HOSTPLUS Member Guide

HOSTPLUS insurance cover is provided by OnePath Life Limited ABN 33 009 657 176 AFSL 238341 (insurer) formerly known as ING Life Limited and the Trustee of HOSTPLUS owns this policy. 

You have the opportunity to choose from Death and TPD, Death Only or Salary Continuance insurance cover. Any death cover also includes Terminal Illness cover.

If a claim is approved, the insurer will pay the insured amount to HOSTPLUS. Then, subject to legislative and trust deed requirements having been met, we will pay:

• Total and Permanent Disability (TPD) benefits to you;
• Death benefits to your dependants (including interdependants) or legal personal representative;
• Terminal Illness benefits to you from your death benefits.

If you are covered for Death insurance, you are automatically covered for Terminal Illness.

Your insurance premiums are used to cover the cost of the insurance policy as well as the cost of its administration.

Generally, if you’re an employee member you receive automatic unitised Death and TPD insurance cover. If you are aged between 25 and 64 you automatically receive two units of Death and TPD insurance cover at the standard scale ($3 per week) and members under 25 years receive one unit of Death and TPD insurance cover at the standard scale ($1.50 per week) subject to your employer making an on-time SG contribution no more than three months after the SG cut-off date as prescribed by law.

To work out the amount you would be covered for (this depends on your age next birthday) see the Death and TPD and Death Only insurance: Unitised cover table.

As a new member joining HOSTPLUS through a participating employer, you have the opportunity to increase your insurance without providing a full health statement. You can increase your Death and TPD cover by one or two units, apply for fixed benefit Death and TPD cover of up to $500,000 and apply for Salary Continuance cover of up to $4,000 per month with a benefit period of up to two years. 

See 8.7.62 Special insurance offer on joining for new members

If you are joining the Personal Super Plan, and are eligible for insurance, you will receive automatic fixed benefit Death and TPD cover to the value of $100,000.

You may apply for any insurance offered (except for the Special insurance offer on joining for new members outlined above) but some additional information may be required. See Insurance for HOSTPLUS Personal Super Plan members.

WARNING: This insurance section only provides a summary of the insurance conditions and arrangements. For full terms and conditions call 1300 HOSTPLUS (1300 467 875) for a copy of the relevant insurance policies. To make a claim, contact the fund for the appropriate claim forms as soon as reasonably possible to avoid any prejudice against your claim.    

If you or your beneficiaries need to lodge an insurance claim with HOSTPLUS please call us on 1300 HOSTPLUS (1300 467 875). We will assist you with your claims enquiry and documentation required.

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

Death Only insurance cover at a cost of 75¢ per unit per week provides you with an insured benefit, payable to your dependants or legal personal representative(s) in the event of your death. This benefit is paid in addition to your HOSTPLUS account balance. For more information and to find out who you can nominate to receive your benefit if you die, see Section 2: How super works - Death benefit nominations at hostplus.com.au

To receive a TPD benefit, you have to meet the conditions of the relevant part of the TPD definition that applies. If you are employed or engaged in a gainful occupation, business, profession or employment or within 6 months of the date you cease to be so employed or engaged and suffer an injury or illness which results in your total and permanent disablement, you will be assessed for TPD under parts 1 - 5 of the TPD definition. If you have been unemployed or not engaged in any work for more than 6 months as at the date you suffer an injury or illness which results in your total and permanent disablement, you will be assessed for TPD if you satisfy either parts 2 – 5 of the TPD definition. See Death and TPD and Death Only insurance cover (includes Terminal illness cover) – definitions for an explanation of the TPD definitions.

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

A death benefit is payable to your dependants and/or legal personal representative(s) in the event of your death. For more information and to find out who you can nominate to receive your benefit if you die, see Section 2: How super works - Death benefit nominations at hostplus.com.au

If you are insured for Death cover, you will also be covered for a Terminal Illness benefit. A Terminal Illness benefit is payable, if you suffer a ‘terminal illness’, as defined in Death and TPD and Death Only insurance cover (includes Terminal illness cover) – definitions and:

• the policy is in force;
• you have not lodged and do not intend to lodge a claim for a TPD benefit;    
• your cover has not ended (see When your insurance cover ends); and
• you have not attained age 65.

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

The Terminal Illness benefit is the lesser of:

• the insured amount; or
• $1 million.

If your death benefit is greater than $1 million, the balance of the benefit is payable upon your death, as long as:

• your death occurs before you attain age 65;
• premiums have continued to be paid for the reduced insured benefit; and
• the policy is in force.

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

With unitised cover your level of cover decreases as your age increases, but your insurance premium remains the same.

With fixed benefit cover your level of cover stays the same but your insurance premium increases as you get older. See 8.7.26 Fixed benefit cover for more information at hostplus.com.au/memberguide/insurance

Generally, for employee members, your automatic insurance cover commences on the date you join HOSTPLUS. This date is usually the date you commence employment, provided your employer makes an on-time Superannuation Guarantee (SG) contribution for you for this period, no more than three months after the SG cut-off date.

When your membership in HOSTPLUS commences, you will be provided with Death and New events TPD insurance cover if you’re:

• away from work due to an injury or illness; or
• at work in a reduced capacity; or
• in receipt of and/or entitled to income support benefits from any source including workers compensation benefits, statutory transport accident benefits and disability insurance benefit.    

New events TPD insurance covers you for Total and Permanent Disability caused by an illness which became apparent to you or an injury that occurred to you on or after the date your insurance cover in HOSTPLUS commenced.

This new events cover will be replaced with full TPD insurance cover when you resume your normal duties with your employer, subject to you not having received or being entitled to receive a TPD benefit from any other source.

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

• the date you commence active duty with the armed forces of any country;
• the date you cease to be a member of HOSTPLUS;
• the date you reach age 65;
• the date we receive your written request to cancel your insurance (or where the request specifies a later date, the later date specified);
• in the event of your death;
• the date you are paid a Terminal Illness benefit which is equal to the amount of your Death benefit;
• the end of the month in which your account balance has insufficient funds to pay the premium;
• by opting out of your insurance cover by selecting this option on your Membership application form available at hostplus.com.au/forms or when you make an online application to join; or
• the date the insurance policy ends.

If you prefer not to have insurance cover, you can elect to cancel your cover on the Personal super plan membership form available at hostplus.com.au/forms or you can cancel it at any time by writing to HOSTPLUS, Locked Bag 3, Carlton South VIC 3053.

If you cancel your cover and subsequently decide that you would like to re-apply for insurance cover down the track, you’ll need to complete the Increase your insurance cover application - Part A and Part B (if applicable) available at hostplus.com.au/forms or apply through your SuperSite account at hostplus.com.au

You are only eligible to retain insurance in one account. You will retain the highest level of insurance cover you hold and this will be transferred into your merged account unless you tell us otherwise. If you have been charged duplicate or overlapping insurance premiums, these will be refunded back to you.

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

You are eligible for insurance cover if you are:

• a member of HOSTPLUS;
• aged between 11 and 64;
• an Australian citizen; or
• a person who is a permanent resident, within the meaning of the Migration Act 1958(Cth); or
• a lawful non-citizen, within the meaning of the Migration Act 1958(Cth) for whom the employer is required to make on-time contributions; and
• not an Excluded Member.

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

• has declined, or elected not to be covered for benefits provided under any Group Life policy issued by the Trustee of HOSTPLUS
• a member who is eligible to receive, or, has received, a lump sum benefit for total and permanent disability from any source;
• a Member who has attained the age of 65;
• for HOSTPLUS Personal Super Plan Members only, because your occupation excludes you from receiving insurance.

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

If you travel or reside overseas, you are covered for claims, provided your insurance premiums continue to be paid from your account and you have sufficient funds in your super account to pay the premiums.

If you have insurance cover through another superannuation fund you may be able to transfer up to $1 million of Death Only or Death and TPD insurance cover into HOSTPLUS provided that:

• your insurance cover held in your other fund is still in force;
• you transfer your superannuation account balance to HOSTPLUS;
• you agree that any loadings, restrictions and exclusions which apply on your policy with the other fund will also apply to your transferred cover; and
• you cancel the insurance held in your other fund once the transfer to HOSTPLUS has occurred.    

To apply to transfer your existing cover to HOSTPLUS, please complete the Insurance transfer form available at hostplus.com.au/forms or call us on 1300 467 875 and we’ll send it to you. We can only assess your application provided you supply proof of your cover and the terms upon which it was granted. You will be advised of your acceptance.

You may vary your level of cover at any time after having been accepted as a member of HOSTPLUS. To reduce your level of cover, you will need to write to us.

If you wish to increase your level of cover (outside of the special offer available to you as a new member) you will need to complete the Increase your insurance cover application Part A and Part B (if applicable) available at hostplus.com.au or through your SuperSite account at hostplus.com.au. You can apply for cover up to a maximum of $3 million in TPD cover and $5 million in Death cover. Underwriting conditions may apply.

Increased cover will start once your application has been approved by the insurer. We will notify you of the insurer’s decision. You are covered by the ‘Interim Accident Cover’ policy while your application to increase your cover is being assessed by the insurer. Keep in mind that you can choose to cancel your cover, reduce your cover or apply for different amounts of Death and TPD insurance cover as long as the TPD cover is less than the Death insurance cover.

To make it easy for you to ensure you have adequate insurance cover when your circumstances change, you can also apply to increase or take out other forms of insurance cover online through your SuperSite account at hostplus.com.au

While the insurer is assessing your application for insurance cover or for an increase in your existing insurance cover, you are provided with Interim Accident Cover. If you die or suffer total and permanent disablement as a result of an accident during the period in which the Interim Accident cover applies, the interim benefit will be at the same level as the cover applied for or in the case of increasing your cover, the difference between the level of increased cover applied for and the level of current cover, up to the maximum benefit level (which is $3 million for TPD cover and $5 million for Death cover).

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

• the date the insurer accepts or rejects your application;    
• 90 days after the date Interim Accident Cover starts; or    
• the date your cover otherwise ends as set out under the heading When your insurance cover ends.    

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

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

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

An accident shall specifically exclude death or total and permanent disablement:

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

Where there is any doubt as to the cause of death or total and permanent disablement sustained as a result of an accident, the cause will be characterised as being the result of a sickness. TPD is defined in the table below.    

TPD definitions

1. Unlikely to return to work

If the insured member is employed or engaged in a gainful occupation, business, profession or employment or within six months of the date an insured member ceases to be so employed or engaged:

1.1. that insured member has suffered an injury or illness and, as a result of that injury or illness, the insured member:

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

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

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

OR

2. Permanent impairment

The insured member suffers an injury or illness and, as a result of that injury or illness, the insured member:

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

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

OR

3. Specific loss

As a result of illness or injury, the insured member suffers the total and permanent loss of the use of:

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

OR

4. Loss of independent existence

As a result of illness or injury, the insured member suffers loss of independent existence.

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

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

OR

5. Cognitive loss

As a result of illness or injury, the insured member suffers cognitive loss.

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

Other definitions

‘Terminally ill’ means having suffered an illness that is such that, in the opinion of an appropriate specialist, the illness or injury is likely to lead to the death of the insured member within 12 months from the date the opinion is provided (terminal illness has the same meaning).

When calculating your benefit, it is based on three factors:

• your occupation;
• your age; and
• the number of units you are covered for.

1. Occupation – determines which insurance scale applies to you

We use two occupation-based categories to assess which scale you are eligible for:

• Management/Clerical (white collar) scale; or
• Standard scale.

Unless you apply for insurance at the Management/Clerical (white collar) scale you will receive insurance cover at the standard scale.

Your occupation at the time you apply for insurance or when you apply to change your insurance scale determines which insurance scale you are eligible for.

Under the Management/Clerical (white collar) scale you can receive a higher level of cover for the same cost. In some cases, depending on your age, this could result in up to 65% more cover than under the standard scale.

So if your occupation changes to Management/Clerical (white collar), don’t forget to tell us. You can apply for insurance cover under the Management/Clerical (white collar) scale if you:

• are employed for at least 15 hours per week on an ongoing basis, and
• spend at least 90% of your working time in an office or similar environment, and
• are employed in one of the following occupations:
  • management;
  • clerical
  • marketing;
  • administration;
  • accounting; and
  • other similar lower risk occupations agreed to in writing by the insurer.

All other occupations, for example, a chef or waiter fall outside this definition and are subject to the standard scale.

You can apply for cover under the Management/Clerical (white collar) scale by answering a few simple questions in your Membership application form available at hostplus.com.au or when you make an online application to join, or you can download the Insurance upgrade to Management/Clerical (white collar) scale form from hostplus.com.au. 

2. Age – Death and TPD and Death Only insurance cover table

Once you have worked out your eligibility for the Management/Clerical (white collar) or standard scale, your age next birthday at the time you become eligible for a benefit determines the amount of insurance you receive for each unit purchased. 

The Death and TPD and Death Only insurance: Unitised cover table shows the value of unitised insurance cover for each age level at your next birthday.

3. How much cover can you apply for?

You can apply for cover up to a maximum of $3 million in TPD cover and $5 million in Death cover. See Calculating your level of unitised cover for an example of how to work out the benefit provided by unitised cover.

You have the option to replace your unitised cover with Fixed benefit cover at any time, as long as you are less than 60 years of age. Where an application is made, you will have your unitised cover converted to an equivalent amount of fixed benefit cover, rounded up to the next $1,000.

Once you have converted to fixed cover, you cannot automatically revert back to unitised cover. You cannot have a combination of unitised cover and fixed benefit cover.

To revert back to unitised cover you will be required to complete the Increase your insurance cover application - Part A and Part B (if applicable) available at hostplus.com.au

To convert your cover from unitised to fixed benefit cover, complete the Application to convert from unitised cover to fixed cover form available at hostplus.com.au

The amount of your benefit is determined by the number of units held and your age next birthday at the time you become eligible for a benefit. So you should review your level of insurance cover every year to ensure you have adequate insurance cover.

You can apply for cover up to a maximum of $3 million for TPD cover and $5 million in Death cover.

The table below shows the value of one unit for each age level at your next birthday. Units cost $1.50 per unit per week for Death and TPD insurance cover and 75¢ per unit per week for Death Only insurance cover.

With fixed benefit cover your level of cover stays the same but as you get older, the amount you pay for the insurance will increase each year. Fixed benefit cover is available in multiples of $1,000. You have the option to switch from unitised cover to fixed benefit cover any time, as long as you are less than 60 years of age. But you cannot hold a combination of unitised and fixed benefit cover.

Under fixed benefit cover you can have different amounts of Death and TPD cover. But you cannot have TPD cover by itself or for an amount which exceeds your Death cover.

If you hold fixed benefit TPD cover, when you turn 61, your TPD cover will be reduced by 20% each year until you get to 65, when it will reach zero. For example, if at age 60 you hold $100,000 of Death and TPD cover, your TPD cover will reduce as detailed in the table below.

Your occupational rating will also affect the premium that you pay for fixed benefit cover. See Understanding occupational ratings. The Death Only and TPD Only insurance: Fixed benefit cover table shows your annual premiums and level of cover at these ages and the Fixed benefit occupational rating.

With fixed benefit cover, in the event of a claim, you are covered for the fixed benefit amount you applied for and the claim being accepted by the insurer. For example, if your age next birthday was 32 and you had $300,000 of Death and TPD cover, providing your insurance cover remains current, at age next birthday 33 you would still have $300,000 worth of Death and TPD cover.

To determine how the fixed benefit cover premium is calculated you must first decide how much cover you would like to be insured for in $1,000 amounts, e.g. $400,000. You then apply factors of occupation, age next birthday, gender and the mix of Death and TPD or Death Only cover you would like to calculate your premium.

See Calculating your level of fixed benefit cover for an example of how to work out the premium for fixed benefit cover.

The occupational ratings are the classification that the insurer applies to the nature of your occupation. Some members will pay an increased premium because of their occupational ratings.

The table below is a description of occupational ratings. There is also a list of occupations in the Membership application form available at hostplus.com.au/forms  If you require assistance determining you occupational rating you can contact HOSTPLUS.

To calculate the premium you will pay for fixed benefit cover, you will need to multiply the applicable Fixed benefit occupational rating by the premium rates shown in the Death Only and TPD Only insurance: Fixed benefit cover table.

Please note: Depending on your occupation and the type of cover you select, you may be assessed on different ‘collar’ types. For example, a hospitality worker will be considered as Light blue collar scale for Death and TPD but Heavy blue collar for Salary Continuance cover.

To change or upgrade your insurance cover from the Standard scale to the Management/Clerical (white collar) scale use the Insurance upgrade to Management/Clerical (white collar) scale form available at hostplus.com.au

You decide how much cover you would like to fix. The amount of your premium is determined by your age next birthday, gender, amount and type of cover required and occupation rating. You can apply for cover up to a maximum of $3 million for TPD cover and $5 million in Death cover. You can have different amounts of TPD cover and Death cover, but you cannot have TPD cover by itself or as a higher amount than your Death Cover.

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

You will join the HOSTPLUS Personal Super Plan as your preferred super fund under Super Choice, if your employer is not currently a participating HOSTPLUS employer or you’re self-employed, a full-time, part-time, temporary or casual employee, a spouse or if you’re not in paid employment.

HOSTPLUS Personal Super Plan members who are eligible for insurance will automatically receive fixed benefit Death and TPD cover, which is subject to Pre-existing conditions exclusion, to the value of $100,000, once money is received and your membership is activated.

The premium calculation is based on your age next birthday, gender and occupational rating. The insurer may elect not to cover certain occupations, so please refer to Excluded occupations  hostplus.com.au/excludedoccupations

For Personal Super Plan members eligible for automatic fixed benefit Death and TPD cover, no benefit is payable where the cause of the death, terminal illness or total and permanent disablement is caused directly or indirectly, wholly or partially, as a result of a Pre-existing condition.

A Pre-existing condition is an injury, illness, condition or related symptom that, in the two years prior to the date your insurance cover commenced through HOSTPLUS, you, or a reasonable person in your position:

• was aware of;
• should have been aware of;
• had a medical consultation for (where a medical consultation is any activity for the detection, treatment or management of an illness, injury, medical condition or related symptom, including but not limited to the application of prescribed drugs or therapy).

If you have fixed benefit Death and TPD cover and you are aged 61 to 65, your TPD cover will be reduced by 20% per annum until your cover reaches zero. How your TPD cover reduces shows how much your TPD cover is reduced, based on your attained age.

HOSTPLUS Personal Super Plan members can use the Increase your insurance cover application - Part A and Part B (if applicable) available at hostplus.com.au/forms to apply for higher levels and/or different types of insurance. Personal Super Plan members cannot have unitised cover. 

Refer to Fixed benefit cover to see how premiums are calculated. 

The insurer may elect not to cover certain occupations - refer to Excluded occupations at hostplus.com.au/excludedoccupations Underwriting conditions may apply.

If you prefer not to have insurance cover, you can elect to cancel your cover on the Personal super plan membership form available at www.hostplus.com.au/forms or you can cancel it at any time by writing to HOSTPLUS, Locked Bag 3, Carlton South VIC 3053.

If you cancel your cover and subsequently decide that you would like to re-apply for insurance cover down the track, you’ll need to complete the Increase your insurance cover application - Part A and Part B (if applicable) available at www.hostplus.com.au/forms or apply through your SuperSite account at www.hostplus.com.au

Salary Continuance insurance helps to protect your income if you can’t work because of illness or injury (temporarily and totally) by providing regular monthly payments to help you meet your living expenses. 

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

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

Your Salary Continuance insurance cover will cease on the earliest of the following events:

• the date you commence active duty with the armed forces of any country;
• the date you cease to be a member of HOSTPLUS;
• the date you become a lost member of HOSTPLUS (see Section 2: How super works - 2.11 Lost members at hostplus.com.au/memberguide/howsuperworks );
• the date you reach age 65;
• the date we receive your written request to cancel your insurance (or where the request specifies a later date, the later date specified);
• the date that you permanently retire from the workforce;
• in the event of your death;
• the end of the month in which your account balance has insufficient funds to pay the premium;
• the date when you no longer satisfy the eligibility criteria (see Who’s eligible for Salary Continuance insurance cover with HOSTPLUS?);
• the date the insurance policy ends.

You are eligible for insurance cover if you are:

• a member of HOSTPLUS;
• aged between 15 and 64;
• capable of, and in fact performing without restriction due to injury or illness, all of the usual duties of your occupation on a full-time basis (if you usually work on a full-time basis), on a part-time basis (if you usually work on a part-time basis) or on a casual basis (if you usually work on a casual basis);
• an Australian citizen; or
• a person who is a permanent resident, within the meaning of the Migration Act 1958 (Cth): or
• a lawful non-citizen, within the meaning of the Migration Act 1958 (Cth) for whom the employer is required to make on-time contributions; and
• not an Excluded Member.

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

• a Member who has attained the age of 65; or
• a Member who works in an excluded occupation.

An excluded occupation is an occupation that the Fund’s insurer will not cover for Salary Continuance insurance. Refer to Excluded occupations at www.hostplus.com.au/excludedoccupations

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

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

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

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

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

The premium for your Salary Continuance cover is calculated by reference to your occupational rating, your age next birthday, the applicable waiting period, your selected benefit period and the number of units you have elected. Each unit represents a monthly benefit of $100.

The occupational rating is the classification that the insurer applies to the nature of your occupation. Some members will pay an increased Salary Continuance premium because of the application of the occupational rating – see Salary Continuance occupational ratings.

To determine what occupational rating you are in for the purposes of Salary Continuance cover, you can contact HOSTPLUS.

See 8.7.59 Calculating your Salary Continuance insurance cover at hostplus.com.au/memberguide/insurance for an example of how to work out the cost of Salary Continuance cover.

HOSTPLUS offers three waiting periods: 30, 60 or 90 days. A waiting period is the period during which you must be totally or partially disabled before any Salary Continuance benefit is payable. You are not entitled to a monthly benefit for the duration of the waiting period.

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

Premiums vary depending on which waiting period or benefit period you choose. Generally, the longer the waiting period and the shorter the benefit period, the lower the premium. See the Salary Continuance insurance: annual premiums table.

If you want to change the waiting period from:

• 90 days to 60 days or 30 days; or
• 60 days to 30 days,

you will need to complete the Increase your insurance cover application - Part A and Part B (if applicable) available at hostplus.com.au/forms. Similarly if you want to change the benefit period from 2 years to, to age 65 you will need to apply.

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

Increase your Salary Continuance insurance when you join HOSTPLUS

As a new member joining HOSTPLUS through a participating employer, you have the opportunity to obtain Salary Continuance insurance to up to $4,000 per month for a benefit period of two years without providing a full health statement. See Special insurance offer on joining for new members.

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

• the benefit represented by the number of units of cover for which the insurer has agreed to cover you;
• 90% of your monthly pre-disability salary of which a maximum of 75% is payable to you and the balance as a contribution to the your HOSTPLUS super account;
• up to a maximum of $25,000 per month or 250 units of cover.

While the insurer is assessing your application for Salary Continuance insurance cover, or an increase in your existing Salary Continuance cover or to amend your Salary Continuance insurance cover, you are provided with interim accident cover. In the event that you suffer total disability or partial disability as a result of an accident during the period in which the interim accident cover applies, the interim accident benefit will be for the same level as the cover applied for or in the case of increasing your cover, the difference between the level of increased cover applied for and the level of current cover, up to the maximum monthly benefit level, for the benefit period selected in the application.

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

• the date the insurer accepts or rejects your application;
• 90 days after the date interim accident cover starts;
• the date your cover otherwise ends as set out under the heading When your Salary Continuance cover ends.

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

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

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

An accident specifically excludes total or partial disability:

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

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

The insurer will pay a total disability benefit if you are totally disabled (see Salary Continuance cover definitions) for longer than the waiting period and the insurer has admitted your claim. The monthly benefit starts to accrue from the day after the end of the waiting period.

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

• the end of the benefit period;
• the date you attain age 65;
• the date of your death;
• the date you are no longer totally disabled.

The insurer will pay a partial disability benefit (a proportion of the total disablement) if you are partially disabled (see Salary Continuance cover definitions) except where you had ceased to be employed for reasons other than illness or injury six months or more prior to the date you become partially disabled.

The partial disability benefit will be calculated as follows:

A – B x monthly benefit

_____

A

Where

A is your pre-disability salary (see Salary Continuance cover definitions)

B is the greater of:

• the salary you earn;
• the salary you are capable of earning, for the month that the partial disability benefit is payable. The insurer will assess the amount you are capable of earning based on medical advice including that of your medical practitioner, and any other relevant information.

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

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

• the end of the benefit period;
• the date you attain age 65;
• the date you cease to be partially disabled;
• the date you are earning, or are capable of earning, monthly salary or wages equal to or greater than your pre-disability salary, or engaging in any occupation on a full-time basis (if working full-time prior to disability) or part-time basis (if working part-time prior to disability) or casual basis (if working casually prior to disability);
• the date of your death.

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

If you suffer a recurrence of disability which was the cause of the earlier claim, within six months of that earlier claim ending, the insurer will treat this subsequent claim as a continuation of the first claim and will waive the waiting period with the following conditions:

• you must have returned to full-time work if you were engaged in full time work immediately prior to the commencement of the earlier claim;
• you must have returned to part-time work if you were engaged in part time or full time work immediately prior to the commencement of the earlier claim.

Salary Continuance benefits are payable monthly in arrears once your claim has been accepted.

Once payment of your Salary Continuance benefits begin, your benefits will be adjusted annually in line with the increase in the CPI to protect your payments from the effects of inflation. However, they will not increase by more than 5% in any year.

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

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

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

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

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

• by way of workers’ compensation;
• under any statutory accident compensation scheme;
• as benefits under any other disability, injury or sickness insurance policy (except for lump sum benefits received from total and permanent disablement under a policy).

Any lump sum payment (such as settlement or commutation amounts) will be converted to an equivalent monthly amount by dividing the lump sum payment by the lesser of the number of months in the benefit period and 60.

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

You have the opportunity to transfer your existing Salary Continuance cover from another superannuation fund to HOSTPLUS provided that the combined level of cover upon transfer is limited to the lesser of:

• the number of units to cover 90% of your pre-disability salary (of which a maximum of 75% is payable to you and the balance paid as a contribution to HOSTPLUS); or
• the maximum cover of $6,000 per month.

Any amount above $6,000 will be assessed by the insurer. Generally, Salary Continuance insurance cover will generally be matched on the same waiting period and benefit period to that which was previously provided under the transferred cover.

If the waiting period is not available, the next lowest waiting period will be provided.

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

• your insurance cover held in your other fund is still in force;
• you must also transfer your superannuation balance to HOSTPLUS;
• any loadings, restrictions and exclusions which apply on your policy with the other fund will also apply to your transferred cover; and
• you must also cancel the insurance held in your other fund once you receive notification of your acceptance by HOSTPLUS.

To transfer your existing Salary Continuance cover to HOSTPLUS, please complete the Insurance transfer form available at hostplus.com.au

To make it easy for you to ensure you have adequate insurance cover when your circumstances change, you can also apply to increase or take out other forms of insurance cover online through your SuperSite account at www.hostplus.com.au

Your premium is determined by your age, gender, amount of cover, occupation, benefit period and waiting period.

Rates are shown per $100 monthly cover. Premium rates include estimated 9% stamp duty.

As a new employer sponsored member of HOSTPLUS you have the opportunity to:

• Increase your unitised Death and Total & Permanent Disability cover by an additional one or two units; or
• Apply for fixed benefit Death and Total & Permanent Disability cover of up to $500,000; and
• Apply for Salary Continuance insurance cover for up to $4,000 per month for a benefit period of two years.

This special offer is available to you as a one-off opportunity when you first complete your Membership application form available at www.hostplus.com.au/forms to join HOSTPLUS and select this option on the form or when you make an online application to join. You must return the form within 6 months from the effective date from the first on time SG contribution is received or within 60 days from the day you receive your HOSTPLUS welcome letter, whichever is the later. The Membership application form is available at www.hostplus.com.au

This offer is only available to new members joining HOSTPLUS who don’t have any current/existing memberships with HOSTPLUS.

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

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

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

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

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

To apply use the Specific life events insurance form available at www.hostplus.com.au/insurance