Case studies: are you affected?
13 November 2020
5
min read
The Product and legislation update November 2020 includes some clarifications to our wording. The case studies below can help you work out whether this is relevant to your situation.
These case studies describe scenarios for a member who is between age 25-64 (the age range where default insurance cover applies to most members).
What if I'm not age 25-64?
Default insurance cover for members who opened their QSuper account directly
I opened my QSuper account directly (not through the Queensland Government or a default employer)
Selected ‘yes’ to receive insurance when I applied
Once I have met all eligibility criteria, between age 25-64, I automatically receive:
This cover comes with a pre-existing exclusion period of five years.
These are the default insurance arrangements available for a member who opens their QSuper account directly (not through the Queensland Government or a default employer).
However...
If I started work for the Queensland Government or a default employer BEFORE my account was opened, I may be eligible for default insurance cover based on my employment arrangement, as shown below:
Working full-time/part-time for the Queensland Government and making standard contributions
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87.75% of your insured salary.1
Waiting period – 90 days or accrued sick leave, whichever is greater
Benefit period – Two years
In most circumstances, this default insurance cover has no pre-existing exclusion period as long as you are at work on the day your cover starts.
Working full-time/part-time for the Queensland Government or a default employer but not making standard contributions
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87.75% of your insured salary.1
Waiting period – 90 days or accrued sick leave, whichever is greater
Benefit period – Two years
In most circumstances, this default insurance cover has no pre-existing exclusion period as long as you are at work on the day your cover starts.
Working as a Queensland Police Officer
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87.75% of your insured salary.1
Waiting period – 180 days or accrued sick leave plus approved Queensland Police Service sick leave bank, whichever is greater
Benefit period – Two years
In most circumstances, this default insurance cover has no pre-existing exclusion period as long as you are at work on the day your cover starts.
Previously worked for the Queensland Government or a default employer BUT cover starts after leaving them
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In most circumstances, this default insurance cover has no pre-existing exclusion period as long as you are at work on the day your cover starts.
Applying for default insurance
I opened my QSuper account directly (not through the Queensland Government or a default employer)
If I apply, and QSuper accepts my application:
If this is you...
...and you want to access higher levels of default cover or avoid having a pre‑existing exclusion period on your cover, apply early in Member Online.
Definitions
At work
You are at work if you are:
- Actively performing or capable of performing all of your normal duties, without limitation or restriction due to injury or illness, and where working are working normal hours on the day cover is to commence.
- In the insurer’s opinion, not restricted by illness or injury from being capable of actively performing your full and normal duties on a full‑time basis (for at least 30 hours per week) even though actual employment may be on a full‑time, part‑ time, casual or contract basis, and
- Not receiving, or entitled to claim, any income support benefits from any source including Workers’ Compensation benefits, statutory transport accident benefits and disability income benefits (including government disability support benefits but excluding benefits under the National Disability Insurance Scheme).
You will be considered to be at work, if you are on approved leave for reasons other than injury or illness and, not taking into account the leave, are able to meet this at work definition.
If you are unemployed, you will meet this at work requirement if you are capable of performing all the duties and work hours of your usual occupation free of limitation or restriction due to injury or illness on the day cover is to start.
If you are not gainfully employed and are actively engaged in full‑time home duties, you will meet this at work requirement if you are able to actively perform your normal full‑time home duties without limitation or restriction due to injury or illness on the day cover is to start.
Default employer
Means an employer registered with the QSuper Board as agreed by QInsure as a default employer who is not a Queensland Government employer.
Pre‑existing exclusion period
A period in which an insurance benefit will not be payable if the illness or injury of which the claim is subject to is related to a pre‑existing condition. A pre‑existing exclusion period starts on the date you became covered for the relevant type of cover.
1. This benefit includes a contribution replacement benefit of 12.75% of your insured salary, which is paid to your QSuper Accumulation account while you are receiving an income protection benefit.