for the purposes of reconsidering decisions of CSC under Part6 of the Rules, includes: (a) making, suspending, revoking or refusing to make an order or determination; (b) giving, suspending, revoking or refusing to give a certificate, direction, approval, consent or permission; (c) issuing, suspending, revoking or refusing to issue an authority or other instrument; (d) imposing a condition or restriction; (e) making a declaration, demand or requirement; (f) retaining, or refusing to deliver up, an article; and. Subject to the SIS Act, CSC may adjust the repaid, returned or refunded contributions for: (a) insurance premiums paid from the persons personal accumulation account during the period the contributions were held in the PSSAP Fund; (b) interest (if any) in respect of the fund earnings or fund losses for the period the contributions were held in the PSSAP Fund; and. Her insurance expertise has been featured in Bloomberg News, Forbes Advisor, CNET, Fortune, Slate, Real Simple, Lifehacker, The Financial Gym, and the end-of-life planning service. CSC to establish a non-member spouse interest account where a non-member spouse interest is created, CSC to establish a non-member spouse interest account. 2.1 There is hereby established from 1 July 2005 a superannuation scheme (to be known as the Public Sector Superannuation Accumulation Plan or PSSAP) for the benefit of members of PSSAP and non-member spouses entitled to benefits, to be administered in accordance with the Deed: (a) in relation to the period from 1 July 2005 to immediately before the commencement of the Governance of Australian Government Superannuation Schemes Act 2011, by the Australian Reward Investment Alliance (which, in this Deed, is called the Board); and. 6.2.4 The decision of CSC or the Reconsideration Advisory Committee under Rule 6.2.3 on a reconsideration must be notified to the person requesting reconsideration of the original decision. 3.1.9 If CSC receives a benefit application from a transitional member pursuant to Rule3.1.1(a)(iv) and CSC has in place arrangements for members to purchase the income product requested in the application, CSC, in accordance with Rule 3.5.1, must, on behalf of the transitional member, arrange for the purchase by the member of an income product of the type so requested costing an amount equal to the total benefit set out in the benefit application. After the first 260 CDDs, if your contribution rate is more than 5%, your ABM accrues at a higher rate. This compensation may impact how and where offers appear on this site (including, for example, the order in which they appear). 2.2.7 CSC must pay any basic employer contributions and any additional employer contributions into the PSSAP Fund. For more information please see our Advertiser Disclosure. A child can be covered by both parents health insurance policies. (b) doing all things necessary to correct the records of the PSSAP Fund to reflect action taken under paragraph (a). Its full name is Public Sector Superannuation Accumulation Plan, and it is defined as a 'non public offer Public Sector fund', meaning only some people can . A married couple has a newborn baby. Court Order: The Employee Retirement Income Security Act of 1974 (ERISA) designates that the birthday rule can be applied to determine which plan is the primary health plan for the children of working parents, according to the child support guidelines from the Center for Policy Research. So, if your birthday is July 15, 1985, and your spouse is September 17, 1983, your health plan would be considered primary because your birthday comes first in the calendar year. Assessment of applications for income protection benefits. 1st Amdt, 2006; 2nd Amdt, 2007; 5th Amdt, 2011. c. 1.3. c. 1.6. c. 1.8. c. 2.1. c. 2.2. c. 3.1. c. 3.2. c. 3.3. c. 3.4. C. 4 c. 5.1. c. 5.2. c. 5.3. c. 5.4. c. 5.5. c. 6.2. c. 6.3. c. 6.4. c. 6.5. c. 6.6. c. 7.1. c. 8.1. c. 8.2. c. 8.3. c. 9.1. R. 1.1.1 R. 1.2.1 am. Format your birthday template or birthday invitation template to provide alerts and even send a birthday email right from Excel. (m) charge reasonable fees in relation to the administration of the PSSAP Fund, including arrangements connected with PSSAP members and non-member spouses choosing particular investment strategies and arrangements connected with splitting of superannuation interests under the Family Law Act 1975. 4.4.11 Where a premium payable for supplementary income protection cover is more than the amount in the personal accumulation account of the ordinary employer-sponsored member, Rule 4.4.10 shall not apply. Thats why its vital to ensure you go to providers in both plans networks. | Terms & Conditions | Privacy, Mechanical Integrity (focused on fixed equipment), Hydrofluoric Acid (HF) Alkylation/API RP-751, Pipeline Strategic Data Tracking System (PSDTS). For example, Rule 2.3.1 is the first Rule in Division 3 of Part 2 of the Rules. Amounts that may be transferred or rolled-over into the PSSAP Fund. ABOUT US. means an account created by CSC in respect of a non-member spouse interest under Rule 7.2.1. means a person who is an ordinary employer-sponsored member of PSSAP in accordance with Part 4 of the Act. Cessation of supplementary death and invalidity cover. It was replaced by the PSSap which is an accumulation fund. 4.3.3 The basic income protection cover of an ordinary employer-sponsored member ceases on the earliest of: (a) the day, or a day after the day, that the ordinary employer-sponsored member ceases to be an ordinary employer-sponsored member, that is specified in the basic income protection cover policy for the purpose of this paragraph; (b) the date the ordinary employer-sponsored member notifies CSC that they no longer wish to have basic income protection cover; (d) where, under Rule 4.3.6, a premium payable for basic income protection cover has not been paid on the day on which the premium became payable and the terms of the basic income protection cover policy provide for cover to end when premiums cease, the day after the day on which the cover ends due to non-payment of premiums; and. But having dual coverage may result in medical cost savings in the long term if the two insurance companies complement each other and provide comprehensive coverage, mitigating expenses for illnesses, for example, and other types of expensive care. Subclauses 5.4 and 5.5 deleted in the 5th amending deed. Certain gov orgs provide employees with a greater than 9.5% contribution, if you're with PSSAP, but if you provide another super fund for them to pay into, then they're only obligated to pay the minimum of 9.5%. Regulations 6.33 and 6.34 of the, Subject to Rule 3.2.1, in the event of the death of a, Following receipt of an application to approve the, must make a claim against the policy or policies providing the, A person in receipt of benefits under Division 1 of this Part may use the benefits to purchase income products arranged by. (b) holds income protection cover. The internal review mechanisms available to have a decision of CSC or its delegate reconsidered in relation to PSSAP. 2.1.2 Where an ordinary employer-sponsored member, who is employed by two or more designated employers at the same time, ceases to be an employee of one or more but not all of those designated employers, the person will not cease to be an ordinary employer-sponsored member. 2.2.6 The designated employer of an ordinary employer-sponsored member must pay basic employer contributions and any additional employer contributions in accordance with any determination of CSC under Rule 2.2.5. This is an updated birthday rule that took effect on January 1, 2020. This double coverage approach can be a money-saver, as the second plan can be used to cover expenses that would otherwise be out-of-pocket costs under the first plan. How does primary and secondary insurance work? 2.4.3 CSC must pay any transfer amount into the PSSAP Fund. They appear throughout the Rules in bold print to remind the reader that they have a special meaning. means the superannuation scheme established by the Trust Deed, as amended from time to time, referred to in section 4 of the 1990 Act. Share. (c) fees, costs and expenses paid from the persons personal accumulation account during the period the contributions were held in the PSSAPFund. Before acting on any such general advice, you should consider the appropriateness of the advice, having regard to your own objectives, financial situation and needs. 3.4.5 Nothing in this Deed requires CSC to pay income protection benefits where: (a) an ordinary employer-sponsored member does not hold income protection cover; or. National Association of Insurance Commissioners. The birth year is not taken into consideration. Advertiser Disclosure: Some of the offers that appear on this website are from companies which ValuePenguin receives compensation. As a side note, its important to understand that new dependent coverage is not necessarily provided if the new parent is covered under their own parents health insurance. Note:CSC may make a claim against a policy providing income protection cover. The plan of the new spouse of the parent with custody pays second. 4.8 Satisfied. 6.4.1 CSC, on its own motion, may initiate the reconsideration of a delegates decision or a decision of CSC in relation to PSSAP and may vary the decision, substitute another decision or set the decision aside. They appear throughout the Rules in, means an Agency within the meaning of the, means an AWA within the meaning of clause 1 of Schedule 7A to the, means insurance coverage provided in respect of an, means insurance cover provided in respect of an, means a notice in such form and manner as, means any period during which a person is absent full-time from his/her employment due to an incapacity for work resulting from an injury in respect of which compensation is payable under section 19 or 22 of the, (short for Commonwealth Superannuation Corporation), means the superannuation scheme established by the, for the purposes of reconsidering decisions of, means a enterprise agreement within the meaning of section 12 of the, means any amounts payable in respect of an, means the termination of the employment of an, in relation to a superannuation interest in the. You should obtain a copy of the relevant Product Disclosure Statement and consider its contents before making any decision regarding your super. 3.1.8 If CSC receives a benefit application from or on behalf of an ordinary employer-sponsored member pursuant to Rule 3.1.1(a)(iii), the member, subject to Rules 3.4.2 and 3.4.5, is entitled to income protection benefits in accordance with Rule3.4.3. That includes the provider if the doctor isnt part of the secondary plans network, the plan may not cover their portion. The TMD also describes our reporting requirements, and events or circumstances where we may need to review the TMD. And make sure you know the payment procedure before you or your children visit the doctor or you may find yourself personally responsible for some unexpected medical bills. The birthday rule is part of a longstanding model act from the National Association of Insurance Commissioners. (g) doing or refusing to do any other act or thing; has the same meaning as in the SIS Act. How is Groundwater Protected During Hydraulic Fracturing? 4.1.6 Subject to Rule 4.1.7, the premium for basic death and invalidity cover provided in respect of an ordinary employer-sponsored member is the amount determined by CSC, being the same amount as the amount of premium specified in the basic death and invalidity cover policy, and must be deducted from the personal accumulation account of the ordinary employer-sponsored member. Investment of the PSSAP Fund, 7. Barry Eitel is a content writer and journalist focused on insurance, small business and finance. 4.3.5 Subject to Rule 4.3.6, the premium for basic income protection cover provided in respect of an ordinary employer-sponsored member is the amount determined by CSC, being the same amount as the amount of premium specified in the basic income protection cover policy, and must be deducted from the personal accumulation account of the ordinary employer-sponsored member. So, in addition to unparalleled assessments, the mentorship that the assessors bring to your site is priceless. In situations where each parent has their own health plan, a newborn or newly adopted child may end up in a coordination of benefits scenario, even if the parents dont intend to maintain more than one policy for the child. The notification is to include a statement of reasons for the decision. (b) may include any other provision that is related to, or consequential on, provisions referred to in paragraph (a) concerning a splitting agreement or splitting order; 1.1 In this Deed, where the context requires or admits, a reference to the Deed shall include a reference to the Rules, as set out in the Schedule, and the Rules shall form part of the Deed. It does not apply to a child or children covered under a single insurance plan. When dual coverage exists, the birthday rule usually determines which insurance serves as the primary carrier and which provides secondary coverage. Amounts paid by an insurer in response to a claim are paid to the PSSAP Fund for payment to the ordinary employer-sponsored member but are not credited to their personal accumulation account. They dont want you, or a hospital, pocketing extra money. The policy linked to the person with the earliest birthday would be primary. 1. 4.2.13 Where a premium payable for supplementary death and invalidity cover is more than the amount in the personal accumulation account of an ordinary employer-sponsored member, Rule 4.2.12 shall not apply. PSSAP Focused will help facilitate smaller refineries, petrochemical, and chemical facilities to take part in the program. Remember that even with dual coverage, the policies' benefits and restrictions still apply. We understand that life is ever changing and full of unexpected moments, so weve designed a flexible insurance to cover you through it all. Splitting of superannuation between a member spouse and a non-member spouse following a splitting agreement or splitting order under the Family Law Act 1975. When a dependent is covered by two health insurance policies, the birthday rule determines the order that the insurance companies will pay. The PSS has been closed to new members since 2005. For information about becoming an assessor, please see the AssessorQualification Process and Assessment Team Memberor Assessment Team Leader qualification requirements. THIS DEED, to be known as the Superannuation (PSSAP) Trust Deed, is made on 29 June 2005 by the COMMONWEALTH OF AUSTRALIA. You may wish to consult a licensed financial advisor. 6.2.1 A person affected by a decision in relation to PSSAP made by a delegate of CSC may request CSC to reconsider the original decision. You cant be reimbursed for more than the value of your bills. means a written application to CSC requesting CSC to pay a benefit under these Rules. 3.1.14 Subject to the SIS Act, a roll-over application must be made in a form acceptable to CSC and must include any supporting evidence of entitlement to the benefit required by CSC. If you are aged 65 and over, you may choose to exit PSS while . 5.1.5 If any or all of the following amounts are paid to the PSSAP Fund in respect of a PSSAP member, the amounts must be credited to the persons personal accumulation account: (b) any additional employer contributions; (c) employee contributions that have been paid by the ordinary employer-sponsored member; (d) eligible spouse contributions accepted by CSC under Rule 2.3.4 paid on behalf of the ordinary employer-sponsored member; (e) the interest credited (if any) in respect of fund earnings on the persons accumulation amount as decided by CSC under Rule5.2.1; (f) any amount paid by a life insurance company to CSC in respect of the person in response to a claim against a life policy unless the amount is an amount referred to in Rule3.4.3; (h) any amount credited to the persons personal accumulation account under Rule7.2.2; (i) amount of any tax offset as determined by CSC. The birthday rule is used to determine how coordination of benefits work when a child is covered by both parents' health insurance policies. Payment of benefits to ordinary employer-sponsored members. (ii) each subsequent birthday of the ordinary employer-sponsored member, or other date as specified in the policy. Many families choose to add children to just one parents plan, but some choose to add them to both plans, especially if the employers cover a significant portion of the monthly premiums. We invest your money. In another situation, if each policy only provided 25% coverage for the procedure, you would pay the remaining out-of-pocket costs after the two insurance companies pay their portion. Rules do not necessarily have their own Rule headings. 8.3 If CSC delegates a power under subclause 8.1, other than paragraph (h), the delegate may, by writing, sub-delegate the power: (a) if the delegate is a member of CSC to: (ii) a person referred to in paragraph 8.1(b), (c), (d), (e) or (f); or, (b) if the delegate is the CEO of ComSuper to a person referred to in paragraph 8.1(c), (d), (e) or (f); or. CSC may take out death cover and invalidity cover in separate policies. 5.4.2 CSC may determine when and how a PSSAP member may make or change an election about their choice of investment strategy. But that plan does not have to (and generally won't) extend coverage to the dependent of a dependent. But if the coverage under both plans took effect on the same day, the birthday rule would apply. The birthday rule does not apply to step-parents or children who live in a blended family. 5 Year: 10.04%. A different type of birthday rule, aimed at allowing people to switch so-called Medigap policies, did change in 2022 in Illinois, Nevada, and Idaho. 3.3.2 An ordinary employer-sponsored member in respect of whom an application under Rule 3.3.1 is made is taken to have also made a benefit application. means the termination of the employment of an ordinary employer-sponsored member on the ground that they are unable to perform their duties because of any mental or physical condition. 4.4.9 All premiums for supplementary income protection cover are to be paid by CSC from the PSSAP Fund. He has researched and written about personal finance since 2012, with a special focus on entrepreneurship, freelancing and other small business operations. ABN 48 882 817 243 AFSL 238069 RSE Licence No: L0001397. CSC may initiate a reconsideration of a decision. Requests by Minister for Information, 8. 7.2.2 Where the non-member spouse is a PSSAP member with both a personal accumulation account and a non-member spouse interest account, CSC shall, within 28days after being requested to do so by the non-member spouse: (a) increase the amount credited to the personal accumulation account of the PSSAP member by the amount credited to the non-member spouse interest account; and. Basic employer contributions into the PSSAP Fund to reflect action taken under paragraph ( )... Subsequent birthday of the offers that appear on this website are from which. To determine how coordination of benefits work when a child can be covered by two health policies. Csc requesting CSC to establish a non-member spouse interest is created, to. And even send a birthday email right from Excel CSC or its delegate reconsidered in relation to PSSAP and cover. But that plan does not have to ( and generally wo n't ) extend coverage to the of. 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