Salary Protection Scheme for PNA members
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Salary Protection Scheme for PNA members
2 Salary Protection Scheme for PNA members
Contents
This booklet is split into the following sections:
1. Introduction 4
2. Benefits 9
3. Cost 26
4. Claims 28
5. Frequently Asked Questions 38
6. Specified Illnesses Appendices 43
Disclaimers
This booklet is intended as a guide only. The scheme is governed by the master Policy Document No. 21028 issued by Irish
Life. Members of the scheme may request a copy of the policy document from the scheme owners or the Dublin office of
Cornmarket Group Financial Services Ltd.
This booklet 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 of May 2019.
If there is any conflict between this document and the policy document, the policy document will prevail.
No part of this booklet should be read in isolation.
Please save a copy of this booklet for future reference.
Information in this booklet is correct as of May 2019 but may change. For the latest information, please see cornmarket.ie
Where we say ‘Insurer’ in this booklet, we mean Irish Life.
Where we say ‘we’ or ‘us’ we mean Cornmarket Group Financial Service Ltd.
Visit cornmarket.ie 3
1. Introduction
Overview of Key Benefits
1
A replacement income of up to 75%* of
Disability Benefit your annual salary if you can’t work due to
illness or injury
2 Life Cover
A Death Benefit of three times your
annual salary
3
A benefit of 25% of your annual salary if
Specified Illness you suffer one of the Specified Illnesses
Benefit covered**
In the event of your spouse or civil partner’s
death, 100% of your annual salary will be
Spouses’/Civil
paid to you
Partners’ Death
4 Benefit or Single
Members’ Specified
or
A lump sum of 25% of salary is payable
Illness Benefit*** if a single member suffers any of the 36
Specified Illnesses covered.**
*Less any other income that you may be entitled to e.g. half pay, Ill Health Early Retirement Pension,
Temporary Rehabilitation Remuneration (previously known as Pension Rate of Pay), State Illness or Invalidly Benefit.
**Please see the Appendices from page 43 to 68 for full details, in particular the policy definition of each Specified
Illness and its pre-existing and related conditions.
***Single Members’ Specified Illness Benefit is in addition to the 25% of gross salary already payable under Specified
Illness Benefit.
4 Salary Protection Scheme for PNA members
The Scheme in action*
The true value of the scheme can be seen in
the vital benefits that it pays out to members
and their families.
1,722 96%
of Disability Benefit claims
have been paid since the
Members currently 2013 review
in the scheme
€4.8 million
Paid in Disability
Benefit to date
€1.8 million €805,000
Paid in Death Benefit Paid in Specified Illness
to date Benefit to 50 members
to date
*Source: Cornmarket & Irish Life, March 2019.
Visit cornmarket.ie 5Eligibility
You may apply to join this scheme if you:
1) Are a member of the PNA union or 6) Actively at work today.*
the National Ambulance Service *Actively at work today
Representative Association (NASRA). This means you:
- Are working your normal contracted hours and
You must remain a member of the - Have not received medical advice to refrain
PNA union or NASRA to remain an from work and
eligible member of the scheme and - Are not restricted from fully performing the
normal duties associated with your occupation.
2) Are under age 60 and You are considered to be ‘actively at work’ if you are
on paid or unpaid maternity leave.
3) Are working 8 hours or more per week
You are not considered to be ‘actively at work’ if you
and are on career break or any other forms of unpaid
leave and cannot apply to join the scheme.
4) Are employed by a recognised health
Those who are job/work sharers (i.e. work 50% or less
service employer and than the normal working week) and who satisfy the
above criteria may apply to join.
5) Are employed under at least one of
the following conditions:
• A permanent basis or
• A contract of indefinite duration or
• A fixed-term contract of at least
12 months duration or
• Working as an agency nurse for
2 or more years and
Apply to join now,
simply call us on
(01) 470 8054
6 Salary Protection Scheme for PNA membersRoles
Cornmarket’s role includes: The Insurer’s role includes:
1. Negotiating with the 1. Deciding the policy
Insurers to obtain the terms and conditions
best possible benefits and creating a policy
and cost. document to reflect
these.
2. Assisting members who
wish to make a claim 2. Medically assessing
from the scheme. Please applications and claims.
see page 28 for more
3. Deciding the various
information.
aspects of an individual
3. Promoting the scheme. member’s cover e.g.
if membership of
the scheme can be
reactivated, if refunds
can be made and
if arrears and/or a
declaration of health
are required.
Visit cornmarket.ie 78 Salary Protection Scheme for PNA members
2. Benefits
i) Disability Benefit
In the event that your salary* is affected because
you are unable to work due to illness or injury, this
benefit aims to pay you an income of up to 75%
of salary after a certain period of time.
The Disability Benefit paid is less any There is no limit on the number of
other income, reward, award, pension, Disability Benefit claims you can make
or benefit that you are entitled to while a member of the scheme.
(regardless of whether you are receiving
If you are in receipt of Disability Benefit
this amount or not). For example:
and return to work on a part time basis,
- Temporary Rehabilitation you may, in some circumstances, still
Remuneration (TRR) - Paid by your be paid Disability Benefit under the
employer to you where there is a scheme. This is referred to as Partial
realistic prospect of you returning to Disability Benefit.
work.
*See page 12 for definition of Salary.
- State Illness Benefit/State Invalidity
Pension - Those paying PRSI at the
‘A’ rate may be entitled to this benefit
from the State.
- Ill Health Early Retirement Pension
(IHERP) - Those who retire on the
grounds of ill health may be entitled
to this from their employer.
This applies regardless of whether
you are a ‘D’ or ‘A’ PRSI contributor
and whether you contribute to the
Superannuation Scheme or not.
Visit cornmarket.ie 9Example of how the Scheme works
This example is based on a Public Sector It is assumed that standard Public
employee, who is a member of the Sector sick leave arrangements apply,
Superannuation Scheme with 20 years’ extended paid sick leave under the
service earning €50,000 per annum, Critical Illness Protocol does not apply
who is now unable to work due to illness and Ill Health Early Retirement Pension is
or disability. granted after 2 years.
WITHOUT Salary Protection WITH Salary Protection
D Rate PRSI Example D Rate PRSI Example
100% 100%
€962 €962
p.w. p.w.
75% 75%
of salary
€240
p.w. €400 €400
50% 50% p.w. p.w.
€481
33% p.w.
of salary €481
€321 €321 25% p.w. €321 €321
p.w. p.w.
p.w. p.w.
0% 0%
First 13 After 13 After 26 After 2 First 13 After 13 After 26 After 2
weeks weeks weeks years weeks weeks weeks years
of illness of illness of illness sick leave of illness of illness of illness sick leave
Scheme Sick Pay Temporary Ill Health Early
Benefit Rehabilitation Retirement
Remuneration Pension
10 Salary Protection Scheme for PNA membersWITHOUT Salary Protection WITH Salary Protection
A Rate PRSI Example A Rate PRSI Example
100% 100%
€962 €962
p.w. p.w.
75% 75%
of salary €240
p.w. €365 €359
50% 50% p.w. p.w.
€481
37% p.w.
of salary €198 €204 €481 €198 €204
p.w. p.w. 25% p.w. p.w. p.w.
€158 €158 €158 €158
p.w. p.w. p.w. p.w.
0% 0%
First 13 After 13 After 26 After 2 First 13 After 13 After 26 After 2
weeks weeks weeks years weeks weeks weeks years
of illness of illness of illness sick leave of illness of illness of illness sick leave
Scheme Sick Pay Temporary Ill Health Early State Illness State Invalidity
Benefit Rehabilitation Retirement Benefit Pension
Remuneration Pension
Staff recruited to the Public Service on
or after 6th April 1995 pay class A PRSI.
Their Superannuation Scheme pension is
integrated to take account of the value
of the Contributory State Pension in
calculating the pension payable. In the
event of illness, they may typically claim
State Illness Benefit.
Visit cornmarket.ie 11Deferred Period Definition of Salary
After you are accepted as a member of For those who pay their premiums
the scheme, if you need to make a claim through their salary, salary is defined as:
the Deferred Period is the waiting period
(i) For members of a Superannuation
before the Disability Benefit becomes
Scheme: Gross basic annual salary
payable.
at the end of the relevant Deferred
For the purpose of this scheme the Period, plus the average of any
Deferred Period is either: allowances received in the preceding
3 years, which are taken into account
for sick pay and/or for the purposes
- 13 weeks (92 days) disability in of that Superannuation Scheme* or
a rolling 12 month period or 26
weeks (183 days) in a rolling 4 (ii) For those who are not members of
year period, where standard sick a Superannuation Scheme: Gross
leave has been granted or basic annual salary at the end of
the relevant Deferred Period, plus
- 26 weeks (183 days) disability in the average of any allowances
a 12 month period or 52 weeks received in the preceding 3 years;
(365 days) in a rolling 4 year which would be taken into account
period, where extended paid for sick pay and for the purposes
sick leave has been granted of a Superannuation Scheme had
- referred to as Critical Illness the member been a member of a
Protocol. Superannuation Scheme.*
For those who pay their premiums by
direct debit, salary is defined as:
If you have been accepted with an
excluded condition, any sick leave The lower of either the salary covered by
relating to that condition will not be your premiums or the actual salary you
taken into account for the calculation of are earning at the end of the relevant
the Deferred Period. Deferred Period, as confirmed by your
employer. You must advise Cornmarket
of any salary changes so that we can
adjust your premium accordingly. This is
to ensure that your cover is provided in
line with your current gross annual salary
and that you are paying the correct
premium amounts.
*Depending on the type of claim being made, the
salary will be established at different points in time e.g.
• Disability Benefit - the end of the relevant Deferred
Period
• Death Benefit - on the date of death
• Specified Illness - on the date of diagnosis.
12 Salary Protection Scheme for PNA membersDisability Benefit
Exclusions
There are general exclusions on this If this happens, a form will be sent to
scheme, in relation to illnesses or injuries you as part of the application process
resulting from: with the details of the exclusion(s) and
- Self harm you will have the opportunity to decide
- A criminal act if you wish to accept the cover with
the exclusion(s) or not. If an exclusion(s)
However, when you apply to join the applies to you, then sick leave used for
scheme, the Insurer may offer you the excluded condition(s) cannot be
cover with some exclusions that apply taken into account for the calculation of
specifically to you. For example, if you the Deferred Period.
inform the Insurer that you have a back
problem on your application form,
they may offer you membership of the
scheme with a back exclusion. This
means that you would never be able to
claim for an illness or injury relating to
your back.
Visit cornmarket.ie 13Disability Benefit
Limitations and Restrictions
Definition of Disability
In order for a claim to be paid, the Insurer must be satisfied that you are totally
disabled. This means that you are totally unable to carry out the duties of your
normal occupation because of illness or injury and that you are not engaged in
any other occupation (whether or not for profit, reward, remuneration or benefit-
in-kind).
Definition of Partial Disability
Following the payment of a disability claim, if:
• you return to work with the consent of the Insurer (either to your normal job or
to a new job) and
• you are partially disabled due to illness or injury, the Insurer may continue to
pay a partial disability claim if:
- your monthly earnings are reduced due to the partial disability and
- you are earning less than the average monthly earnings that you had in
the 12 months immediately before your period of disability.
Please note: Partial Disability Benefit is payable for a maximum of 12 months.
Disability Benefit will not be paid If your claim is admitted...
if you cannot work due to strike or - 75% of salary will be paid for
unemployment. maximum of two years only. After this
The maximum benefit is €150,000 per a pension amount will be deducted
year. from the benefit regardless of
whether or not you are in receipt of
Any sick leave used before you are same. This is referred to as Notional
accepted as a scheme member will Early Retirement Pension (NERP)
not be used in the calculation of the
- the benefit you receive from the
Deferred Period.
Insurer will be treated as income and
If you have been accepted with an as such is liable to income tax, PRSI,
excluded condition, any sick leave Universal Social Charge, etc. The
relating to that condition, will not be Insurer will deduct any tax due from
taken into account for the calculation of the Benefit made to the member,
the Deferred Period. in the same way as an employer
deducts tax from an employee.
14 Salary Protection Scheme for PNA membersIf your claim is admitted, Disability Late Notification of Claims:
Benefit will continue until: It is not often possible to retrospectively
- You recover assess the validity of a claim in cases
- You resign where a significant period of time
(approx. 3 months) has elapsed since
- You go back to work (benefit may
your salary reduced or ceased. For
continue to be paid if the return is
this reason, it is vital that you register
at a reduced level due to partial
your claim promptly. In the case of late
disability)
notification of a claim, cases will be
- the Insurer decides that you are fit assessed on individual merit and the
to return to work based on medical Insurer reserves the right to decline to
evidence* assess the claim.
- You reside outside of Ireland or the
UK for more than 6 calendar months
(unless agreed otherwise with the
Insurer in advance)
- You retire (except if you are claiming
from the scheme and retire on an Ill
Health Early Retirement Pension)
- You reach age 60 or 62 depending
on the date you entered the Public
Sector
- You die
whichever is earliest.
*If you have been in continuous receipt of Disability
Benefit for more than 12 months, 3 months notice will be
given before your Disability Benefit is ended.
Visit cornmarket.ie 15ii) Death Benefit
In the event of your death, a once-off lump
sum will be paid to your estate. For members
the amount paid will be three times their gross
annual salary*.
If a Death Benefit claim is admitted, the Terminal Illness Benefit
benefit will be paid by the Insurer tax In the event that you are certified by
free. However, thereafter, beneficiaries a medical specialist with a terminal
of the estate will be subject to illness, with death expected within 12
whatever taxes apply at the time of months, and the Insurer accepts this;
the inheritance and it will be their the scheme will pay 25% of the Death
responsibility to ensure they are meeting Benefit to you tax-free.
their full tax liability.
Terminal Illness Benefit -
Limitations and Restrictions
Exclusions
This Benefit ceases at age 65.
There are no general exclusions on the
As this is a Group Scheme you cannot Terminal Illness Benefit.
assign the Death Benefit against a
mortgage. Terminal Illness Benefit -
Limitations and Restrictions
This benefit ceases at age 62.
*See page 12 for definition of Salary.
16 Salary Protection Scheme for PNA membersAccidental Death Benefit Children’s Death Benefit
In the event of accidental death, a In the event that a member’s child
benefit of €15,000 is payable tax-free between the ages of 0 and 21 dies, a
in addition to the normal Death Benefit. Death Benefit of €4,000 will be paid to
‘Accidental Death’ is defined as ‘death the member, tax-free. Children’s Death
as a direct result of a bodily injury arising Benefit applies to all natural or adopted
from an external and accidental cause’ children.
which leaves a visible bruise or wound
and is in no way linked to disease or Children’s Death Benefit -
physical disorder. Exclusions
This benefit can only be claimed by the
Accidental Death Benefit - scheme member. This means that the
Exclusions scheme member’s estate cannot claim
Exclusions apply where death is caused it in the event that the scheme member
directly or indirectly by: has died.
1. Taking part in any criminal act In the event that both parents are
2. Taking drugs (other than under the members of this scheme, this benefit will
direction of his/her own or any other only be paid once.
registered medical practitioner) or
alcohol Children’s Death Benefit -
3. Taking part in aviation (other than as Restrictions and Limitations
a fare-paying passenger) or in motor This benefit ceases on your child’s 21st
car or motor cycle racing or birthday.
4. The member’s own deliberate act.
Accidental Death Benefit -
Restrictions and Limitations
This benefit ceases at age 65.
Visit cornmarket.ie 17iii) Specified Illness Benefit
Full Benefit
If you are diagnosed with one of the illnesses listed below, and
meet the definition/criteria of that illness (see pages 43-68),
this benefit will pay a once-off, tax-free lump sum of 25% of your
annual salary* at the date of diagnosis.
Please note: The Specified Illnesses marked ❖ below were introduced at the
1st December 2013 review. The other Specified Illnesses were introduced on
1st December 2008. Only diagnoses that occur after these dates are eligible to claim
Specified Illness Benefit for these illnesses. If, prior to joining the scheme, you have
suffered from one of the Specified Illnesses you will never be covered for that illness.
• Alzheimer’s Disease • HIV infection
• Aorta graft surgery • Kidney failure
• Aplastic Anaemia ❖ • Liver failure ❖
• Bacterial Meningitis ❖ • Loss of limbs
• Benign brain tumour • Loss of speech
• Benign spinal cord tumour ❖ • Major organ transplant
• Blindness • Motor Neurone Disease
• Cancer (malignant) • Multiple Sclerosis
• Cardiomyopathy ❖ • Paralysis of Limbs
• Coma • Parkinson’s Disease (idiopathic)
• Coronary artery bypass graft • Primary Pulmonary Hypertension ❖
• Creutzfeldt-Jakob Disease • Progressive Supranuclear Palsy ❖
• Deafness • Pulmonary Artery Surgery ❖
• Dementia ❖ • Respiratory failure of specified
• Encephalitis ❖ severity
• Heart attack (diagnosed) • Severe burns or 3rd-degree burns
• Heart structural repair with surgery • Stroke – permanent symptoms
to divide the breastbone • Systemic Lupus Erythematosus ❖
• Heart valve replacement or repair • Traumatic head injury ❖
*See page 12 for definition of Salary.
18 Salary Protection Scheme for PNA membersPartial Benefit
If you are diagnosed with one of the illnesses listed below, and
meet the definition/criteria of that illness (see pages 43-68), this
benefit will pay a once-off, tax-free lump sum of the lesser of
€10,000 or 25% of your salary* at the date of diagnosis.
Please note: The qualifying Specified Illnesses covered under the Partial Payment
section were introduced on 1st December 2013. If, prior to joining the scheme,
you have suffered from one of the Specified Illnesses you will never be covered
for that illness.
• Brain abscess drained using a • Ductal carcinoma in situ – breast,
craniotomy treated by specific surgery
• Carcinoma in situ – oesophagus, • Less severe burns or 3rd-degree
treated by specific surgery burns covering at least 5% of the
• Carotid artery stenosis – treated body’s surface
by endarterectomy or angioplasty • Low level prostate cancer with
• Cerebral arteriovenous specific treatment
malformation – treated by • Loss of one limb
craniotomy or endovascular repair • Surgical removal of one eye
• Coronary Angioplasty – to two or
more coronary arteries
*See page 12 for definition of Salary.
Visit cornmarket.ie 19Specified Illness Benefit Exclusions Specified Illness Benefit and Partial Specified Illness Benefit Claims will not be paid, if, in the opinion of the Insurer, the diagnosis arises directly or indirectly as a result of: a) taking alcohol or drugs (other than under the direction of a registered medical practitioner) or b) failure to follow reasonable medical advice in relation to a cause or latent cause of sickness. 20 Salary Protection Scheme for PNA members
Specified Illness Benefit
Limitations and restrictions
- Specified Illness Benefit became - You will not be able to make a
a benefit of the scheme on 1st Specified Illness claim for an illness
December 2008. that:
- The Specified Illnesses marked ❖ • You suffered from prior to joining
on page 18, were introduced on 1st the scheme
December 2013. The other Specified • Relates to a condition which
Illnesses were introduced on 1st you were already suffering from
December 2008. You can only claim at the time of your application
for diagnoses that occur after these and/or where you were under
dates. medical investigation, regardless
- Partial Payment Specified Illness of whether you were aware of the
Benefit became a benefit of the condition at that time
scheme on 1st December 2013. • Relates to a condition which you
Therefore, you can only claim for a were already suffering from before
diagnosis that occurs after this date. the date that Specified Illness was
- If you make a Full Specified Illness introduced to the scheme
claim, you will not be able to make a • If, in the Insurer’s opinion, the
further Full or Partial Specified Illness diagnosis has occurred directly
claim. If you make a Partial Specified or indirectly as a result of taking
Illness claim, you will still be able to alcohol or drugs (other than
make a Full Specified Illness claim. under the direction of a registered
- If you are diagnosed with one of the medical practitioner)
Full Specified Illnesses within 30 days • If, in the Insurer’s opinion, the
of diagnosis of a Partial Specified diagnosis has occurred directly or
Illness, a claim will be assessed on the indirectly as a result of failure to
Full Specified Illness only. follow reasonable medical advice
- A Specified Illness claim will only in relation to a cause or latent
be paid if the diagnosis/severity cause of sickness.
meets the specific definition/
criteria outlined for that illness in the
Appendices on pages 43-68.
Visit cornmarket.ie 21Late Notification of Claims: Definition of Salary for Specified
You must make a Specified Illness Claim Illness Benefit
within 12 months of being diagnosed. Please refer to page 12 for definition of
Failure to make a claim within this time Salary.
period may result in the Insurer declining
to assess your claim.
- There is a waiting (deferred) period
for some Specified Illnesses. Please
see Appendices on pages 43-68 for
more details.
- There is a survival period for some
Specified Illnesses. You must survive
for a minimum period after the date
of diagnosis or surgery took place,
before a payment can be made. In
the event of death within this period
no benefit is payable. The relevant
periods are:
(a) 14 consecutive days after
diagnosis or surgery for Illnesses
covered under the Full Specified
Illness except for those named in
(b) and (c) below
(b) 6 months for Alzheimer’s Disease,
Blindness or Parkinson’s Disease.
(c) 12 months for deafness or loss of
speech.
Please see Appendix from pages 43-68
for more details.
The Benefit ceases at age 65.
22 Salary Protection Scheme for PNA membersiv) Spouses’/Civil Partners’ Death Benefit OR
Single Members’ Specified Illness Benefit
In addition to Disability Benefit, Specified Illness Benefit and
Death Benefit, the scheme includes an additional valuable
benefit for members in the form of either:
A. Spouses’/Civil Partners’ Death Benefit or
B. Single Members’ Specified Illness Benefit
Members can only ever benefit from either option A or B. The benefit is only payable
once per member.
A. Spouses’/Civil Partners’ Death Benefit
In the event of the death of a member’s
Spouse or Civil Partner, a lump sum of
100% of the member’s annual salary* will
be paid to the member.
Limitations and Restrictions
This benefit only applies if you are
legally married or civil partnered at the
date of their death, as defined in the
Civil Partnership and Certain Rights and
Obligations of Cohabitants Act 2010.
You can only claim from either the
Specified Illness Benefit or the Spouses’/
Civil Partners’ Death Benefit; you cannot
claim from both.
This benefit ceases at age 65.
*Please refer to page 12 for definition of Salary.
Visit cornmarket.ie 23B. Single Members’ Specified Illness Benefit In the event a single member suffers any of the 36 Specified Illnesses an additional lump sum of 25% of salary* is payable. This is in addition to the 25% of gross annual salary already payable under the Specified Illness Benefit. Limitations and Restrictions This benefit only applies if you are single at the date of diagnosis. You can only claim from either the Single Specified Illness Benefit or the Spouses’/Civil Partners’ Death Benefit; you cannot claim from both. This benefit ceases at age 65. *See page 12 for definition of Salary. 24 Salary Protection Scheme for PNA members
Visit cornmarket.ie 25
3. Cost
The total scheme premium is 2.17% of gross
salary. This includes the 1% insurance levy.
Scheme cost Income Tax Relief
The breakdown of this premium is: The portion of your scheme premium
that is paid towards Disability Benefit is
Disability Benefit 1.49% eligible for Income Tax Relief.
Death Benefit 0.36% Below are some examples of cost for
Specified Illness Benefit 0.12% various salary amounts taking income
Spouses’ /Civil Partners tax relief into account:
Death Benefit or Single Income Weekly ‘Real’ weekly
0.15%
Members’ Specified premium premium
Illness Benefit after tax relief
Medical Immunity for €35,000 €14.56 €10.56*
Retired Members’ Life 0.05% €45,000 €18.71 €13.57**
Cover Plan*
€55,000 €22.87 €16.60**
Total Cost 2.17%
*If you are paying income tax at 20% your net premium rate
*Allows members to join Cornmarket’s Retired Members’ will be 1.87%
Life Cover Plan, without medical underwriting. Terms & **If you are paying income tax at 40% your net premium rate
Conditions apply. will be 1.57%.
Warning: The current premium may
increase after the next scheme
review which should take place on/
after 1st March 2021.
Cornmarket’s Retired Members’ Life
Cover Plan Medical Immunity* For more details on this plan,
0.05% of your overall premium entitles
please contact us on
you to join Cornmarket’s Retired
Members’ Life Cover Plan when you (01) 470 8054 or email
retire, without any medical underwriting, clientservices@cornmarket.ie
once you apply to join within a
certain time period of retiring or your
membership of this scheme ceasing.
*Cornmarket Retired Members’ Life Cover Plan is underwritten by Irish Life. Irish Life Assurance plc is regulated by the Central
Bank of Ireland.
26 Salary Protection Scheme for PNA membersPayment Methods
Your premiums may be paid via deduction at
source from salary or direct debit.
If you pay your premiums last gross salary you notified to
through salary Cornmarket or the last gross salary
The premium will be split under two that we estimated for you at the last
headings on your payslip. One heading scheme review. As a result, the salary
reflects the Disability Benefit portion covered by the scheme will be based
of your premium and automatically on either the salary covered by your
receives income tax relief, the other premiums or the actual salary you are
heading reflects the premium for the earning at the end of the Deferred
remaining benefits and does not receive Period as confirmed by your employer,
income tax relief. You are eligible for whichever is lower. The onus is on you
income tax relief at your highest rate to ensure you advise Cornmarket of
of income tax on the Disability Benefit any salary changes so that we can
premium. adjust your premium accordingly so
that your cover is provided in line with
Your premiums will increase and your current gross salary and you are
decrease in line with your salary paying the correct premium amounts
changes and as a result, the salary
- You may incur charges from your
covered by the scheme will be your
bank.
salary as confirmed by your employer on
the last day of your Deferred Period.
Remember...
You must ensure that the premiums
deducted from your salary are correct As this is an insurance policy, you
and reflect your salary. must pay your premiums in order
to stay on cover. Failure to pay
If you pay your premium by premiums, could result in your
direct debit membership of the scheme lapsing.
This means you will no longer be a
- You will need to send a Premium
member of the scheme and you will
Statement to Revenue in order to
not be on cover for any benefits. In
claim income tax relief. If, throughout
the event that you wish to become
the course of your membership of
a member of the scheme again,
the scheme, your premium amount
you would have to apply to be
changes, you should request an
a member and your application
up-to-date Premium Statement from
would be medically underwritten.
Cornmarket to send to Revenue so
Your application may be accepted,
that Revenue can amend your income
declined, postponed or accepted
tax relief accordingly.
with exclusions.
- Your premiums will reflect the
Visit cornmarket.ie 274. Claims
Roles
Cornmarket’s role
Cornmarket’s role is to help guide members through the claims process.
Cornmarket has considerable experience in this area and works closely
with the claimant, Insurer and third parties to help get claims processed as
efficiently as possible. Cornmarket has its own dedicated, in-house Claims
Administration Team. The team members will do all they can to help in a
member’s time of need. If you need to make a claim, it will be dealt with in a
professional and sensitive manner.
Our contact details for making a claim are:
Phone: (01) 408 4018
In the interest of Customer Service we may record and monitor calls.
Email: spsclaims@cornmarket.ie
Post: SPS Claims Department, Cornmarket Group Financial Service Ltd,
Christchurch Sq., Dublin 8.
Our offices are open Monday-Friday 9:00-17:30.
The Insurer’s role
The Insurer’s role is to medically assess claims and decide whether or not claims
should be paid. If they decide that a claim is payable, they will calculate and
pay the benefit.
28 Salary Protection Scheme for PNA membersDisability and Specified Illness Benefit Claims
How to make a Disability or Specified Illness
Specified Illness Benefit claim Contact Cornmarket as soon as
possible, as it may take a number of
Disability
weeks to process the claim. See Late
Contact Cornmarket as soon as you Notification clause on page 22.
think that your salary may reduce to half
pay or cease altogether due to illness or It is not often possible for the Insurer
injury because: to retrospectively assess the medical
validity of a claim. If they cannot
(i) Disability Benefit claims take medically assess a claim, the Insurer
approximately three months reserves the right to decline to assess
to process from the date your the claim.
completed claim form is received.
The exact length of time it will take to Can I nominate someone to
process a claim is dependent upon contact Cornmarket on my
how long it takes for the Insurer to get
behalf in relation to a Disability
data from third parties such as G.P.s,
specialists, unions/associations and
or Specified Illness Benefit
employers. With that information they claim?
must be satisfied that: You can nominate someone to contact
- A member is a valid member of the Cornmarket on your behalf and to
scheme and assist you with your claim, for example,
a spouse, next of kin etc. If you wish
- A member is or was medically
to do so, please send us a letter,
incapable of working for the
signed and dated by you, outlining
period being claimed for and
the name, address, and date of birth
- They are paying the correct of your nominated person. Please be
benefit amount. aware that if you nominate someone
to act in this capacity, they will have
(ii) It is often not possible for the Insurer
access to the information related to
to retrospectively assess the medical
your claim such as your medical, salary
validity of a claim. If they cannot
and financial details. However, they
medically assess a claim, the Insurer
will not have the authority to make any
reserves the right to decline to assess
changes, for example, to cancel your
the claim. See Late Notification
membership of the scheme.
clause on page 15.
Visit cornmarket.ie 29What will happen after I initially Items 2, 3 and 4 are at the Insurer’s
contact Cornmarket to make expense and reasonable travel
expenses will be covered, if travel is
a Disability or Specified Illness
necessary.
Benefit claim?
We will liaise with your employer,
Following an initial phone call, if
the Insurer and you throughout the
appropriate, we will send you a claim
assessment.
form, information about the scheme
and details of the documentation you
will need to provide.
What happens after my
Disability Benefit claim is
You should return the forms and
documentation to Cornmarket as soon assessed?
as possible and we will send these to Following the assessment, the Insurer will
the Insurer. The Insurer will then start make a decision on your claim. Claims
medically assessing your claim. can be admitted or declined.
What will happen if my Disability
Are all Disability and Specified
Benefit claim is admitted?
Illness Benefit claims medically
- If your claim is admitted, and you
assessed? have completed the relevant deferred
All claims will be medically assessed by period, the Insurer will arrange for
the Insurer. If you have been granted benefit to be paid to your bank
Ill Health Early Retirement by your account. Disability Benefit will be
employer, this does not mean that paid in arrears and may be paid on a
you will be automatically entitled to monthly basis. Therefore, it may take
Disability Benefit from the scheme. up to four weeks after your claim is
As part of their assessment, to confirm admitted to receive your first benefit.
that you meet the definition of disability, - If your claim is admitted after you
the Insurer may require you to: have been reduced to half-pay or
1. provide medical evidence from your your pay has ceased altogether, the
Doctor (your Doctor may charge you benefit may be backdated to the
for this) and/or date when salary was first affected.
2. provide medical evidence from your - As a benefit is subject to income
Specialists and/or tax, you can request the Revenue
3. complete a Tele-claims Interview with Commissioner to issue a Certificate
a nurse and/or of Tax to the Insurer. This will enable
4. attend an Independent Medical the Insurer to apply the correct tax
Examination (IME) and/or the Insurer’s rate for future benefits. However, the
Occupational Health and Safety first benefit may have emergency
Advisor to confirm that you meet the tax rates applied. Any overpayment
definition of disability. It generally or underpayment of tax may be
takes about 3 weeks for the IME report subsequently rectified.
to be returned to the Insurer.
30 Salary Protection Scheme for PNA members- In order to ensure you continue to the rate of increase in the Consumer
meet the definition of disablement, Price Index (if lower).
the Insurer may seek completed - If you plan to return to work or take up
continuation forms, certificate of other paid work, you must inform the
continued disablement, medical Insurer immediately.
certificates from your Doctor, and/or
require you to attend an independent
medical examination and/or organise What will happen if my Disability
for a Health Claims Advisor to visit Benefit claim is declined?
you. Claims in payment for greater - If your claim is declined, the Insurer
than 6 years, will not be subject to will inform you of the reasons for the
ongoing medical assessments. decision in writing.
- In the event that you fail to follow - You may appeal the decision
medical advice, the Insurer may cease by sending additional evidence
paying you benefits. supporting the fact that your claim
- You will not be expected to pay should be admitted to the Chief
premiums towards the scheme while Medical Officer of the Insurer. You
claiming. However, if your benefit must do this within 3 months of the
stops for some reason other than decline decision being made. The
reaching the ceasing date of the review of their decision may require
benefit, you will be expected to start you to attend further Independent
paying premiums again in order to Medical Examinations.
maintain your cover. If you continue - If you do not appeal, premiums must
to receive Disability Benefit up to continue or restart in order for you to
the ceasing age of the benefit, you remain a member of the scheme.
can continue to avail of the other - If your appeal with the Insurer is
scheme benefits without having to unsuccessful, you may bring your case
pay premiums for them up until the to the Financial Services and Pensions
ceasing age of those benefits. Ombudsman.
- While claiming Disability Benefit, any
Death Benefit or Specified Illness What happens after my
Benefit that you have as a scheme
Specified Illness Benefit claim is
member remains in force until the
ceasing date of those benefits. In
assessed?
the event that you will need to claim Following the assessment the Insurer will
from these, the benefits will be based make a decision on your claim. Claims
on the salary you were earning can be settled or declined.
at the time your Disability Benefit Settled
commenced. - If your claim is settled, the Insurer will
- The benefit paid to you by the arrange for a payment to be sent to
scheme increases by 5% each year, or you.
Visit cornmarket.ie 31- If you claimed from the Full Specified How does Ill Health Early
Illness Benefit, you will no longer be Retirement Pension (IHERP)
covered for any Specified Illness
affect my Disability Benefit
Benefit and you will no longer be
required to pay for it and we will claim?
reduce your premium accordingly. In If you are making a claim and decide
the event that you pay your premiums not to apply for IHERP, perhaps because
by salary and your employer is unable you intend to return to work, and the
to facilitate the reduced premium, you Insurer agrees that there is a reasonable
may need to switch to paying your expectation for you to return to work,
premiums by direct debit. then the Insurer may pay a benefit
- If you claimed from the Partial of 75% of salary less any State Illness
Specified Illness Benefit, you can still Benefit or Temporary Rehabilitation
make a claim under the Full Specified Remuneration for a maximum of 2
Illness Benefit and so your premiums years. This means no deduction will be
will not reduce. made from the Benefit for an amount
equivalent to IHERP, as no IHERP is being
Declined
claimed.
- If your claim is declined, you will be
However, after 2 years a pension
informed of the reasons for that
amount will be deducted from the
decision in writing.
benefit regardless of whether or not you
- You may appeal the decision
are in receipt of same. This is referred
by sending additional evidence
to as Notional Early Retirement Pension
supporting the fact that your claim
(NERP).
should be admitted to the Chief
Medical Officer of the Insurer. You If you retire subsequently and IHERP
must do this within 3 months of the is paid, the additional amount that
decline decision being made. The was paid under the scheme since the
review of their decision may require effective date of early retirement must
you to attend further Independent naturally be repaid to the Insurer.
Medical Examinations.
- If your appeal with the Insurer is
unsuccessful, you may bring your case
to the Financial Services and Pensions
Ombudsman.
32 Salary Protection Scheme for PNA membersWhat if I am on a Fixed Term What happens if I return to work
Contract and make a Disability after making a Disability Benefit
Benefit claim? claim?
If you are unable to work due to illness If you return to your normal occupation
or injury and your contract ends before at your normal hours, or to full salary
the expiry date of the Deferred Period, (e.g. you take annual leave), you must
(13 weeks in any 12 month period), your ensure that premiums restart in order for
claim will be considered subject to the you to remain a member of the scheme.
usual medical evidence requirement. For If you return to your normal occupation
example, if you suffer an illness with 3 at reduced hours, or to a different
months remaining on your contract and occupation at reduced pay, the Insurer
remain unable to work due to illness or may continue to pay you a benefit but
injury to the end of the Deferred Period, at a proportionately reduced amount.
your claim will be considered in the This will be subject to medical evidence
normal manner. supporting the view that you are only
partially fit for work.
If my illness is due to an injury at If you return to work but have to
work, how does this affect my stop working again due to illness or
injury within a period of 183 days from
Disability Benefit claim?
the date you return, you will not be
Please inform the Cornmarket Claims expected to complete the Deferred
Administration team as soon as possible, Period again.
if this applies to you.
If, as a result of your workplace injury,
you are entitled to an additional
payment, it may mean that your income
remains higher than 75% of your salary
and hence there will be no Disability
Benefit payable from the scheme.
Visit cornmarket.ie 3334 Salary Protection Scheme for PNA members
Tax Return Service for members making
Disability Benefit Claims
Cornmarket’s Tax Return Service is
available to claimants who are in receipt For more
of Disability Benefit for a continuous
period of 3 months or more. Only information, please
claimants who submitted their claim
after 1st January 2014 are eligible to
call (01) 408 4106
avail of this service.
Cornmarket’s Tax Return Service will
prepare and file your tax return and act
on your behalf with Revenue, to ensure
that you do not pay any more tax than
is necessary while you are receiving
income from multiple sources. We will
also reclaim any overpayments of tax
which may have been made by you
during the period of your claim. The
service includes PAYE returns and up to
two rental properties, where relevant.
Additional properties or returns for non-
PAYE income may attract extra charges,
and/or may not be offered within this
service.
Cornmarket’s Tax Return Service is not a regulated financial product. This service is provided by Cornmarket Retail Trading Ltd.,
a wholly-owned subsidiary of Cornmarket Group Financial Services Ltd. Telephone calls may be recorded for quality control
and training purposes.
Visit cornmarket.ie 35Death Benefit Claims
How to make a Death How long will it take to process a
Benefit claim Death Benefit claim?
Depending on the type of death claim If your estate is being processed through
being made (accidental, terminal or the Probate Office, this may result in
children’s), you or your Estate/Next of delays in the processing of the claim.
Kin/Solicitor should contact Cornmarket. These delays could take over 12 months.
Once the Insurer receives all the required
After initial contact is made, if
documentation and information
appropriate, Cornmarket will advise of
required and the Insurer decides to
the documentation required to process
admit the claim, benefit is usually paid
the claim.
to the estate/trustees within 10 working
days.
36 Salary Protection Scheme for PNA membersVisit cornmarket.ie 37
5. Frequently Asked
Questions
How can I apply to join the - you may find it difficult to purchase
scheme? another Life Insurance product.
To apply, you must complete an
application form either: What happens if my application
(i) Over the phone - call (01) 470 8054
is accepted?
Your cover begins from the date the
(ii) With your Cornmarket Consultant
Insurer accepts your application.
(iii) By printing and completing an
- You will be sent a formal acceptance
application form at cornmarket.ie.
letter.
Applications may require underwriting
- You will have 30 days after the date
(medical assessment) which may
the acceptance letter is sent to you
include providing medical information
to cancel your membership of the
by telephone to a nurse or attending
scheme and receive a full refund of
a medical examination at the Insurer’s
any premiums paid.
expense. Following the underwriting
period, the Insurer may accept your - Premiums should start as soon as
application, postpone your application, possible after you are accepted as a
decline your application or offer you member.
membership of the scheme with certain
specified conditions excluded from What happens if my application
cover. is not accepted?
During the application process it is If your application is postponed,
important that you tell the Insurer all declined, or if you are offered
relevant medical information. This acceptance with certain specified
means information that the Insurer conditions excluded, you may request
would regard as likely to influence the details for the reasons for the decision
assessment and acceptance of your to be sent from the Insurer to your
application. If you do not: own doctor and you may appeal the
- your membership of the scheme decision.
could be void; you will not be covered
under the scheme
- a claim will not be paid and the
Insurer will not refund any premiums
you have paid
38 Salary Protection Scheme for PNA membersWhat if I have unearned What if I am placed on
income? administrative/special/
In general, investment and rental income gardening leave?
will not be taken into account when Please contact us on (01) 408 4195 as
making a claim under the scheme. soon as possible.
What if I plan to take a Career When does membership of the
Break or take Unpaid Leave? scheme cease?
If you plan to take a Career Break • Your 60th birthday for Disability
or Unpaid Leave please contact us Benefit if you joined the Public
to discuss the options that may be Service before the 1st April 2004
available to you by calling (01) 408 4195 • Your 62nd birthday for Disability
or emailing spsadmin@cornmarket.ie. Benefit if you joined the Public
If you wish to avail of the Career Service on or after 1st April 2004
Break options, you must apply for • Your 65th birthday for Death Benefit
these options within 4 months of and Specified Illness Benefit
taking a Career Break. Otherwise your • Your 65th birthday for Spouses/
membership of the scheme will cease. Partners’ Death Benefit or Single
You must remain a member of the Members’ Specified Illness Benefit.
Psychiatric Nurses Association of Ireland
Cover for all benefits ceases in the
union or a member of the National
following situations:
Ambulance Service Representative
• If you retire (other than on grounds of
Association for the duration of your
ill health) or
Career Break.
• If you resign or
If you wish to avail of the Unpaid • If you no longer fulfil the eligibility
Leave options you must notify us requirements or
at least 4 weeks in advance of the • If you leave the Psychiatric Nurses
commencement of unpaid leave. Association of Ireland or the National
Additionally, if you plan to do any of the Ambulance Service Representative
following, please contact us in advance Association or
in order to ensure your membership • If your premiums cease or
of the scheme does not lapse, and • If you become unemployed or
so that we can offer you any cost • If you die.
and/or benefit options which may be
applicable:
Remember - Cornmarket will not be
- Acquire a second job automatically informed if some of
- Go on Secondment the above events occur so please
- Change role/job ensure we are advised at the earliest
- Change terms of employment opportunity.
- Start Job sharing/work sharing
(i.e. work 50% or less of the normal
working week).
Visit cornmarket.ie 39Can I cancel my membership of What commission does
the scheme? Cornmarket receive?
Yes. You may cancel your membership
Initial charge €400
of the scheme at any time by clearly
instructing Cornmarket to do so in Premium Deduction Charge 2.5%
writing. Please ensure your name,
Renewal charge paid by
address and date of birth is included 12.50%
Insurer to Cornmarket
on the cancellation instruction. If
you cancel within 30 days of the
acceptance letter being sent to you, What if I travel abroad?
we will cancel your membership of the
In order to remain on cover under this
scheme and refund you any premiums
scheme you must remain a resident
you have paid.
within Ireland.
If you cancel your membership of the
If you travel briefly for normal holiday
scheme, and then wish to become a
purposes this will not affect your cover
member again, you will have to apply
under the scheme. However, if you
for membership again and provide
decide to reside or work abroad you
information about the state of your
must contact Cornmarket immediately.
health. If your health deteriorated
In such circumstances, the Insurer
between the time you cancelled your
may decide to vary your premium and
membership of the scheme and re-
benefits accordingly or cease your
applied, you may not be accepted as a
membership of the scheme.
member again or you may be accepted
with an exclusion. If you are in receipt of Disability Benefit
from the scheme, the Insurer will pay this
benefit to you if you are living anywhere
What happens if I cease to be
in the world for a maximum of 6 months.
a member of the PNA union or The Insurer reserves the right for
NASRA? claimants to come back to Ireland for
If you leave the PNA union or NASRA an Independent Medical Examination
you must inform Cornmarket in writing. during this 6 month period. If during the
Cornmarket will then cancel your 6 months you are required to attend a
membership of the scheme. medical assessment you must return to
Ireland for it, the expense of which must
Is there a surrender or cash- be agreed between you and the Insurer
in advance. Only reasonable expenses
in value associated with the
will be covered by the Insurer.
scheme?
After 6 months, you must reside in
No. There is no surrender or cash-in
Ireland or the UK. In exceptional cases
value associated with this scheme; it is
where a beneficiary is forced to live
not a savings plan.
abroad, the Insurer will consider this on
a case-by-case basis.
40 Salary Protection Scheme for PNA membersAre all claims paid? What if I wish to make a
The great majority of claims are paid. complaint about the
When claims are not paid it is usually service I have received from
due to one or more of the following Cornmarket?
reasons: Please write to:
- Medical opinion is that the member is Compliance Department,
not disabled from carrying out his or Cornmarket Group Financial
her normal occupation. Services Ltd, Christchurch Square,
- When applying to join the scheme, Dublin 8.
the member did not give all relevant, If you are dissatisfied with the outcome
requested medical information of your complaint through Cornmarket,
(information that the Insurer would you may submit your complaint to
regard as likely to influence the the Financial Services and Pensions
assessment and acceptance of your Ombudsman, Lincoln House,
application). This is called non- Lincoln Place, Dublin 2, or log onto
disclosure. In addition to being the www.fspo.ie
reason for a claim not being paid,
non-disclosure may also result in
membership of the scheme being
cancelled. If this occurs, premiums will
not be refunded.
- A claim is notified late, for example,
approximately three months after the
end of the Deferred Period/diagnosis
has occurred and hence the Insurer
is no longer in a position to medically
assess the claim.
- The illness or injury is a result of one of
the general exclusions that exist on
the scheme.
- The member attempts to claim for an
illness or injury for which they received
a specific exclusion.
Visit cornmarket.ie 41General Scheme Information Full scheme name: Salary Protection Scheme for PNA members. The scheme owner is the Psychiatric Nurses Association of Ireland. The current scheme broker is Cornmarket Group Financial Services Ltd. The current scheme Insurer is Irish Life. The current policy number for this scheme is 21028. This is a Group Protection Scheme. This means that the costs and benefits cannot be changed by any individual member. Instead, the scheme owner reviews the scheme periodically with a Broker and Insurers and then decides the best combination of benefits, cost, restrictions, limitations and features for all the members of the scheme. At a review it may be decided that the scheme should move Brokers and/or Insurers. In the event that this occurs, all scheme membership data will be transferred to the new Broker and/or Insurer. Additionally, at a review, it may be decided to terminate the scheme altogether. In the event that this occurs, any members who are already receiving a Disability Benefit will continue to receive that benefit under the terms of the scheme. Decisions taken by the scheme owner will be binding on all members. The next scheme review is due on or after 1st March 2021. 42 Salary Protection Scheme for PNA members
6. Specified Illnesses Appendices Explanation of each Specified Illness and its pre-existing conditions
APPENDIX 1:
Explanation of each Specified Illness
(Full Payment) and its pre-existing conditions
This section outlines: A claim can be made if the life covered has
• The policy definition of the Specified Illnesses been diagnosed by a consultant neurologist or
that are covered under the scheme consultant geriatrician as having Alzheimer’s
• A simple explanation of each illness. Disease and their judgement, understanding
The notes in the sections headed `In simpler and rational thought processes have been
terms’ are meant to provide a less technical seriously affected.
explanation of the illness definitions, and Pre-existing conditions
some of the medical terms used in that
If you have been diagnosed with Alzheimer’s
definition. They are not an alternative
Disease prior to the commencement date
definition of the illness and will not be used
of cover, you can never claim for Alzheimer’s
to assess claims. If there is any dispute, the
Disease under the Specified Illness Benefit.
illness `definition’ overrules the `In simpler
terms’ explanation If you have a history of arteriosclerotic
• Information on related conditions which, if dementia, amnesia or memory loss prior to the
present before joining the scheme, means commencement date of cover and you are
the member is not covered for the Specified found to have Alzheimer’s Disease within the first
Illness if diagnosis occurs within the first 2 2 years of cover no benefit will be payable under
years of cover the Specified Illness Benefit and you will cease
to be covered for Alzheimer’s Disease.
1. Alzheimer’s Disease - resulting in permanent Survival period: 6 months.
symptoms
Policy definition
2. Aorta Graft Surgery – for disease or
A definite diagnosis of Alzheimer’s Disease traumatic injury
by a Consultant Neurologist, Psychiatrist or
Policy definition
Geriatrician. There must be permanent clinical
loss of the ability to do all of the following: The undergoing of surgery for disease to the
• remember aorta with excision and surgical replacement of
• reason a portion of the diseased aorta with a graft.
• perceive, understand, express and give effect The term aorta includes the thoracic and
to ideas. abdominal aorta but not the branches.
For the above definition, the following are not For the above definition, the following are not
covered: covered:
• Other types of dementia. • Any other surgical procedure, for example
the insertion of stents or endovascular repair.
In simpler terms
Alzheimer’s Disease occurs when the nerve cells We also cover surgery for traumatic injury
in the brain deteriorate over time and the brain to the aorta needing excision and surgical
shrinks. There are various ways in which this replacement of a portion of the aorta with a
can affect someone, for example, severe loss of graft.
memory and concentration and mental ability
gradually failing.
44 Salary Protection Scheme for PNA membersYou can also read
