SIPTU Nurses and Midwives Salary Protection Scheme - Cornmarket
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SIPTU Nurses and Midwives Salary Protection Scheme
2 SIPTU Nurses and Midwives Salary Protection Scheme
Contents
This book is split into the following sections:
1. Introduction 4
2. Benefits 9
3. Cost 24
4. Claims 26
5. Frequently Asked Questions 36
6. Specified Illnesses Appendices 40
Important: You must remain a member of the SIPTU Nursing and Midwives
Sector or the SIPTU National Ambulance Service Sector Grades to remain an
eligible member of the Scheme. If you leave SIPTU you must inform Cornmarket
in writing, as you can no longer stay in the Scheme and you will not be able to
claim.
Disclaimers
This book is intended as a guide only. The Scheme is governed by the master Policy Document No. V000059E issued by New
Ireland Assurance. 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 book is issued subject to the provisions of the policy and does not create or confer any legal rights. The information
contained herein is based on our current understanding of Revenue law and practice as of October 2018.
If there is any conflict between this document and the policy document, the policy document will prevail.
No part of this book should be read in isolation.
Please save a copy of this book for future reference.
Information in this book is correct as of October 2018 but may change. For the latest information, please see cornmarket.ie.
Where we say ‘Insurer’ in this book, we mean New Ireland.
Where we say ‘we’ or ‘us’ we mean Cornmarket.
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
A Death Benefit of twice your annual salary.
Also:
2
• Accidental Death Benefit – €15,000
Death Benefit
• Children’s Death Benefit – €4,000
• Terminal Illness Benefit – 25% of Death
Benefit
In the event of your spouse or civil partner’s
death, 100% of the members’ annual salary
Spouses’/Civil
will be paid to the member
Partners’ Death
3 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 37
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 40 to 62 for full details, in particular the policy definition of each Specified Illness and
its pre-existing and related conditions.
4 SIPTU Nurses and Midwives Salary Protection SchemeThe 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.
€5.1 million €1.1 million
Paid in Disability Benefit Paid in Disability Benefit
to date since the 2013 review
960 €777,000
Members currently Paid in Death Benefit
in the Scheme† to date
€558,000 €334,000
Currently paid annually Paid in member’s
in Disability Benefit to 35 Death Benefit since
members the 2013 review
*Source: New Ireland & Irish Life, April 2018.
† Membership: Cornmarket, April 2018.
Visit cornmarket.ie 5Eligibility
You may apply to join this Scheme if you are:
1) A member of the SIPTU Nursing and You are not considered to be ‘actively at work’ if you
are on Career Break or any other forms of unpaid
Midwives Sector or a member of the leave and cannot apply to join the Scheme.
SIPTU National Ambulance Service Those who are job/work sharers (i.e. work 50% or less
Sector Grades. than the normal working week) and who satisfy the
above criteria may apply to join.
You must remain a member of the
SIPTU Nursing and Midwives Sector
Important: For Members of the SIPTU
or the SIPTU National Ambulance
National Ambulance Service Sector
Service Sector Grades to remain an
Grades.
eligible member of the Scheme and
Membership of the Scheme is
2) Under age 60 and available to members of the SIPTU
3) Employed as a Nurse or Midwife or National Ambulance Service Sector
Employed as part of the SIPTU Grades as a pilot programme for 12
National Ambulance Service Sector months from the 1st October 2018.
Grades and This arrangement will be reviewed
on the 1st of October 2019 and may
4) Working 8 hours or more per week be reviewed annually thereafter. At a
and review it may be decided to remove
5) Employed under at least one of the this option for future new entrants.
following conditions: In the event that this occurs, any
• On a permanent basis or members accepted for benefits
• On a fixed-term contract of at before the removal of this option will
least 12 months duration or continue to have cover, provided
• Working continuously for the past they continue to satisfy the eligibility
12 months or conditions. In addition, any member
• Working as an agency Nurse/ who is already receiving Disability
Midwife for 2 or more years and Benefit will continue to receive
that benefit under the terms of the
6) Actively at work today.*
Scheme.
*Actively at work today
This means you:
- Are working your normal contracted hours
- Have not received medical advice to refrain Apply to join now,
simply call us on
from work
- Are not restricted from fully performing the
normal duties associated with your occupation
You are considered to be ‘actively at work’ if you are (01) 470 8054
on paid or unpaid maternity leave.
6 SIPTU Nurses and Midwives Salary Protection SchemeRoles
Cornmarket’s role The Insurer’s role
includes: 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 26 for more Please see page 26 for
information. more information.
3. Promoting the Scheme. 3. Deciding the various
aspects of an individual
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 SIPTU Nurses and Midwives Salary Protection Scheme
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 This applies regardless of whether
other income, reward, award, pension, you are a ‘D’ or ‘A’ PRSI contributor
or benefit that you are entitled to and whether you contribute to the
(regardless of whether you are receiving Superannuation Scheme or not.
this amount or not). For example:
There is no limit on the number of
- Temporary Rehabilitation Disability Benefit claims you can make
Remuneration (TRR) - May be paid by while a member of the Scheme.
an employer to an employee subject
*See page 12 for definition of Salary.
to certain criteria.
- 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.
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
D Rate PRSI Example A Rate PRSI Example
100% 100%
€962 €962
p.w. p.w.
75% 75%
50% 50%
€481 €481
33% 37% p.w.
p.w. of salary €198 €204
of salary
€321 €321 p.w. p.w.
p.w. p.w.
€158 €158
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
Sick Pay Temporary Ill Health Early State Illness State Invalidity
Rehabilitation Retirement Benefit Pension
Remuneration Pension
10 SIPTU Nurses and Midwives Salary Protection SchemeWITH Salary Protection
D Rate PRSI Example A Rate PRSI Example
100% 100%
€962 €962
p.w. p.w.
75% 75%
of salary
€240
of salary €240
€400 €400 p.w. €365 €359
p.w.
50% p.w. p.w.
50% p.w. p.w.
€481 €481 €198 €204
25% 25% p.w. p.w. p.w.
p.w. €321 €321
p.w. p.w. €158 €158
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 of a
sick leave has been granted Superannuation Scheme.*
- referred to as Critical Illness
Protocol. For those who pay their premiums by
direct debit, salary is defined as:
The lower of either the salary covered by
If you have been accepted with an your premiums or the actual salary you
excluded condition, any sick leave are earning at the end of the relevant
relating to that condition will not be Deferred Period, as confirmed by your
taken into account for the calculation of employer. You must advise Cornmarket
the Deferred Period. 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.
For agency nurses/midwives joining
the Scheme, your salary is based on
self-declared earnings. Declared salary
should be the average of the previous 2
years’ earnings.
12 SIPTU Nurses and Midwives Salary Protection SchemePeriodically, you may review your *Depending on the type of claim being made, the
salary will be established at different points in time e.g.
declared earnings subject to proof of • Disability Benefit - the end of the relevant Deferred
actual earnings e.g payslip or P60. Period
• Death Benefit - on the date of death
You must advise Cornmarket of any • Specified Illness Benefit - on the date of diagnosis.
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 salary and that
you are paying the correct premium
amounts.
Disability Benefit
Exclusions
There are no general exclusions on If this happens, a form will be sent to
Disability Benefit. you as part of the application process
with the details of the exclusion(s) and
However, when you apply to join the you will have the opportunity to decide
Scheme, the Insurer may offer you if you wish to accept the cover with
cover with some exclusions that apply the exclusion(s) or not. If an exclusion(s)
specifically to you. For example, if you applies to you, then sick leave used for
inform the Insurer that you have a back the excluded condition(s) cannot be
problem on your application form, taken into account for the calculation of
they may offer you membership of the the Deferred Period.
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.
Important:
Late Notification of Claims: It is not often possible to retrospectively
assess the validity of a claim in cases where a significant period of time (approx.
3 months) has elapsed after the end of the Deferred Period. For this reason, it is
vital that you register your claim promptly in line with the guidelines given (the
earlier of: 1 month after commencement of disability or 10-12 weeks before the
end of the Deferred Period. In the case of late notification of a claim, cases will
be assessed on individual merit and the Insurer reserves the right to decline
to assess the claim.
14 SIPTU Nurses and Midwives Salary Protection SchemeDisability Benefit will not be paid If your claim is admitted, Disability
if you cannot work due to strike or Benefit will continue until:
unemployment. The maximum benefit is - You recover
€150,000 per year.
- You resign
Any sick leave used before you are - You go back to work (benefit may
accepted as a Scheme member will continue to be paid if the return is
not be used in the calculation of the at a reduced level due to partial
Deferred Period. disability)
If you have been accepted with an - the Insurer decides that you are fit
excluded condition, any sick leave to return to work based on medical
relating to that condition, will not be evidence*
taken into account for the calculation of
- You reside outside of Ireland for more
the Deferred Period.
than 12 calendar months (unless
If your claim is admitted... agreed otherwise with the Insurer in
- 75% of salary will be paid for advance)
maximum of two years only. After this - You reach age 60
a pension amount will be deducted
- You retire (unless you are claiming
from the benefit regardless of
from the Scheme and retire on an Ill
whether or not you are in receipt of
Health Early Retirement Pension)
same. This is referred to as Notional
Early Retirement Pension (NERP) - You die
- the benefit you receive from the whichever is earliest.
Insurer will be treated as income and
*If you have been in continuous receipt of Disability Benefit
as such is liable to income tax, PRSI, for more than 12 months, 3 months notice will be given before
your Disability Benefit is ended.
Universal Social Charge, etc. The
Insurer will deduct any tax due from
the Benefit made to the member,
in the same way as an employer
deducts tax from an employee.
Visit cornmarket.ie 15ii) Death Benefit
In the event of your death, a once-off lump sum
will be paid to your estate. For most members
the amount paid will be twice their gross annual
salary*.
However, for some members who Terminal Illness Benefit
availed of the option to increase their In the event that you are certified by
Death Benefit, this will be 3 or 4 times a medical specialist** with a terminal
their gross annual salary*. illness, with death expected within 12
If a Death Benefit claim is admitted, the months, and the Insurer accepts this;
benefit will be paid by the Insurer tax the Scheme will pay 25% of the Death
free. However, thereafter, beneficiaries Benefit to you tax-free.
of the estate will be subject to **The specialist must be a medical specialist of a major
whatever taxes apply at the time of hospital in Ireland or the United Kingdom.
the inheritance and it will be their
responsibility to ensure they are meeting Terminal Illness Benefit -
their full tax liability. Exclusions
There are no general exclusions on the
Limitations and Restrictions Terminal Illness Benefit.
This Benefit ceases at age 65.
As this is a Group Scheme you cannot
Terminal Illness Benefit -
assign the Death Benefit against a Limitations and Restrictions
mortgage. This benefit ceases at age 63.
Life expectancy must be no greater
than 12 months.
*See page 12 for definition of Salary.
16 SIPTU Nurses and Midwives Salary Protection SchemeAccidental Death Benefit Accidental Death Benefit -
In the event of accidental death, a Restrictions and Limitations
benefit of €15,000 is payable tax-free This benefit ceases at age 65.
in addition to the normal Death Benefit.
‘Accidental Death’ is defined as ‘death Children’s Death Benefit
as a direct result of a bodily injury arising
In the event that a member’s child
from an external and accidental cause’
between the ages of 0-18 or 18-21 (if
and is in no way linked to disease or
in full-time education) dies, a death
physical disorder.
benefit of €4,000 will be paid to the
Accidental Death Benefit - member tax-free. Children’s Death
Exclusions Benefit applies to all natural or adopted
children.
Exclusions apply where death is caused
directly or indirectly by: Children’s Death Benefit -
1. Suicide, attempted suicide or
Exclusions
intentional self inflicted injury
This benefit can only be claimed by the
2. Death linked to alcohol or drugs
Scheme member. This means that the
(temporarily or otherwise)
Scheme member’s estate cannot claim
3. Engaging in any hazardous activity or it in the event that the Scheme member
sports, including but not limited to: has died.
• scuba diving & water sports
• motor sports This benefit is payable once per
• aviation member.
• hang gliding & parachuting
• horse racing Children’s Death Benefit -
• mountaineering, rock climbing & Restrictions and Limitations
caving This benefit ceases at age 18, or 21 if the
• winter/ice sports child is in full-time education.
4. Flying other than a fare paying
passenger
5. Taking part in any riot, civil
commotion, uprising or war whether
declared or not
6. Failure to follow reasonable medical
advice or failure to follow medically
recommended therapies, treatment
or surgery
7. Directly or indirectly by taking part in
a criminal act.
Visit cornmarket.ie 17iii) Spouses’/Civil Partners’ Death Benefit OR Single Members’ Specified Illness Benefit In addition to Disability 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. Please see below for further information on each of these benefits and the terms and conditions that apply. A. Spouses’/Civil Partners’ Death Benefit In the event of the death of a member’s This benefit ceases on either: Spouse or Civil Partner, a lump sum of • The members 65th birthday or 100% of the member’s annual salary* will • The members spouse or civil partner’s be paid to the member. 65th birthday Limitations and Restrictions whichever is earlier. 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. *Please refer to page 12 for definition of Salary. 18 SIPTU Nurses and Midwives Salary Protection Scheme
B. Single Members’ Specified Illness Benefit
Full Benefit
If you are diagnosed with one of the illnesses listed below, are single
at the date of diagnosis and meet the definition/criteria of that
illness (see Appendices from page 40-62), 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 June 2013
review. The other Specified Illnesses were introduced from 1st April 2007. 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 • Heart Valve Replacement or Repair
• Aorta Graft Surgery • HIV Infection
• Aplastic Anaemia ❖ • Kidney Failure
• Bacterial Meningitis ❖ • Liver Failure ❖
• Balloon Valvuloplasty ❖ • Loss of Hands or Feet
• Benign Brain Tumour • Loss of Speech
• Benign Spinal Cord Tumour ❖ • Major Organ Transplant
• Blindness • Motor Neurone Disease
• Cancer • Multiple Sclerosis
• Cardiomyopathy ❖ • Paralysis of 2 or more Limbs
• Chronic Lung Disease • Parkinson’s Disease (Idiopathic)
• Coma • Primary Pulmonary Hypertension ❖
• Coronary Artery By-Pass Graft • Progressive Supra-Nuclear Palsy ❖
• Creutzfeldt-Jakob Disease • Pulmonary Artery Graft Surgery ❖
• Deafness ❖ • Stroke ❖
• Dementia • Systemic Lupus Erythematosus
• Encephalitis ❖ • Third Degree Burns covering 20% of
• Heart Attack the body’s surface area
• Heart Structural Repair • Traumatic Head Injury
*See page 12 for definition of Salary.
Visit cornmarket.ie 19Partial Benefit
If you are diagnosed with one of the illnesses listed below, are single
at the date of diagnosis and meet the definition/criteria of that
illness (see Appendices from page 40-62), 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 – Partial Payments below were introduced at the
1st June 2013 review. If, prior to joining the Scheme, you have suffered from one of the Specified
Illnesses you will never be covered for that illness.
• Angioplasty for coronary artery • Ductal carcinoma in situ – breast,
disease – of specified severity treated by surgery
• Brain abscess drained via • Loss of one limb – permanent
craniotomy physical severance
• Carcinoma in situ – oesophagus, • Low level prostate cancer with
treated by specific surgery Gleason score between 2 and 6 –
• Carotid artery stenosis – treated and with specific treatment
by endarterectomy or angioplasty • Third degree burns – covering at
• Cerebral arteriovenous least 5% of the body’s surface area
malformation – treated by • Surgical removal of one eye
craniotomy or endovascular repair
*See page 12 for definition of Salary.
20 SIPTU Nurses and Midwives Salary Protection SchemeSingle Members’
Specified Illness Benefit
Exclusions
Specified Illness Benefit and Partial Specified
Illness Benefit Claims will not be paid, if:
a) You are residing outside the following cannot claim for that illness or a
list of places for 13 or more weeks related Specified Illness. Due to
consecutively, 12 months prior to a the links between heart attack,
Specified Illness Claim being made.* coronary artery by-pass surgery,
• European Union heart transplant, angioplasty and
(since 1st January 2013) stroke, if you have suffered from or
• Australia undergone surgery for one of these
• Canada conditions before joining the Scheme
• New Zealand you cannot claim under the policy in
• Norway respect of any of the four illnesses. For
• Switzerland example, if you underwent coronary
• U.S.A. artery by-pass surgery before joining
you will never be covered for coronary
b) If prior to your Specified Illness Benefit artery by-pass surgery, heart attack,
cover commencing you suffered from heart transplant, angioplasty or
a condition related to one of the stroke.
Specified Illnesses and you contract
that particular illness within 2 years d) No cancer claims will be paid where
of joining the Scheme, you will not the condition presents within the first
be covered. For example, a claim will 6 months of a member joining the
not be paid for a heart attack within Scheme. In such circumstances cover
the first 2 years of joining, if prior to in respect of cancer ceases.
joining you suffered from Diabetes. The related Specified Illnesses and
This is due to the recognised link pre-existing conditions set out in
between Diabetes and a heart Appendix 1 and 2 are examples
attack. However, a diabetic who first which can result in a Specified Illness
suffers a heart attack 3 years after diagnosis. This is not an exhaustive
joining the Scheme will be eligible to list and New Ireland’s Chief Medical
claim. Officer can look at other pre-existing
conditions which may have caused a
c) If you suffered from one of the
Specified Illness.
Specified Illnesses before your
* Unless you have been on Career Break, prior
cover commenced, you will never agreement was received from the Insurer and the
be covered for that illness and relevant premium was paid.
Visit cornmarket.ie 21Single Members’
Specified Illness Benefit
Limitations and Restrictions
You must be single i.e. not married or - A Specified Illness Claim will only
in a Civil Partnership at the date of be paid if the diagnosis/severity
diagnosis in order to be eligible for meets the specific definition/
either the Full or Partial Single Members criteria outlined for that illness in the
Specified Illness Benefit. Appendices on pages 40-62.
Specified Illness Benefit became a - You will not be able to make a
benefit of the Scheme on 1st April 2007. Specified Illness Claim for an illness
The Specified Illnesses marked ❖ on that:
page 19, were introduced on 1st June • You suffered from prior to joining
2013. The other Specified Illnesses were the Scheme
introduced on 1st April 2007. You can
• Relates to a condition which
only claim for diagnoses that occur after
you were already suffering from
these dates.
at the time of your application
- Partial Payment Specified Illness and/or where you were under
Benefit became a benefit of the medical investigation, regardless
Scheme on 1st June 2013. Therefore, of whether you were aware of the
you can only claim for diagnosis that condition at that time
occur after this date. • Relates to a condition which you
- If you make a Full Specified Illness were already suffering from before
Claim, you will not be able to make a the date that Specified Illness was
further Full or Partial Specified Illness introduced to the Scheme
Claim. If you make a Partial Specified - There is a waiting (deferred) period
Illness Claim, you will still be able to for some Specified Illnesses. Please
make a Full Specified Illness Claim. see Appendices on pages 40-62 for
more details.
- If you are diagnosed with one of the
Full Specified Illnesses within 30 days - Late notification clause: You must
of diagnosis of a Partial Specified make a Specified Illness Claim
Illness, a claim will be assessed on the within 3 months of being diagnosed.
Full Specified Illness only. Failure to make a claim within this
time period may result in the Insurer
declining to assess your claim.
22 SIPTU Nurses and Midwives Salary Protection Scheme- There is a survival period for some Definition of Salary for Specified
Specified Illnesses. You must survive Illness Benefit
for a minimum period after the date
Please refer to page 12 for definition of
of diagnosis or surgery took place,
Salary.
before a payment can be made. In
the event of death within this period
no Specified Illness Benefit is payable.
The relevant periods are:
(a) 14 days for heart attack, coronary
artery surgery, angioplasty(two
or more arteries), cancer, coma,
emphysema(chronic), stoke,
kidney failure, heart valve surgery,
aorta graft surgery, major organ
transplant, benign brain tumour,
multiple sclerosis, motor neurone
disease, severe burns, CID, HIV/
AIDS from needle stick injury, HIV/
AIDS from physical assault, HIV/
AIDS from blood transfusion,
paralysis of two or more limbs and
severance of two or more limbs.
(b) 6 months for Parkinson’s disease,
Alzheimer’s disease and loss of
sight.
(c) 12 months for loss of hearing and
loss of speech.
Please see Appendices on pages 40-62
for more details.
The benefit ceases at age 65.
Visit cornmarket.ie 233. Cost
The total Scheme premium is 2.50% 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 2.06% eligible for Income Tax Relief.
Death Benefit 0.25% Below are some examples of cost for
Spouses’ /Civil various salary amounts taking income
Partners Death tax relief into account:
Benefit or Single 0.14%
Income Weekly ‘Real’ weekly
Members’ Specified
premium premium
Illness Benefit after tax relief
Medical Immunity €35,000 €16.77 €14.00*
for Retired Members’ 0.05%
€45,000 €21.56 €14.45**
Life Cover Plan*
€55,000 €26.35 €17.67**
Total Cost 2.50%
*If you are paying income tax at 20% your net premium rate
*Allows members to join Cornmarket’s Retired Members’ will be 2.09%
Life Cover Plan, without medical underwriting. Terms & **If you are paying income tax at 40% your net premium rate
Conditions apply. will be 1.68%.
Warning: The current premium may
increase after the next Scheme
review which will take place on/after
1st June 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.
*Cornmarket Retired Members’ Life Cover Plan underwritten by Irish Life. Irish Life Assurance plc is regulated by the Central Bank
of Ireland.
24 SIPTU Nurses and Midwives Salary Protection SchemePayment 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 being
lapsed. This means you will no longer
- You will need to send a Premium
be a member of the Scheme and you
Statement to Revenue in order to
will not be on cover for any benefits.
claim income tax relief. If, throughout
In the event that you wish to become
the course of your membership of
a member of the Scheme again, you
the Scheme, your premium amount
would have to apply to be a member
changes, you should request an
and be medically underwritten.
up-to-date Premium Statement from
Your application may be accepted,
Cornmarket to send to Revenue so
declined, postponed or accepted
that Revenue can amend your income
with exclusions.
tax relief accordingly.
- Your premiums will reflect the
Visit cornmarket.ie 254. 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.
26 SIPTU Nurses and Midwives Salary Protection SchemeDisability 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 23.
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 14.
Visit cornmarket.ie 27What 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
assessed?
documentation to Cornmarket as soon
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
admitted to receive your first benefit.
As part of their assessment, the Insurer
may require you to: - If your claim is admitted after you
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)
date when salary was first affected.
2. provide medical evidence from your
Specialists - As a benefit is subject to income
3. complete a Tele-claims Interview with tax, you can request the Revenue
a nurse Commissioner to issue a Certificate
4. attend an Independent Medical of Tax to the Insurer. This will enable
Examination (IME) and/or the Insurer’s the Insurer to apply the correct tax
Occupational Health and Safety rate for future benefits. However, the
Advisor to confirm that you meet the first benefit may have emergency
definition of disability. It generally tax rates applied. Any overpayment
takes about 3 weeks for the IME report or underpayment of tax may be
to be returned to the Insurer. subsequently rectified.
28 SIPTU Nurses and Midwives Salary Protection Scheme- In order to ensure you continue to year, or the rate of increase in the
meet the definition of disablement, Consumer Price Index (if lower).
the Insurer may seek completed However, if the claim commenced
continuation forms, certificate of before 1st June 2018, the benefit will
continued disablement, medical continue to increase by 5% each
certificates from your Doctor, and/or year, or the rate of increase in the
require you to attend an independent Consumer Price Index (if lower).
medical examination and/or organise - If you plan to return to work or take up
for a Health Claims Advisor to visit other paid work, you must inform the
you. Claims in payment for greater Insurer immediately.
than 10 years, will not be subject to
ongoing medical assessments.
What will happen if my Disability
- In the event that you fail to follow
medical advice, the Insurer may cease Benefit claim is declined?
paying you benefits. - If your claim is declined, the Insurer
- You will not be expected to pay will inform you of the reasons for the
premiums towards the Scheme while decision in writing.
claiming. However, if your benefit - You may appeal the decision
stops for some reason other than by sending additional evidence
reaching the ceasing date of the supporting the fact that your claim
benefit, you will be expected to start should be admitted to the Chief
paying premiums again in order to Medical Officer of the Insurer. You
maintain your cover. If you continue must do this within 3 months of the
to receive Disability Benefit up to decline decision being made. The
the ceasing age of the benefit, you review of their decision may require
can continue to avail of the other you to attend further Independent
Scheme benefits without having to Medical Examinations.
pay premiums for them up until the - If you do not appeal, premiums must
ceasing age of those benefits. continue or restart in order for you to
- While claiming Disability Benefit, any remain a member of the Scheme.
Death Benefit or Specified Illness - If your appeal with the Insurer is
Benefit that you have as a Scheme unsuccessful, you may bring your case
member remains in force until the to the Financial Services and Pensions
ceasing date of those benefits. In Ombudsman.
the event that you will need to claim
from these, the benefits will be based What happens after my
on the salary you were earning
Specified Illness Benefit claim is
at the time your Disability Benefit
commenced.
assessed?
Following the assessment the Insurer will
- The benefit paid to you by the
make a decision on your claim. Claims
Scheme increases by 1.5% each
can be settled or declined.
Visit cornmarket.ie 29Settled How does Ill Health Early
- If your claim is settled, the Insurer will Retirement Pension (IHERP)
arrange for a payment to be sent to affect my Disability Benefit
you.
claim?
- If you claimed from the Full Specified
If you are making a claim and decide
Illness Benefit, you will no longer be
not to apply for IHERP, perhaps because
covered for Specified Illness Benefit
you intend to return to work, and the
and you will no longer be required
Insurer agrees that there is a reasonable
to pay for it and we will reduce your
expectation for you to return to work,
premium accordingly. In the event that
then the Insurer may pay a benefit
you pay your premiums by salary and
of 75% of salary less any State Illness
your employer is unable to facilitate
Benefit or Temporary Rehabilitation
the reduced premium, you may need
Remuneration for a maximum of 2
to switch to paying your premiums by
years. This means no deduction will be
direct debit.
made from the Benefit for an amount
- If you claimed from the Partial equivalent to IHERP, as no IHERP is being
Specified Illness Benefit, you can still claimed.
make a claim under the Full Specified
However, after 2 years a pension
Illness Benefit and so your premiums
amount will be deducted from the
will not reduce.
benefit regardless of whether or not you
Declined are in receipt of same. This is referred
- If your claim is declined, you will be to as Notional Early Retirement Pension
informed of the reasons for that (NERP).
decision in writing. If you retire subsequently and an IHERP
- You may appeal the decision is paid, the additional amount that
by sending additional evidence was paid under the Scheme since the
supporting the fact that your claim effective date of early retirement must
should be admitted to the Chief naturally be repaid to the Insurer.
Medical Officer of the Insurer. You
must do this within 18 months of the
decline decision being made. The
review of their decision may require
you to attend further Independent
Medical Examinations.
- If your appeal with the Insurer is
unsuccessful, you may bring your case
to the Financial Services and Pensions
Ombudsman.
30 SIPTU Nurses and Midwives Salary Protection SchemeWhat 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 stop
work, how does this affect my working again due to illness or injury
you may not have to complete the
Disability Benefit claim?
Deferred Period again. Please refer to
Please inform the Cornmarket Claims the Deferred Period on page 12.
Administration team as soon as possible,
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 3132 SIPTU Nurses and Midwives Salary Protection Scheme
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 June 2018 are eligible to avail of
call (01) 408 4106
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 33Death 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, you or your Estate/Next of the Probate Office, this may result in
Kin/Solicitor should contact Cornmarket. delays in the processing of the claim.
These delays could take over 12 months.
After initial contact is made, if
Once the Insurer receives all the required
appropriate, Cornmarket will advise of
documentation and information and
the documentation required to process
the Insurer decides to admit the claim,
the claim.
benefit is usually paid to the estate/
trustees within 10 working days.
34 SIPTU Nurses and Midwives Salary Protection SchemeVisit cornmarket.ie 35
5. Frequently Asked
Questions
How can I apply to join the - a claim will not be paid and the
Scheme? Insurer will not refund any premiums
you have paid
You can apply to join the Scheme:
- you may find it difficult to purchase
(i) Over the phone - call (01) 470 8054
another Life Insurance product.
(ii) With your Cornmarket Consultant
(iii) By printing and completing an What happens if my application
application form at cornmarket.ie. is accepted?
To apply, you must complete an Your cover begins from the date the
application form. Insurer accepts your application.
Applications may require underwriting - You will be sent a formal acceptance
(medical assessment) which may letter.
include providing medical information
- You will have 30 days after the date
by telephone to a nurse or attending
the acceptance letter is sent to you
a medical examination at the Insurer’s
to cancel your membership of the
expense. Following the underwriting
Scheme and receive a full refund of
period, the Insurer may accept your
any premiums paid.
application, postpone your application,
decline your application or offer you - Premiums should start as soon as
membership of the Scheme with certain possible after you are accepted as a
specified conditions excluded from member.
cover.
During the application process it is What happens if my application
important that you tell the Insurer all is not accepted?
relevant medical information. This If your application is postponed,
means information that the Insurer declined, or if you are offered
would regard as likely to influence the acceptance with certain specified
assessment and acceptance of your conditions excluded, you may request
application. If you do not: details for the reasons for the decision
- your membership of the Scheme to be sent from the Insurer to your
could be void; you will not be covered own doctor and you may appeal the
under the Scheme decision.
36 SIPTU Nurses and Midwives Salary Protection SchemeWhat if I have unearned What if I am placed on
income? administration/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 the Disability
or Unpaid Leave please contact us Benefit
to discuss the options that may be • Your 63rd birthday for Terminal Illness
available to you by calling (01) 408 4195 Benefit
or emailing spsadmin@cornmarket.ie. • Your 65th birthday for the Death
If you wish to avail of the Career Break Benefit and Spouses’/Civil Partners’
options, you must apply within 4 months Death Benefit or Single Members’
of taking a Career Break. Otherwise your Specified Illness Benefit.
membership of the Scheme will cease.
Cover for all benefits ceases in the
You must remain a member of the
following situations:
SIPTU Nursing and Midwives Sector or
• If you retire (other than on grounds of
the SIPTU National Ambulance Service
ill health) or
Sector Grades union for the duration of
• If you resign or
your Career Break.
• If you no longer fulfil the eligibility
If you wish to avail of the Unpaid requirements or
Leave options you must notify us • If you leave the SIPTU Nursing and
at least 4 weeks in advance of the Midwives Sector or the SIPTU National
commencement of unpaid leave. Ambulance Service Sector Grades or
Additionally, if you plan to do any of the • If your premiums cease or
following, please contact us in advance • If you become unemployed or
in order to ensure your membership • If you die.
of the Scheme does not lapse, and
so that we can offer you any cost
Remember - Cornmarket will not be
and/or benefit options which may be
automatically informed if some of
applicable:
the above events occur so please
- Acquire a second job ensure we are advised at the earliest
- Go on Secondment opportunity.
- Change role/job
- Change terms of employment
- Start Job sharing/work sharing
(i.e. work 50% or less of the normal
working week).
Visit cornmarket.ie 37Can I cancel my membership of What if I travel abroad?
the Scheme? In order to remain on cover under this
Yes. You may cancel your membership Scheme you must remain a resident
of the Scheme at any time by clearly within Ireland.
instructing Cornmarket to do so in If you travel briefly for normal holiday
writing. Please ensure your name, purposes this will not affect your cover
address and date of birth is included under the Scheme. However, if you
on the cancellation instruction. If decide to reside or work abroad you
you cancel within 30 days of the must contact Cornmarket immediately.
acceptance letter being sent to you, In such circumstances, the Insurer
we will cancel your membership of the may decide to vary your premium and
Scheme and refund you any premiums benefits accordingly or cease your
you have paid. membership of the Scheme.
If you cancel your membership of the If you are in receipt of Disability Benefit
Scheme, and then wish to become a from the Scheme, the Insurer will pay this
member again, you will have to apply benefit to you if you are living anywhere
for membership again and provide in the world for a maximum of 12
information about the state of your months. The Insurer reserves the right for
health. If your health deteriorated claimants to come back to Ireland for
between the time you cancelled your an Independent Medical Examination
membership of the Scheme and re- during this 12 month period. If during the
applied, you may not be accepted as a 12 months you are required to attend a
member again or you may be accepted medical assessment you must return to
with an exclusion. Ireland for it, the expense of which must
be agreed between you and the Insurer
Is there a surrender or cash- in advance. Only reasonable expenses
in value associated with the will be covered by the Insurer.
Scheme? After 12 months, you must reside in
Ireland or the UK. In exceptional cases
No. There is no surrender or cash-in
where a beneficiary is forced to live
value associated with this Scheme; it is
abroad, the Insurer will consider this on
not a savings plan.
a case-by-case basis.
What commission does
Are all claims paid?
Cornmarket receive?
The great majority of claims are paid.
Initial charge €400 When claims are not paid it is usually
Premium Deduction Charge 2.5% due to one or more of the following
reasons:
Renewal charge paid by - Medical opinion is that the member is
12.50%
Insurer to Cornmarket not disabled from carrying out his or
her normal occupation.
38 SIPTU Nurses and Midwives Salary Protection Scheme- When applying to join the Scheme, General Scheme Information
the member did not give all relevant, Full Scheme Name: SIPTU Nurses and
requested medical information Midwives Salary Protection Scheme.
(information that the Insurer would
The Scheme owner is SIPTU.
regard as likely to influence the
assessment and acceptance of your The current Scheme broker is
application). This is called non- Cornmarket Group Financial
disclosure. In addition to being the Services Ltd.
reason for a claim not being paid, The current Scheme Insurer is
non-disclosure may also result in New Ireland Assurance plc.
membership of the Scheme being The current policy number for this
cancelled. If this occurs, premiums will Scheme is V000059E.
not be refunded.
This is a Group Protection Scheme.
- A claim is notified late, for example, This means that the costs and benefits
approximately three months after the cannot be changed by any individual
end of the Deferred Period/diagnosis member. Instead, the Scheme owner
has occurred and hence the Insurer reviews the Scheme periodically with
is no longer in a position to medically the Scheme Broker and Insurers and
assess the claim. then decides the best combination of
- The illness or injury is a result of one of benefits, cost, restrictions, limitations
the general exclusions that exist on and features for all the members of the
the Scheme. Scheme. At a review it may be decided
- The member attempts to claim for an that the Scheme should move Brokers
illness or injury for which they received and/or Insurers. In the event that this
a specific exclusion. occurs, all Scheme membership data will
be transferred to the new Broker and/or
What if I wish to make Insurer. Additionally, at a review, it may
be decided to terminate the Scheme
a complaint about the
altogether. In the event that this occurs,
service I have received from any members who are already receiving
Cornmarket? a Disability Benefit will continue to
Please write to: receive that benefit under the terms
Compliance Department, of the Scheme. Decisions taken by the
Cornmarket Group Financial Scheme owner will be binding on all
Services Ltd, Christchurch Square, members.
Dublin 8. The next Scheme review is due on or
If you are dissatisfied with the outcome after 1st June 2021.
of your complaint through Cornmarket,
you may submit your complaint to
the Financial Services and Pensions
Ombudsman, 3rd Floor, Lincoln House,
Lincoln Place, Dublin 2, or log onto
www.fspo.ie
Visit cornmarket.ie 39You can also read
