NZDF Reserve Force MIBP · NZDF Reserve Force MIBP MEMBER INSURANCE BENEFITS PROGRAMME Frequently...

The information contained in this publication is general in nature and is not intended as advice. It may not be relevant to individual circumstances. This FAQ is dated 3 September 2014.

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NZDF Reserve Force MIBP MEMBER INSURANCE BENEFITS PROGRAMME

Frequently Asked Questions (FAQ) 1st October 2014

NZDF in conjunction with their Insurance Brokers Aon New Zealand have created the MIBP for Regular, Civilian & Reserve Force personnel and their spouses. The NZDF MIBP comes into force from 1st October 2014 and this is the Reserve Force FAQ. MIBP for Reserve Force members is made up of four key components:-

• Tier 1: ‘BaseSecure’ – Death, Physical Loss and ACC top up, all by Accident, all whilst on duty. The cost of this is fully funded through NZDF.

• Tier 2: ‘ReinforcementSupport’ – Voluntary top-up insurance benefits including Life, Terminal Illness, Physical Loss, and Trauma. These are funded by you and your insurance is between you and the provider.

• Tier 3: ‘LifePartner’ – Voluntary benefits for your spouse/partner (does not apply if they are Members of NZDF) including Life, Terminal Illness & Trauma. These are funded by you and your insurance is between you and the provider.

• Tier 4: ‘ExtraCare’ – Over and above Tiers 1, 2 & 3, a range of insurance options, with personal advice from Aon, available to you and your spouse/partner at discounted rates. These are funded by you and your insurance is between you and the provider.

MIBP – Reserve Force Tiers 1, 2 & 3 benefit summary:

Insurance Benefit

Tier 1 BaseSecure

Tier 2 ReinforcementSupport

Tier 3 LifePartner

Death by Accident Yes No No

Life & Terminal Illness No Yes Yes

Physical loss Yes Yes No

ACC Top Up Yes No No

Trauma Insurance No Yes Yes

MIBP Site Seminars, Gateway & Member Packs Seminars will be held on NZDF sites throughout September and October 2014. You are strongly encouraged to attend these Seminars and read the information in the Member Packs. Please complete your Registration Form so that your Tier 1 Certificate can be sent to you, along with information on Tiers 2 & 3. Copies of the Seminar presentation can be found on the DPE HR Toolkit and the MIBP Gateway – www.aonwell.com Password MIBP. NZDF Contacts Contact either HRSC phone 0800 334 772, or else your local HRA. Aon Contacts A free call number 0800 MIBP4U (0800 642 748) is available Monday to Friday 8.30 – 6.00 to answer any queries you may have. Claims or questions should be directed initially to our Insurance Brokers Aon New Zealand (Aon) on this 0800 number or by email to [email protected] . A Disclosure Statement is available free of charge from Aon. Please note:- This FAQ document is not a substitute for any Insurance Policy wordings or other specific product documentation. The Tier 1 Policy Documents are held by NZDF, and the Tier 2 & 3 Policy Documents are held by Perpetual Guardian as corporate trustee, copies are available on the DPE HR Toolkit and the MIBP Gateway www.aonwell.com Password MIBP.


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MIBP

Tier 1 BaseSecure General Information

Q1

What Tier 1 benefits do I receive under MIBP?

As a Reserve Force member you receive the following insurance benefits under Tier 1 BaseSecure whilst on active duty with NZDF. Active duty starts from the time your leave your home to attend that duty and ceases when you return home from that duty, these Tier 1 benefits are fully funded through NZDF

• Death by Accident - $300,000

• Physical Loss up to $50,000 – see Schedule at back of this FAQ or on the DPE HR Toolkit, or on the MIBP Gateway:

• ACC Top Up Benefits:

- If you are injured whilst on NZDF duty this tops up your 80% of salary ACC benefit to 100% of your civilian salary ACC entitlement

- This is payable monthly in arrears

- Payable for two years

These benefits are worldwide 24 hours a day, seven days a week whilst on NZDF active duty & going to and from your home to that duty.

Q2 How do I get cover for these benefits?

You are automatically covered for these benefits, subject to the eligibility criteria in the policy wordings, from the 1 October 2014 or when you join NZDF if later.

Q3 What is the eligibility criteria?

All active members of the NZDF Reserve Force are covered

Q4 How much does this cost me?

The premiums for Tier 1, BaseSecure are fully funded through NZDF there is no cost to you.

Q5 Is there anything I am required to do; how do I join?

As a Reserve Forces member, from 1 October 2014 you are automatically enrolled by NZDF for membership in MIBP.

Please complete your Registration Form to receive your Tier 1 Certificate of Insurance and additional information on Tiers 2 & 3 by 31 December 2014. If you join NZDF after 1 October 2014 you must complete the registration form within 2 months of joining NZDF. If you miss these deadlines it may impact the joining concessions available to you under Tier 2 & 3.

NB you are still covered under Tier 1 even if you don’t request your certificate of insurance.


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Q6

Are NZDF “belligerent operations” anywhere in the world covered by these insurance benefits?

Yes they are under Tier 1.Please see the section on Tier 2 for information on this there. Cover is not available for this under Tiers 3 or 4.

Q7 Are there any age limits?

All Tier 1 commercial insurances cease when you turn age 70. NZDF self-insures for members aged 70 and above.

Q8 Can I assign my cover to another person?

No, cover is through a group plan and cannot be assigned by individual members. However if you register with Aon you will receive a certificate confirming your cover.

Q9

As a member of the existing Death and Disablement Insurance (DDI) scheme how does this MIBP affect me?

Currently you are insured for 3 x salary Death and Total & Permanent Disablement by accident causes while on NZDF duty. From 1 October 2014 you will move to the Tier 1 NZDF provided $300,000 Death and $50,000 Physical Loss benefits. You will lose the Total & Permanent Disablement benefit but gain the Physical Loss benefits and the ACC top up benefit.

Q10 Why will I lose the total and permanent disablement cover?

Very few claims are paid under a total and permanent disablement benefit as the qualification threshold for a claim is very high. NZDF’s view is that the Physical Loss and the ACC top up benefits are better aligned to serving the needs of Reserve Force members.

Q11

The current DDI benefit is 3 x salary the new benefit of $300,000 is less than my 3 x salary, why?

For most members a change to $300,000 is beneficial. It is considered more equitable in that it places the same value on each member’s life. Analysis of 70 NZDF death payments made in recent years shows that all but two of the recipients would have received a greater payment had the death cover been set at $300,000.

Overall this change benefits the greatest number of members.

Some members will have reduced cover by the change from 3 x salary to $300,000. If this is your situation you contact Aon and they will be able to help you.

Please complete the Registration Form by 31 December 2014 and Aon will contact you with information on your options. From receiving this information you will have 60 days to take up this higher level of cover without providing any health evidence and fully protecting your pre-existing conditions.

Q12

Was any Comparison done with other countries for benefit levels?

Yes, analysis was done of the UK, US, Australia and Canada armed forces, and NZ Police and NZ Fire Services Commission. The NZDF MIBP are comparative to other jurisdictions taking into account ACC cover available to NZDF personnel is not available to other armed forces.

Q13

I am a Civilian NZDF employee and also a Reserve Force member do I receive both covers?

No, you will only be entitled to the Civilian benefits


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Q14

What happens if I am “Deployed” as a Regular Force member or assigned on a “Tour of Duty as a Reserve Force Member”?

In both of these instances you will be eligible for the Regular Force benefits under Tier 1 and any subsequent flow into Tier 2.

Refer to the Regular Force FAQ, or your HRA, the DPE HR Toolkit or the MIBP Gateway.

Q15 What happens if I take parental leave or leave without pay?

You will not be covered as Reserve Force members are only covered while on duty.

Q16

If I leave NZDF can I continue some or all of my Tier 1 insurances at my own expense?

Tier 1 Cover ceases when you leave NZDF. You will however be able to arrange continuation of this insurance through Tier 4.

Your Tier 2 & 3 cover if you have any can continue at the Tier 2 & 3 concessionary premiums.

If this might apply to you please contact [email protected] or ring 0800 MIBP 4U.

Q17 Can I top-up this Tier 1 Cover or purchase additional cover?

Yes, you can top-up your Tier 1, BaseSecure cover. Refer to Tier 2 ReinforcementSupport section in this FAQ, or the DPE HR Toolkit or the HRSC or your HR Advisor.

Q18 Is any cover available for my spouse / partner?

Tier 3 provides some insurance options for your spouse / partner. Refer this Section in this FAQ.

Q19

Are any Death or Physical Loss payments subject to KiwiSaver or other superannuation contributions?

No, benefits paid under Tiers 1, 2 & 3 are not liable for any contributions to KiwiSaver or any other superannuation scheme.

Q20

Would KiwiSaver, Veteran Pensions or any other superannuation Payment impact on any benefit payments received?

For Death and Physical Loss there are no reductions if you are in receipt of KiwiSaver, Veteran pensions or superannuation payments.

Q21

What other cover is available for me or my spouse / partner or children?

Tier 4, provides a range of insurance options not covered in Tiers 1, 2 & 3. If this is of interest to you please email [email protected] or ring 0800 MIBP 4U.

Q22

I am unable to attend any MIBP Seminars, how can I sight the presentation?

Please go to the DPE HR Toolkit or the MIBP Gateway where you will find a tab with the Seminar Presentation.


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MIBP

Tier 1 BaseSecure

Death By Accident & Physical Loss Insurance Information

Q1 How does this Death by Accident insurance work?

Death by Accident Insurance provides an automatic lump sum payment of $300,000 if you die, from an accident whilst on active duty for NZDF or going to or from home to that duty.

Q2 As the payment of a death claim can sometimes be delayed with estate issues, can an advance Funeral Benefit be paid?

Yes it can. Subject to NZDF approval, a Bereavement Support Benefit of up to $15,000 can be advanced from the $300,000 Death by Accident Benefit to cover approved funeral expenses.

Enquiries about a Claim for a Bereavement Support Benefit should be directed to an HRA or Aon, 0800 MIBP 4U (0800 642 748).

The estate should check for any other entitlement with NZDF and or Veterans Affairs New Zealand.

Q3 How long am I covered for under this Plan?

The benefits cover you until you either leave NZDF, attain the age of 70 or if a death by accident claim is made under this policy. NZDF self-insures Tier 1 cover for those members aged 70 and over.

Q4 How does the Physical Loss Benefit work?

The physical loss accident benefit is based on a specified list of events and a payment associated with each event. The maximum amount under Tier 1 is $50,000. Refer to the Physical Loss Schedule attached to this FAQ to see the scale of payments.

Q5 Are Physical Loss payments in addition to ACC (AEP)?

Yes, all Physical Loss payments are additional to any ACC payments.

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MIBP


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Tier 1 BaseSecure

ACC Top Up Benefits

Q1 How does the ACC top up work

If you are injured whilst on NZDF duty and you qualify for a continuation of your Civilian salary via an ACC Payment. This payment is equal to 80% of your Civilian salary to the maximum AAC salary level, currently $118,191.

Under the ACC top up NZDF insurance cover will top up the 20% shortfall of your ACC payment.

Q3

How much is my benefit and how long is the Tier 1 benefit period?

The benefit is 20% of your Civilian salary.

The benefit will cease upon recovery or two years, whichever occurs first.

Q4 How long am I covered for under this Plan?

As a summary statement, ACC benefit payments under Tier 1 will cease:

• Once you stop being injured/disabled

• If you pass away

• When you reach age 70 or at the end of the 2 year benefit period, whichever is the soonest

• If you are in jail or otherwise detained as a result of a criminal act

• You make a false, dishonest or fraudulent claim or support any claim with false evidence

• You do not undertake medical treatment and/or rehabilitation which would assist you to return to work

Q5

What sort of injuries or events that might prevent me from working are not covered?

Some injuries or events that can prevent you from working are not covered:

• Intentional self- inflicted bodily injury or illness

• The taking of non- prescription drugs

Q6

If my Civilian salary is above the ACC maximum benefit level can I claim for the additional amount?

No, The ACC maximum salary for benefits is currently $118,191 and this is the level at which payment calculations are capped.

Q7

Is there a stand down period before a claim can be made?

Yes - there is a stand down or waiting period before the top up benefit commences, this is 4 weeks from the date of your disablement.

The claim payment is then made one month following completion of the 4 weeks and monthly thereafter.

Q8 What will I be paid in the 4 week stand down?

You will qualify for the normal AAC benefit i.e. 80% of salary up to a maximum salary of $118,191.

Q9 If I am only Partially injured can I claim?

Yes if an ACC claim is accepted


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Q10

Is the ACC top up benefit taxable?

Yes - your ACC top up benefit is income and therefore taxable just like your salary.

Q11

How often are claim payments made?

Claim payments are made monthly in arrears. The first payment will be made one month following the end of the 4 week stand down.

Q12

Once I am on the ACC top up claim what happens next?

Every month you will be sent a form to complete & return that gives the Insurer an update of your disablement condition to ensure you are still entitled to payments.

Q13

Who makes the medical assessment if I claim and what happens if I have claims issues or my claim is declined?

The insurer makes the medical assessment in conjunction with the NZDF

If there are any issues you should contact your local HRA or Aon.

MIBP

Tier 2 ReinforcementSupport General Information

Under the NZDF MIBP, Tier 2 offers insurance benefits you may not be able to obtain in a retail policy. Premiums may usually be lower and up to certain limits within an initial 60 day Special Offer Period, pre-existing conditions are fully protected without any health assessment. Here are the details:-

Q1

What extra insurance benefits are available to me under Tier 2?

All Reserve Force members are eligible for:

• Life, Terminal Illness & Physical Loss Insurance – available in units of $50,000 extending Tier 1 benefits up to an maximum amount of $500,000 (and Physical Loss by an additional $50,000)

• Trauma Insurance- providing an additional ”cash injection” benefit – available in units of $5,000 up to a maximum amount of $150,000

These would be in addition to any other insurance policies you may hold.


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Q2

I understand that there are some important joining concessions for me under Tier 2, what are they?

Concessionary Cover & Full Pre-existing Conditions Protection

Concessionary cover up to the limits detailed below is available if you apply for Tier 2 options within 60 days of you being offered them. This means no health questions and cover for pre-existing conditions applies, subject to you being able to sign the declaration on the Tier 2 Quote Acceptance Form:

1) Life, & Terminal Illness insurance –

a) You can buy up to 3 x units of $50,000 i.e. total of $150,000. Additional units may be purchased with completion of health questions.

b) Physical Loss is automatically included in the 1st $50,000 unit, it is not available separately.

2) Trauma insurance –

a) You can buy units in multiples of $5,000 up to a total of $60,000

i) Refer below to Trauma for explanation as there are some conditions around pre-existing conditions during your first 3 months of Trauma cover

3) NZDF “belligerent operations” are covered under Tier 2 providing you apply for Tier 2 benefits within the Special Offer 60 day period. Cover is also available outside this period, please contact Aon for information.

How to apply for top up cover within the joining concession limits

When you receive your Tier 2 Quotations from Aon, see Q2 above, you have a Special Offer 60 days to sign and return the Quote Acceptance and Direct Debit Forms to Aon to gain acceptance without any health assessment and this includes full pre-existing conditions protection to the limits detailed under each policy.

NB If you apply for Tier 2 options outside the Special Offer 60 days then NZDF “belligerent operations cover” will not apply, a full health assessment may be required and pre-existing conditions may not be covered or terms or exclusions could apply.

Q3

How do I find out about how much these Tier 2 insurance benefits will cost me?

Refer to information on the DPE HR Toolkit or the MIBP Gateway. With the launch of the NZDF MIBP on 1 October 2014, you have until 31 December 2014 to submit your completed Registration Form. Aon, on receipt of this Form will send you your Tier 1 Certificate of Insurance and your Tier 2 insurance benefit quotations including a Quote Acceptance Form. These will set out the monthly cost to you of the various options and you can make your decision from there.

Q4 How do I take out the Tier 2 cover?

Complete and sign the Tier 2 Quote Acceptance Form and the declaration shown on that Form and return this with the signed Direct Debit Form to Aon.

Q5 What if I am unable to sign the declaration?

Contact Aon and they will provide assistance in this regard.


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Q6

How do I pay for these Tier 2 insurance benefits?

By direct debit from your bank account.

With the Tier 2 Quotations, Aon will send you a Direct Debit Form to complete and to return to them with your Tier 2 Quote Acceptance Form. Tier 2 premiums will then be deducted from the Bank Account nominated by you on a monthly basis, until you advise to the contrary.

Q7

Is suicide covered under my Tier 2 Life & Terminal Illness insurance?

Suicide is covered 13 months after you take this Tier 2 Life & Terminal Illness insurance out. If you are transferring Life & Terminal Illness cover above the Tier 1 $300,000 benefit that you previously had under the NZDF DDI Plan, suicide will be covered for that transfer cover, contact Aon for details.


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Tier 2 Trauma Insurance

Q7

How does Trauma insurance work and if I purchase Trauma insurance can a claim under it impact on my Life insurance?

If you are diagnosed with any of the Trauma conditions listed, meet the terms and conditions of the policy, and provided you survive for 14 days (not on life support), and your claim is accepted by the insurer, a lump sum will be paid to you.

If your purchase Trauma Insurance and claim paid under it will have no impact on your Life Insurance.

Q8 What are the Trauma conditions?

There are over 30 conditions covered. Please refer to the schedule attached to this FAQ or to the policy on the DPE HR Toolkit or the MIBP Gateway.

NB Each Trauma critical condition is specifically defined in the policy document e.g. what actually is a heart attack? For example a very minor heart attack may not reach the policy definition of a “heart attack”. The same principle may apply to other Trauma critical conditions. If you have any questions or any doubt on the above contact Aon New Zealand.

Q9

What are the options available to me under Trauma insurance

Trauma insurance is available in units of $5.000, up to $60,000 without medical assessment.

The maximum amount of Trauma you can buy is $150,000.

Q10 How could I use a Trauma benefit?

A trauma insurance payment may be used to cover additional expenses, or loss of income where a partner is required to give up work or go on reduced income to care for you.

Q11 What are the limitations on the Trauma benefits?

Only new events diagnosed after the 1 October 2014 or after you join this policy if later are covered. The joining concession is still very important as there are many medical conditions that lead to an event that are still covered for example high blood pressure is often a precursor to heart or stroke conditions.

There is a 90 day exclusion for certain events occurring in the first three months of your joining (refer to Schedule 2 of this FAQ).

When a Trauma benefit has been paid all cover ceases. The exception is the angioplasty benefit which is 10% of the insured amount. Upon payment of an angioplasty benefit the remaining insured amount reduces to 90% of the original amount.

Q12

How do I find out about the costs of the Tier 2 benefits?

If you request this you will be provided with a Registration Form to complete and return to Aon. Aon will send you your Tier 1 Certificate and special offer information on Tier 2 & 3 benefit options this will include details of the monthly costs. Costs are also shown on the DPE HR Toolkit and the MIBP Gateway.

Q13 How are the Tier 2 premiums paid?

You pay your Tier 2 premiums by monthly Direct Debit from your bank account.


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Q14

What happens if for some reason my direct debit doesn’t pay?

If for some reason you miss a direct debit payment a double payment will be requested next month.

If you also miss payment the next month you will be requested to pay the missing amounts by cheque / or bank transfer.

If you miss three months direct debit payments the covers will lapse. If you are still a member of NZDF you can reapply to join the MIBP however you will need to complete a health assessment for all covers. If you are no longer a member of the NZDF you will be unable to re-join.

If premiums are in arrears no claims under Tiers 2 & 3 will be paid until premiums are up to date.

Q15 How do I take out the extra benefits I want?

When Aon sends you the special offer information, along with your Tier 1 certificate, this will include a quotation showing all options under the automatic concessions (i.e. no requirement to complete medical assessment). You indicate the options you require, sign the quotation along with the direct debit payment form and return these to Aon.

Aon will also detail premiums for options above the automatic concessions. If you want cover over the automatic concessions you indicate the level you want and return the application to Aon and we will send you the heath assessment questionnaire.

Aon/Sovereign will always protect your automatic concession levels whilst we arrange any additional covers, it is very important that you respond to Aon within the 60 day offer period to gain the automatic cover concession.

Q16 What is health assessment?

Health assessment is required where you want cover above the automatic concession for that benefit.

Initially the assessment is the completion of a health questionnaire. The insurer may also ask for a doctor’s report or some tests, usually these tests will depend upon your age, the level of additional cover you want and your health history.

When undertaking health assessment some people are accepted at standard conditions and premiums, however equally some applicants are charged an additional premium or a medical condition might be excluded for cover. Very rarely the additional cover might be declined. In those instances the automatic benefits are not affected.

Q17 How long can I be covered for under Tier 2?

You are covered up to age 70 for all benefits under Tier 2 unless you have been paid a trauma benefit whereupon the trauma cover ceases.

Q18 What happens to my Tier 2 benefits if I leave NZDF?

As your premiums are paid by direct debit your cover will continue as long as the premiums are paid. You should contact Aon if you have any questions or want to change this cover.

Q19 If I leave NZDF what happens to my Tier 1 covers?

Your Tier 1 cover ceases.


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Q20

Who do I contact about claims or for general information?

If you wish to enquire about Claims for Life, Terminal Illness, Physical Loss, Trauma or Income Protection insurance, please contact Aon in the first instance, 0800 MIBP 4U.

All other items please contact your HRA, HRSC or Aon on 0800 MIBP 4U or email [email protected]

Q21 Who is the Insurer?

The NZDF MIBP Tiers 1, 2, 3 & 4 Insurances are insured by Sovereign.

FAQs- GLIPs (Army and RNZAF Group Life Insurance Plans)

Q1

What is the impact of these new arrangements on the current GLIPs?

The current GLIPs will cease to accept new subscribers from 1st October 2014.

Current GLIP subscribers as at 1 October 2014 are able to continue with their current arrangements, or alternatively, access the new Tiers 2, 3 or 4 arrangements where no health evidence is required and full pre-existing conditions are fully protected within the automatic cover concessions.

As there are differences between the Tier 2 Trauma cover and GLIP, it is recommended that you contact Aon if you are considering a change.

Q2

What is the difference between Tiers 2 and 3 cover and the cover available under the GLIPs?

What is the cost difference?

GLIP’s provide Life, Terminal Illness and has Trauma insurance options but the acceptance by the Insurer was subject to full health assessment.

Tiers 2 & 3 provide options for Life, Terminal Illness, Trauma and Income Protection insurance to supplement Tier 1 cover, but have certain “automatic joining concessions” that can provide cover up to generous limits without health assessment.

The cover under the GLIPS cease at age 65 whereas cover under the MIBP cease at age 70.

See the FAQ for more details and Aon will provide Tier 2 & 3 quotations so that cost comparisons can be made. Information is also available on the DPE HR Toolkit and the MIBP Gateway.

Q3

How will a GLIP subscriber be able to compare the current and new arrangements?

Your MIBP Member Pack contains information on the Tiers 2, 3 or 4 options and completion of the Registration Form will enable Aon to send you quotations. Compare the quotations with the prices for your current GLIP cover.

A key difference between the two is that the GLIPs are a retail product and require completion of a medical questionnaire. Tiers 2, 3 or 4 are priced differently and no medical questionnaire is required up to the limits detailed in the information pack.


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Q4 Can I keep my GLIP covers and join Tier 2 as well?

Yes you can keep your benefits under the GLIPS and choose any of the options under Tiers 2 & 3.

Southern Cross - Medical Insurance

Q1

What does the Southern Cross medical insurance package offer NZDF personnel?

Refer to the Information Pack; there are attractive premium discounts available. Alternatively, information is also available on the DPE HR Toolkit or the MIBP Gateway.

Q2

What benefits does the Southern Cross package offer NZDF members?

A range of cover offered at rates below the retail rates applying to other members. Contact Southern Cross for all information.

Q3 Are members able to sign up their family members?

Yes. Refer to the information pack.

Q4

Does the Southern Cross policy cover my medical costs if I am posted or deployed overseas?

No, generally Southern Cross only covers medical expenses incurred in NZ; some policies may have an allowance for some overseas treatment not otherwise available in NZ. You should check with Southern Cross.


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Tier 3 LifePartner You can obtain benefits for your Spouse / Partner who is not a member of NZDF at your own cost

Q1 What options are available to my partner/ spouse under Tier 3?

The Partner/ Spouse of all full time and part time members of the Regular Force, and all permanent or fixed term Civilian employees are eligible for:

• Life & Terminal Illness insurance in units of $50,000 to a maximum

of $500,000.

• Trauma insurance is available with an initial unit of $20,000 and thereafter in units of $5,000 to a maximum value of $150,000.

Note – The Tier 3 Trauma cover is an accelerated benefit which means Trauma cover can only be taken with the Life & Terminal illness cover and the Tier 3 Life benefit will be reduced by the amount of any Trauma claim payment.

Q2 What are Tier 3 “joining concessions”?

Automatic cover up to the limits detailed below is available if your Partner/ Spouse applies for Tier 3 options within 60 days being offered them. This means no health assessment and cover for pre-existing conditions applies, subject to your Partner/ Spouse being able to sign the declaration on the Tier 3 Quote Acceptance Form:

1. Life & Terminal Illness insurance – has an automatic cover of $100,000 i.e. 2 x units of $50,000. You do not have to take 2 units the minimum amount is I unit

2. Trauma insurance – The base unit of $20,000 is automatic and all additional units need health assessment

These concessions are only available for 60 days from the date of offer. If you respond after the Special Offer 60 day period you will need to be health assessed and the “joining concessions” cannot apply.

Q3

How does my Partner/ Spouse take out the Tier 2 cover?

Your partner/ Spouse will need to sign the declaration on the Tier 3 Quotation Acceptance Form that will be sent to you after your send your Registration Form to Aon.

Q4

What if my Partner/ Spouse is unable to sign the declaration?

Contact Aon and they will provide assistance in this regard.

Q5 Are there any exclusions

Yes, no benefit will be payable arising from suicide within the first 13 months, please also see the Trauma conditions Tier 2 Q 7.

Q6 How are the Tier 3 premiums paid?

You pay your Tier 3 premiums by monthly Direct Debit from your bank account or your Partner / Spouse may elect to pay the premiums from their bank account. If so a separate Direct Debit Form will be required.


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Q7

What happens if for some reason my direct debit doesn’t pay?

If for some reason you miss a direct debit payment a double payment will be requested next month.

If you also miss payment the next month you will be requested to pay the missing amounts by cheque / or bank transfer.

If you miss three months direct debit payments the covers will lapse. If you are still a member of NZDF your partner/ spouse can reapply to join the MIBP however they will need to complete a health assessment for all covers. If you are no longer a member of the NZDF your partner/spouse will be unable to re-join.

If premiums are in arrears no claims under Tiers 3 will be paid until premiums are up to date.

Q8 If I have a Trauma claim and then have a claim for a different event do I get another benefit?

No. Once you have had a trauma claim the insurer’s obligation to you under this policy ends. The one exception to this is the Angioplasty benefit which is 10% of the sum insured, if this has been paid the sum insured for the remaining benefits reduce by 10%.

Q9 How long can my Spouse / Partner be covered for under Tier 3?

You can continue to be covered up to age 70 at the discounted rate, thus just continue your monthly direct debit payments at the discounted rates.

Q10 If I leave NZDF can my Spouse Partner’s Tier 3 benefits be retained to keep their insurance protection in place?

Yes they can. Just continue your monthly Direct Debit payments.

Q11 If my Spouse / Partner should change, can my new Spouse/ Partner access Tier 3?

Yes they can please contact Aon on 0800 MIBP 4U, and they will be able to help.

Q12 If my new Partner/ Spouse joins Tier 3 can my previous Partner/ Spouse remain covered?

Yes as long as premiums continue to be paid.


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Tier 4 ExtraCare You can obtain additional benefits, for yourself, your Spouse / Partner and your children at your own cost

Q1 What cover is available under Tier 4?

Other options not available under Tiers 2 & 3 e.g. cover for adult children.

Q2 Are there any concessions?

Tier 4 is outside the spectrum of the group policies and is a retail option. However any cover taken out via Tier 4 may attract a premium discount.

Q3 How do I get further information?

Attend a presentation or contact Aon email [email protected] or phone 0800 MIBP 4U.

About the Insurer All insurances available as part of the NZDF MIBP (Tier 1, 2, 3 and 4) are underwritten by Sovereign Insurance Company Limited (Sovereign). For full details of the products and benefits offered by Sovereign, please refer refer to the policy document(s) which are available from Aon or Sovereign. Sovereign, the policy insurer, is part of the Commonwealth Bank of Australia Group and is a related company of ASB Bank Limited and its subsidiaries (‘the Banking Group’). None of the Banking Group, the Commonwealth Bank of Australia, any of their directors, or any other person, guarantees Sovereign or its subsidiaries, or any of the products issued by Sovereign or its subsidiaries. Copies of Sovereign’s disclosure statements are available on request, free of charge. Sovereign has an A.M. Best financial strength rating of A+ (Superior), and paid out over $320 million in claims in the last financial year ending 30th June 2014, representing 94% of all claims made. Sovereign’s rating is given by A.M. Best Inc., an approved insurance rating agency. A copy of the scale, of which this rating forms part, is available from Sovereign.


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Schedule 1 Physical Loss Schedule

Events are only covered if they occur by Accident Causes

Sum Insured $50,000

Insured events % of sum insured payable Diplegia Total and permanent loss of function of both arms or both legs due to injury of the spinal cord

100%

Hemiplegia Total and permanent loss of function of one side of the body due to brain injury

100%

Paraplegia Total and permanent loss of function of both legs due to injury of the spinal cord

100%

Quadriplegia/Tetrapelgia Total and permanent loss of function of both upper and lower limbs due to injury of the spinal cord

100%

Permanent total loss of use of limbs (entire hand or entire foot) a) Two or more limbs b) One limb

100% 50%

Permanent total loss of entire sight whether aided or unaided of a) Both eyes b) One eye

100% 50%

Permanent total loss of entire sight of one eye (whether aided or unaided) and permanent total loss of use of one limb (entire hand or entire foot)

100%

Permanent loss of all hearing whether aided or unaided in a) Both ears b) One ear

100% 20%

Permanent loss of use of 4 fingers and thumb of either hand (fingers 2 joints or more, thumb one joint or more)

40%

Permanent loss of use of 4 fingers of either hand – 2 joints or more 25% Permanent loss of use of thumb of either hand – 1 joint or more 25% Permanent loss of use of 1 finger of either hand – 2 joints or more 5% Permanent loss of use of toes of 1 foot – all 15% Permanent loss of use of toes of 1 foot – great (big toe) – both joints 5% 3rd degree burns (covering more than 40% of body) (Burns means damage caused by thermal, electrical or chemical agents resulting in tissue injury to a percentage of the body surface as measured by The Rule of Nines of the Lund and Browder Body Surface Chart)

50%

Fractured upper or lower leg or patella – non-‐union (Fracture means the cracking or breaking of a bone as result of an accidental injury but specifically Excludes any fractures that result from excessive physical activity (e.g. stress fractures) or a Degenerative condition and not from any specific injury

10%

Shortening of leg by at least 5cm 7.5%


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Schedule 2

Trauma Schedule for MIBP Tiers 2 & 3

• Alzheimer’s disease and dementia

• Angioplasty ( 10% of sum insured)

• Aplastic anaemia

• Cancer

• Chronic liver failure

• Chronic lung disease

• Chronic renal failure

• Creutzfeldt-Jakob disease

• Heart Attack

• HIV (only for emergency services professionals)

• Major Burns

• Major transplant surgery

• Stroke

• Loss of functionality

- Loss of independent existence

- Permanent Blindness

- Permanent Loss of Speech

- Permanent Loss of Hearing

- Permanent Loss of Two or more Limbs

• Major cardiovascular disease

- Aortic Surgery

- Cardiomyopathy

- Coronary artery Bypass surgery

- Heart Valve Surgery

- Out of Hospital Cardiac Arrest

- Pulmonary Hypertension

• Major neurological disease (other than stroke)

- Benign Brain Tumour

- Coma

- Encephalitis

- Idiopathic Parkinson’s Disease

- Major Head Trauma

- Motor Neurone Disease

- Multiple Sclerosis

- Muscular Dystrophy

- Peripheral Neuropathy

• Paralysis

- Diplegia

- Hemiplegia

- Paraplegia

- Quadriplegia

NB Each Trauma critical condition is specifically defined in the policy document e.g. what actually is a heart attack? For example a very minor heart attack may not reach the policy definition of a “heart attack”. The same principle may apply to other Trauma critical conditions. If you have any questions or any doubt on the above contact Aon New Zealand.


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A trauma benefit shall not be payable for the following conditions if you know you already have the condition prior to joining MIBP or suffer the condition for the first time within 3 months of commencement of this insurances under MIBP. The conditions that fall under this no claim benefit period are:

• Angioplasty ( 10% of sum insured)

• Aortic surgery

• Cancer

• Chronic liver disease

• Chronic lung disease

• Coronary artery by-pass surgery

• Heart attack

• Heart valve surgery

• Multiple sclerosis

• Permanent blindness

• Stroke

After the no claim benefit period is up, full cover for all trauma conditions applies though a condition would be excluded without separate approval if you have previously suffered that trauma event prior to joining the plan. If you have any questions or any doubt on the above contact Aon New Zealand.

The Trauma Insurance Policy Definitions as at 1st October 2014 are as follows:-

SCHEDULE 2 -‐ CRITICAL CONDITIONS For Comprehensive Workplace Living Assurance the following critical conditions are covered under this policy: Alzheimer's disease and dementia The unequivocal diagnosis of Alzheimer's disease or other dementia. The diagnosis must confirm permanent irreversible failure of brain function and result in significant cognitive impairment for which no other cause has been identified. Significant cognitive impairment means a deterioration or loss of intellectual capacity that results in a requirement for continual supervision to protect the member or others. The diagnosis is confirmed by a medical consultant, specialising in psycho-‐geriatrics, psychiatry, neurology or geriatrics. Dementia as the result of alcohol use or drug abuse is specifically excluded. Angioplasty The actual undergoing of coronary artery balloon angioplasty, considered medically necessary by a consultant cardiologist, to correct a narrowing or blockage of one or more coronary arteries. Aplastic anaemia The member has suffered the first occurrence of bone marrow failure which results in anaemia, neutropenia and thrombocytopenia, requiring treatment over a period of at least two months with at least one of the following: * Blood product transfusion * Marrow stimulating agents * Immunosuppressive agents * Bone marrow transplantation Cancer The presence of one or more malignant tumours, characterised by uncontrolled growth and spread of malignant cells, with the invasion and destruction of normal tissue for which major interventionist treatment or surgery is considered medically necessary. The following tumours are included:


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* Intra-‐ductal carcinoma of the breast if it results in the removal of the entire breast to arrest spread of malignancy. * Malignant melanoma, if it is at least Clark level 3, or greater than 1.5mm thickness as measured using the Breslow histological classification. The following tumours are excluded: * Tumours classified as carcinoma in situ (including intraepithelial neoplasia). * Prostate tumours with a Gleason score of less than 6. If the Gleason score is unavailable, Sovereign will use the TNM classification and tumours classified as T1 or its equivalent will be excluded. * All skin cancers unless there is evidence of metastases. * Papillary micro-‐carcinoma of thyroid or bladder. * Chronic Lymphocyctic Leukaemia less than RAI stage 3. Chronic liver failure The member suffers end stage liver failure as evidenced by: * Permanent jaundice; and * Ascites; and * Encephalopathy; and * Portal hypertension. Liver disease caused by alcohol or drug abuse is specifically excluded. Chronic lung disease The member has reached end stage respiratory failure as diagnosed by a medical practitioner specialising in respiratory disease. As a result the member requires continuous oxygen therapy and has a FEV 1 test result of less than 1 litre. Chronic renal failure The kidneys of the member have reached the end stage of renal disease resulting in chronic irreversible failure of the kidneys to function, as a result of which regular renal dialysis is instituted or transplantation performed. Creutzfeldt-‐Jakob disease The diagnosis of Creutzfeldt-‐Jakob disease confirmed by a consultant neurologist. The member must exhibit signs and symptoms of cerebellar dysfunction, severe progressive dementia, uncontrolled muscle spasm, tremor and athetosis, resulting in the member requiring permanent and continual medical supervision. Heart attack The death of a portion of the heart muscle arising from the inadequate blood supply to the relevant area. The diagnosis shall be based on the following criteria being present and consistent with a heart attack: * Clinical features (including but not limited to chest pain, nausea and dizziness); and * Confirmatory new electrocardiogram (ECG) changes; and * A diagnostic rise and fall (other than as a result of cardiac or coronary intervention) in either Troponin I in excess of 2.0microgram/L or Troponin T in excess of 0.6microgram/L or cardiac enzyme CK-‐MB. If any of the above criteria are not met then Sovereign will consider a claim based on evidence that the event produced a permanent reduction in the Ejection Fraction to 50% or less (as measured one year after the event). HIV The member being a medical or emergency services professional has (only for emergency services been infected with the Human Immunodeficiency Virus as the result of professionals) an accident which happened during the course of normal occupational duties. HIV infection contracted any other way is excluded. No claim for a benefit is payable unless the accident giving rise to a potential claim is reported to Sovereign within 30 days after the accident happens and a HIV antibody test is taken within seven days of the accident and is negative. Seroconversion must occur within six months of the


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accident. No benefit is payable for this critical condition if a medical cure is found for the HIV virus or a medical treatment is discovered that prevents the occurrence of AIDS. Major burns The member has suffered tissue injury caused by thermal, electrical or chemical agents. As a result the member has third degree burns to at least 20% of the body surface area (as measured by The Rule of 9 or the Lund and Browder Body Surface Chart). Major transplant surgery The member has had one or more of the following human organs or substances completely transplanted from a human into that member's body: * Kidney * Heart * Lung * Liver * Pancreas * Bone marrow * Intestine The transplant of all other organs, parts of organs or any other tissue transplant is excluded. Stroke A cerebrovascular incident producing neurological sequelae and causing at least 25% continuous impairment of whole person functioning, as measured at 6 months after diagnosis. This requires evidence of: * Infarction of brain tissue; or * Intracerebral or subarachnoid haemorrhage. Excluded from this definition are transient ischaemic attacks (TIA), reversible ischaemic neurological deficit (RIND), cerebral symptoms due to migraine, cerebral injury from trauma or systemic hypoxia and vascular disease affecting the eye or optic nerve. Loss of functionality The member has suffered one of the following conditions: Loss of independent existence The member is totally and irreversibly disabled, with the effect that they are unable as a result of sickness or injury, to perform without assistance at least two of the following activities for themselves: * Bathing and showering * Dressing and undressing * Eating and drinking * Using a toilet * Moving from place to place by walking, in a wheelchair, or with a walking aid. Alternatively, the member is unable to perform one of the above and his or her intellectual capacity has reduced or deteriorated to such an extent that the member requires permanent and constant supervision. Permanent blindness Complete and irrecoverable loss of the sight of both eyes (whether aided or unaided) as a result of sickness or injury. The extent of vision must be 6/36 or less in both eyes. Blindness as a result of alcohol or drug abuse is specifically excluded. Permanent loss of speech, hearing or limbs The member, as a result of sickness or injury, loses all hearing in both ears (aided or unaided) or all speech (aided or unaided) or two or more limbs (the complete severance of an entire hand or foot). The loss of hearing and speech must be expected to be permanent, and in the case of speech, must be suffered for at least a continuous period of 12 months.


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Major cardiovascular disease The member has suffered or undergone one of the following conditions: Aortic surgery Open chest surgery or laparotomy to correct or repair any narrowing, dissection or aneurysm of the thoracic or abdominal aorta. Cardiomyopathy Impaired ventricular function of variable aetiology due to primary disease of the heart muscle, resulting in permanent and irreversible physical impairments to the degree of at least Class 4 of the New York Heart Association classification of cardiac impairment. Cardiomyopathy caused by drug and alcohol abuse is specifically excluded. Coronary artery bypass surgery Open heart bypass surgery to correct or treat coronary artery disease. Heart valve surgery Open heart surgery to correct any defects in, abnormalities of, or disease-‐affected cardiac valves. Out of hospital cardiac arrest Cardiac arrest not associated with any medical procedure and is documented by an electrocardiogram and occurs out of hospital, and is due to: * cardiac asystole; * ventricular fibrillation with or without ventricular tachycardia. Pulmonary hypertension Primary pulmonary hypertension with substantial right ventricular enlargement resulting in permanent and irreversible physical impairment to the degree of at least Class 4 of the New York Heart Association classification of cardiac impairment. Major neurological disease (other than stroke) The member has suffered any one of the following conditions and as a consequence sustained a neurological deficit causing at least a 25% impairment of whole person functioning, as measured 6 months or beyond initial diagnosis. Any of these conditions caused by alcohol or drug abuse are specifically excluded. Benign brain tumour A benign intracranial tumour which cannot be removed by surgery, or growth arrested by other available techniques. Coma A state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least 96 hours, requiring the use of life support systems. Encephalitis Severe inflammatory disease of the brain. Idiopathic Parkinson's disease The unequivocal diagnosis of idiopathic Parkinson's disease where the condition cannot be controlled by medication and shows signs of progressive impairment. Major head trauma An accidental cerebral injury. Motor neurone disease The unequivocal diagnosis of motor neurone disease.


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Multiple sclerosis The unequivocal diagnosis of multiple sclerosis confirmed by CT or MRI scans. A single episode of multiple sclerosis from which full remission has occurred will not be covered under this policy. Muscular dystrophy The unequivocal diagnosis of muscular dystrophy. Peripheral neuropathy Irreversible inflammation or degradation of a peripheral nerve, made upon first diagnosis by a medical practitioner specialising in neurology. Paralysis The member suffers one of the following conditions: Diplegia Total and permanent loss of function of both arms or both legs due to injury or disease of the spinal cord. Hemiplegia Total and permanent loss of function of one side of the body due to brain injury or disease. Paraplegia Total and permanent loss of function of both legs due to injury or disease of the spinal cord. Quadriplegia Total and permanent loss of function of both upper and lower limbs due to injury or disease of the spinal cord. Key Terms Emergency services professionals Eligible medical or emergency services include doctors, registered nurses, dentists, surgeons, ambulance paramedics, police officers, midwives, professional fire fighters and lab technicians. Whole person functioning As defined in the "Guides to the Evaluation of Permanent Impairment -‐ 4th Edition" (or subsequent editions), produced by the American Medical Association.

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