period of disability is
related to that which caused the first claim.
If you are able to return to work in your normal job on
a reduced basis as a result of ill health, Zurich Life will
continue to pay you a proportionately reduced income,
i.e. your benefit under the Scheme will be reduced to take
account of additional income you are now earning. Should
you be unable to follow your normal job and take up a
different job at a lower rate of pay, again Zurich Life will
continue to pay you a proportionately reduced income.
ASTI SPS Policy
|
25
Death Benefit
1
What Benefit is paid on death?
A Death Benefit equivalent to twice your annual salary is
included automatically in the Scheme. Some members may
have availed of the option to increase their Death Benefit to
a maximum of four times their salary (from time to time the
underwriters provide this option). This amount will be paid
free of taxes to your estate should you die. Bear in mind that
the estate of a deceased member must be processed through
the Probate office. This can result in delays to the payment
of Death Benefit to the beneficiaries (anywhere between 3
months to a year or more). This benefit ceases on your 65th
birthday, or when you retire (other than on grounds of ill
health) or leave the Scheme, if earlier.
However, all members of the ASTI Scheme have an automatic
right to join the Retired Members’ Life Cover Plan (see this
page: Can my death benefit remain in force after I retire? for
details).
2
Can my Death Benefit remain in force if I claim under
the Disability Benefit?
If you are claiming Disability Benefit under the ASTI Scheme,
your Death Benefit will remain in force (as will the Medical
Immunity Benefit) unless you expressly ask for your Death
Benefit to be cancelled. No deduction will be made in respect
of the Death Benefit element while you are claiming from
the Scheme although you will continue to enjoy the security
the benefit provides. Your Death Benefit will be based on the
salary you were earning at the time you became disabled.
In cases where a member who has been claiming Disability
Benefit under the Scheme returns to work before age 65, the
Death Benefit element, which was based on a pre-disability
salary while that member was disabled, will, from the time
the member returns to work, be based on his/her current
salary and deductions will re-commence.
3
26
4
Payment of Death Benefit
As administrators of the Scheme, Cornmarket's role is to
help guide members’ families through the claims
procedure. Once notified of a member’s death, Cornmarket
will send a letter to the next of kin/legal personal
representative explaining the documentation that the
underwriters require in order to process the Death Benefit
claim, including:
• Original Death Certificate
• Confirmation of final annual salary
• Original or certified Birth Certificate
• Certified copy of the Will and Grant of Probate
(or if there is no Will the underwriters may
require Letters of Administration).
Bear in mind that the estate of a deceased member must
be processed through the Probate office (the next of kin
or solicitor can deal directly with the probate service). This
can result in delays to the payment of Death Benefit to the
beneficiaries (anywhere between 3 months to a year or more).
Once Zurich Life receive all the documents and information
they require, payment of the Death Benefit claim is usually
made within 10 days.
Can my Death Benefit remain in force at retirement?
Yes, all retired and retiring members of ASTI are eligible to
apply to join the Retired Members’ Life Cover Plan. It provides
for the payment of a tax-free lump sum in the event of
death after you retire. If you are a member of the Salary
Protection Scheme at the date of retirement and apply
within 4 months of retirement you will not have to undergo
any medical underwriting and can join using a shortened
application form. This Plan provides for the payment of a
tax-free lump sum in the event of death after retirement.
The amount paid depends upon the age of the member
at death.
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ASTI SPS Policy
3376 ASTI SPS policy book 12/09
Other Common Questions
1
What happens if I cancel my membership?
Membership of the ASTI Scheme may be cancelled at any
time by notifying Cornmarket or Zurich Life in writing. As
your contributions are designed to cover the cost of paying
benefit to those members of the ASTI Scheme who become
disabled, there is no cash value paid to you should you stop
contributions to the ASTI Scheme.
It is important that you think carefully before cancelling
your membership of the ASTI Scheme as once you have left
the ASTI Scheme you will be required to provide information
about your state of health should you apply for cover again.
Should any medical problems have arisen in the interim, it is
unlikely that you will be re-admitted to the ASTI Scheme.
2
Under what circumstances can the Scheme be
amended?
3
Who administers and insures the ASTI Scheme?
The ASTI Salary Protection Scheme is administered by
Cornmarket Group Financial Services Ltd. and is insured
by Zurich Life. For this important role, Cornmarket gets
remunerated directly by the insurer (no direct charge to
the client).
Initial charge (paid by Insurer to Cornmarket)
€0 - €300
Deduction at source charge
(paid by Insurer to Cornmarket)
1.0%
Renewal charge (paid by Insurer to Cornmarket)
Disability Benefit/Pension Protection Benefit: 12.5%
Death Benefit: 6.0%
Benefit levels and the rate of contributions under the
Scheme are reviewed on a regular basis. The next review
of the ASTI Scheme is June 1st, 2014. These reviews are
designed to provide Cornmarket with an opportunity to
canvass the market to ensure that the best deal is being
provided for members. Likewise, the reviews provide the
insurer with an opportunity to adjust the benefit levels
and/or the rate of contribution in the light of relevant
factors such as membership level, age profile, the male/
female ratio of the membership, and the claims experience
of the ASTI Scheme.
At such reviews, the Scheme’s insurer reserves the right
to increase or reduce the rate of contribution and vary
the benefit levels under the Scheme for all members or
terminate the Scheme as a whole.
The ASTI Branch represents the interests of members in
the Scheme and any decisions taken in these areas by ASTI
will be considered binding on all members of the Scheme.
This is a condition of membership and entry to the Scheme
is allowed to members only on this understanding. In the
event of termination or amendment of the ASTI Scheme,
those members who are already receiving benefit payments
under the ASTI Scheme will continue to receive those benefit
payments and any subsequent increases in those benefits
due under the terms of the ASTI Scheme.
3376 ASTI SPS policy book 12/09
ASTI SPS Policy
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27
Notes
This guide provides an outline only of the main benefits of the Salary Protection Scheme for ASTI members
as of December 1st, 2009 and is issued subject to the provisions of the policy and does not create or confer
any legal rights.
The information contained herein is based upon our current understanding of Revenue law and practice
as at December 1st 2009.
The ASTI Scheme is governed by the master Policy Document No. G00272 issued by Zurich Life. Members
of the ASTI Scheme may examine the policy at any reasonable time at the Head Office of ASTI or the Dublin
office of Cornmarket Group Financial Services Ltd.
Cornmarket is committed to providing a high level of service and has a complaint handling procedure in place.
Should you feel that you have not received a satisfactory level of service, please write in the first instance to
Jane Horan, Cornmarket Group Financial Services Ltd, Christchurch Square. Dublin 8. You may also submit any
complaint to the Financial Services Ombudsman, 3rd Floor, Lincoln House, Lincoln Place, Dublin 2.
Christchurch Square,
Dublin 8.
Tel: (01) 408 4000
Fax: (01) 408 4011
Cornmarket House,
6 Kings Terrace,
Lower Glanmire Road, Cork.
Tel: (021) 455 3335
Fax: (021) 450 2044
Galway.
Tel: (091) 562 727
E-mail:
info@cornmarket.ie
Website:
www.cornmarket.ie
Cornmarket Group Financial Services Ltd. is regulated by the Financial Regulator. Telephone calls may be recorded for quality control purposes.
Irish Life & Permanent plc is regulated by the Financial Regulator. Zurich Life Assurance plc is regulated by the Financial Regulator. Eagle Star House,
Frascati Road, Blackrock, Co. Dublin, Ireland, Telephone: 01 283 1301 Fax: 01 283 1578 Website: www.zurichlife.ie
A member of
the Irish Life &
Permanent Group.
3376 ASTI SPS policy book 12/09