FundsAtWork Quote in detail for 5-15 members

FundsAtWork Umbrella Funds
Your quote in detail for new schemes with 5 to 15 members
May 2015
CONTENTS
Page
FundsAtWork and MMI
3
Retirement, insurance and lifestyle solutions
4
Your FundsAtWork quote
12
Definitions and standard terms and conditions
18
Standard industry policy definitions for certain dread disease conditions
23
Fees and other expenses
26
Tax aspects
28
Statutory Disclosure in terms of the Policy Protection Rules (Long-term Insurance Act)
& Financial Advisory and Intermediary Services Act
31
Conditions for use
33
Your quote in detail for new schemes with 5 to 15 members
May 2015
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FundsAtWork and MMI
MMI Holdings Limited (MMI) is a South African based financial services group listed on the South African stock
exchange. The core businesses of MMI are long and short-term insurance, asset management, savings,
investment, healthcare administration and employee benefits. These product and service solutions are provided to
all market segments through operating brands Metropolitan and Momentum.
MMI’s vision is to be the preferred lifetime financial wellness partner, with a reputation for innovation and
trustworthiness. Our purpose is to enhance the lifetime financial wellness of our people, their communities and
their businesses. Our culture is grounded in the values of accountability, excellence, integrity, diversity,
innovation and teamwork. MMI’s growth initiatives support our vision, purpose and strategic focus areas of
growth, client-centricity and excellence. MMI Group Limited has a Level 2 B-BBEE rating.
FundsAtWork is a holistic financial wellness solution that offers insurance, retirement and preservation solutions.
Our products are tailored to meet individual needs across all employer sizes and industries. We understand that
employers want to take care of their businesses and also fulfil their moral obligation of taking care of their
employees. Momentum is a companion each step of the way, for everyone’s financial wellness.
Momentum understands the business owner’s need for employee benefits with built-in intelligence that takes care
of the individuals within the group. We also understand the importance of expert financial advice and education. At
our core is the ability to deliver innovative products that offer flexibility, ease of use and value for money, as well as
transparent information and services.
FundsAtWork has grown exponentially since its inception in 2000. The FundsAtWork Umbrella Funds and
insurance only solution have membership in excess of 325 000, over 5 000 participating employers and over R28b
assets.
The FundsAtWork solution is made up of the following distinct parts:
•
•
insurance benefits
retirement benefits
•
•
preservation benefits
lifestyle benefits
This Quote in Detail applies to FundsAtWork schemes for employers with between 5 and 15 employees.
Your quote in detail for new schemes with 5 to 15 members
May 2015
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Retirement, insurance and lifestyle solutions
Product options
All members will belong to the FundsAtWork Umbrella Provident or Pension Fund on the Provider product option
and will be invested in the Momentum Lifestages portfolio, unless they have made use of the housing loan facility.
Contribution flexibility is allowed through additional voluntary contributions (AVCs).
On leaving the Umbrella Fund members can:
•
•
•
use the continuous assurance option (CAO) to continue their insurance benefits with Momentum Myriad;
use the auto-preservation facility to transfer their assets to the Momentum Corporate Preservation Fund;
buy the default annuity selected by the Trustees when they retire.
Investment portfolios
Momentum Lifestages
Momentum Lifestages has been selected by the trustees as their preferred life stage strategy. Switching between
the life stages is fully automated and based on each member’s individual date of birth and years to retirement, as
seen in the illustration below.
The objectives and the glide paths are:
Portfolio
Objective & time period
Glide path
Momentum Lifestages
Accumulator
CPI + 7% over 7 year rolling periods
(Momentum Enhanced Factor 7)
Greater than 7 years to normal
retirement age (NRA)
Momentum Lifestages Builder
CPI + 6% over 6 year rolling periods
(Momentum Enhanced Factor 6)
Between 5 and 7 years to NRA
Momentum Lifestages
Consolidator
CPI + 5% over 5 year rolling periods
(Momentum Enhanced Factor 5)
Between 3 and 5 years to NRA
Momentum Lifestages Defender CPI + 3% over 3 year rolling periods
(Momentum Enhanced Factor 3)
Less than 3 years to NRA
Momentum Enhanced Factor 3
If the employer makes the home loan facility available to the members of the scheme, when a member takes out a
housing loan, the amount of the member’s retirement savings account equal to the initial value of the housing loan
plus tax will be invested in the Trustee Choice Portfolio (currently investing in Momentum Enhanced Factor 3).
Momentum Enhanced 3 is a conservative market-linked portfolio. The portfolio is diversified and invests in a
number of asset classes, such as local and global equities, local property, local and global bonds, local cash and
local inflation linked bonds. The portfolio is multi managed across a number of well-known and highly rated
investment managers, for example Prudential, Coronation and Foord.
Momentum Enhanced Factor 3 has a 67.5% exposure to conservative asset classes and is likely to behave in a
conservative way, which we believe is suitable for members that are risk averse.
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May 2015
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Growth assets are expected to provide returns in excess of inflation over the long term and these asset classes
typically include listed local and offshore equities and listed local properties.
Growth asset classes are generally volatile and portfolios that maintain high exposures to these assets are
expected to have a higher unpredictability compared to portfolios with high exposures to more conservative asset
classes such as bonds, inflation linked bonds and cash.
The portfolio is not only well diversified from an asset allocation perspective but also from an investment manager
perspective because it is multi managed. The underlying manager exposures are actively managed and if any of
the underlying managers disappoint, they will be replaced with a more suitable investment manager.
Momentum Outcomes–based Solutions (previously Momentum Manager of Managers) has been appointed to
manage the asset class building blocks of the portfolio and their investment team will ensure that the underlying
asset classes ie equities, bonds, cash and inflation linked bonds, are properly managed and exposed to the best
investment managers in the industry.
Momentum Enhanced Factor 3 targets a return of inflation +3% per annum over a rolling 3 year period.
Momentum Enhanced Factor 3 complies with Regulation 28 and represents our best thinking in terms of portfolio
construction. We also believe that there is a high probability of this portfolio achieving its targeted return objectives
in normal market cycles.
Insurance benefits
The insurance benefits available under the Provider product option are separate standalone (unapproved) policies:
•
•
•
•
•
Standard group life cover (GLA)
Standard lump sum disability (PTD)
Standard permanent health insurance (PHI)
Standard dread disease
Family Protector BASE
Group life cover (GLA)
On the death of a member, the cover is paid as a lump sum. The employer can choose cover between 1 and 6
times annual insurance salary, capped at the quoted maximum rand amount.
Lump sum disability benefit (PTD)
A lump sum is paid to the member if they are totally and permanently disabled in terms of the provisions of the
policy.
Matching group life cover at least equal to the permanent and total disability benefit must be provided.
The employer can choose cover up to a maximum benefit equal to the lesser of 6 times annual salary, the quoted
maximum rand amount and the member’s group life cover. This maximum rand amount will increase automatically
from time to time unless the employer informs Momentum to the contrary.
The waiting period is 6 months.
The benefit amount is reduced over the 5 year period prior to the benefit termination age.
Permanent health insurance (PHI)
If the member becomes disabled in terms of the policy, a monthly benefit is paid until the member recovers or
retires or dies or lives outside South Africa for more than 12 consecutive months unless an arrangement is made
with Momentum.
The benefit is 75% of the insurance salary subject to the maximum quoted amount, provided that the sum of the
member’s benefit and employer waiver is limited to 100% of net pay, where net pay is the member’s total cost-tocompany salary, less income tax calculated according to the applicable tax table and assuming that the member
has no deductions from that salary.
The employer’s waiver covers the employer’s contributions to the Umbrella Fund and the insurance benefit costs
and is shown in the quote.
The waiting period is 3 months.
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May 2015
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The benefit paid to a disabled member escalates at a rate of 6% per annum. The escalation rate is limited to year
on year increases in the official Consumer Price Index (all items).
Momentum has embraced the philosophy of actively assisting incapacitated employees to return to work, when
possible. The success of return to work interventions is largely dependent on the stability of the medical condition,
the employee’s motivation to participate in a return to work programme and the employer’s willingness to
reasonably accommodate an employee in the workplace.
The skills shortage in South Africa makes the retention of workers imperative. This is compounded by high
employee replacement costs. The active rehabilitation of disabled employees therefore presents a win-win situation
to all the relevant stakeholders. We have added the vocational rehabilitation benefit to the permanent health
insurance benefit.
There are two periods where different definitions of occupation can apply:
•
The initial period
The initial period is the initial 24 months including the waiting period. During this period a disability definition of
“own occupation with own employer” applies.
•
The deferred period
After the initial period expires Momentum will consider whether the member is capable of performing any
occupation for which, in the opinion of Momentum, the member is, or could reasonably be expected to become
qualified or suited taking into account their degree of disability, knowledge, training, education, ability and
experience.
Dread disease – Inclusive
The inclusive dread disease benefit is an accelerated payment of the lump sum death benefit, paid on essential
and inclusive conditions.
The essential conditions are:
•
•
•
•
Cancer
Heart attack / surgery
Kidney failure
Major organ transplant
•
•
•
Paralysis
Stroke
Blindness
•
•
•
•
•
•
•
Poliomyelitis
Aplastic anaemia
Severe ulcerative colitis
Severe Crohn’s disease
Primary pulmonary hypertension
Acquiring of HIV from blood transfusion
Occupationally acquired HIV
The inclusive conditions are:
•
•
•
•
•
•
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Loss of limbs / hearing / speech
Coma
Severe burns
Multiple sclerosis
Motor neuron disease
Parkinson’s disease
Benign brain tumour
Alzheimer’s disease
The maximum cover is the lesser of 2 times annual salary and the quoted maximum rand amount, subject to a
maximum of the group life cover. This maximum benefit will increase automatically from time to time unless the
employer informs Momentum to the contrary.
The group life benefit cannot be reinstated if the member survives after the date that the dread disease was first
diagnosed.
There are two levels of payment (please read in conjunction with section titled “Standard Industry Policy Definitions
for Certain Dread Disease Conditions”):
•
Full payment: 100% of the benefit paid for serious and life threatening conditions.
•
Partial payment: A percentage of the benefit paid for non-life threatening conditions depending on the severity
of the claim.
This excludes the four “core” diseases explained in the section “Standard industry policy definitions for certain
dread disease conditions”.
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May 2015
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Members who receive any benefit remain covered for unrelated causes, i.e. multiples of 100% of payments can be
made. Members who receive a partial benefit will remain covered for the same condition if there is progression to a
higher severity level, but the benefit paid will be reduced by the amount previously paid. For example if a member
has had kidney failure then he may claim again for cancer or blindness or loss of speech as these are unrelated
conditions but may not claim for a heart attack or paralysis or a stroke as these as classified as related causes. So
the dread disease benefit covers unlimited unrelated claims and allows payment of the balance of related claims
where the member has only received a partial benefit.
Family Protector
The Family Protector benefit comprises three parts, namely:
•
•
•
funeral benefits
education benefits
health premium waiver benefits
Family Protector PLUS is not available to members of the scheme.
Benefits the member must
have to qualify
Family Protector BASE
Retirement benefits
Funeral benefit BASE
• R10 000 per main member and spouse/s
• R5 000 per child
8 family members covered (the member, up to 2 spouses and 5 children)
Funeral benefit BASE
+
Health premium waiver BASE (on disability)
• pays medical scheme contributions if a member is disabled
• only for members on Momentum Health
Retirement and disability
•
Retirement and death benefits
member is the premium payer
• contributions are paid for 12 months
Funeral benefit BASE
+
Health premium waiver BASE(on death)
Retirement, disability and
death benefits
+
Education benefit BASE
• R10 000 per child for a maximum of 5 children if a member dies
• money administered by Absa Trust Services
Funeral benefit BASE
+
Health premium (waiver BASE (on disability and death)
+
Education benefit BASE
Funeral benefit BASE
Following the death of the member or the member’s spouse or child, the funeral benefit will provide a lump sum to
cover the urgent expenses following a death. It provides the members with basic insurance cover to ease the
financial burden placed on the family at a difficult time.
Eligibility
The funeral benefit BASE option is provided automatically to all members, under normal retirement age, with
retirement benefits. A member’s spouse/s and children will also enjoy cover.
The term “child” refers to:
•
A natural or legally adopted child of the member and / or the member’s spouse, up to the age of 21 if the child is
unmarried or up to the age of 25 if studying full time. There is no restriction if the child is incapable of earning an
income because of a mental or physical defect.
•
A stillborn child; a stillbirth is when a foetus dies after the 26 week of pregnancy but before delivery.
th
A maximum of 5 children will be covered under this policy. For practical purposes the first five claims will be paid
(regardless of whether the child is one of the eldest or not).
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May 2015
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Spouse means the partner of the member, whether married legally or by custom or living as man and wife. Where
the member has more than one spouse, up to two spouses may qualify for this benefit. For same sex partnerships,
the member needs to have registered the partner as the “spouse” for the purpose of any employment records and
benefits.
For every member (employee) a benefit is paid. For example if a husband, wife and 20-year old child are working
for the same employer and the child dies, then three benefits are paid: one to the husband, one to the wife and one
as the child is a member.
Benefit
The benefit for the member and spouse is R10 000 and for children it is R5 000. This amount of cover is fixed and
does not depend on the member’s salary or contribution.
Claims
Funeral claims are paid within 48 working hours of receipt of all relevant documentation. Notification of a claim
must be received within 6 months of the date of death for it to be admitted. All requirements must be received
within 7 months for the claim to be paid.
On the death of a child the details of the child will be compared to that stored on the system, except in the case of a
stillbirth.
Information required at time of claim:
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•
•
•
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Fully completed claim form
Birth certificate
Marriage certificate
Death certificate
Further proof of relationship with the member, which could include correspondence from the employer / minister
/ pastor / person of good standing in the community.
Education benefit BASE
The benefit is paid if the member dies and is used for the education of the member’s children. The benefit
supplements the group life cover that the member has.
Eligibility
The education benefit is provided automatically to all members, under normal retirement age, with retirement
benefits and group life cover.
The benefit paid is in respect of the member’s children. The term child refers to a natural or legally adopted child of
the member and / or the member’s spouse, up to the age of 21. The benefit is paid to children that have been born
at the time of the member’s death.
Up to five children are covered.
Benefit
The benefit is a lump sum payment of R10 000 per child for a maximum of five children, up to the child reaching the
age of 21. The benefit is paid into the Momentum Educational Trust administered by Absa Trust Ltd. Absa does all
the administration including the payment of the education costs.
If a child dies before the age of 21 then the remaining benefit will be distributed to the surviving siblings. If there are
no siblings then the remaining benefit will be paid into the deceased child’s estate. If a member has more than five
children and did not choose to add the additional children, then the remaining benefit will be paid to the child that
was not previously a beneficiary. If a member does not have any children, this benefit will not be paid out.
Payment from the trust will be made in accordance with the following rules:
•
Where there is more than one child, rules will apply per child.
•
Payment will only be made on providing proof of education expenses. These educational expenses include, but
are not limited to, school fees, school clothes and stationary.
•
Interest at the ABSA standard call rates is earned on the balance of the lump sum in the trust.
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May 2015
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•
Trust costs will be deducted from the benefit amount. This includes an acceptance fee of R250, an annual
management fee of R250 and a capital distribution fee of R30 from the second payment request per year (the
first payment request is free). All these fees exclude VAT.
•
There is no annual limit on amounts withdrawn from the trust provided they education related. Once the lump
sum in the trust has been exhausted, the benefit will cease.
•
When children finish school or reach the age of 21 and are no longer studying (whichever is last), they will
receive the remainder of the benefit as a tax-free lump sum.
•
If at any time the amount in the trust is less than or equal to R5 000, the balance of the benefit will be paid out
as a tax free lump sum.
Claims
The claims process follows the same terms and conditions as for the funeral benefit.
Health premium waiver BASE
The health premium waiver pays the premium to the member’s medical scheme on the member’s disability (if the
member has an income or lump sum disability benefit) or on the member’s death (if the member has a group life
benefit). The premium paid will be for the same option that the member was on just before their death or disability.
Eligibility
The health premium waiver is provided automatically to all members under normal retirement age with retirement
benefits and lump sum death benefit or retirement benefits and disability benefits. The BASE option covers
members on the Momentum Health medical scheme and Metropolitan Medical Scheme. The member must have
been on a medical scheme for a year prior to date of death or disability and must have been the medical scheme
premium payer.
Benefit
The payment of the Momentum Health contributions will be for a period of 12 months from the end of the waiting
period in respect of the disability benefit. This will be paid only for the member and dependants that were on the
medical scheme prior to the member becoming disabled and on the option the member had chosen prior to
becoming disabled. The contributions will be paid to Momentum Health or Metropolitan Medical Scheme for a
member’s dependants within a month of being notified of the member’s death in respect of the option and the
dependants that were on the medical scheme just before the member’s death.
Lifestyle benefits
Housing guarantees
With the employer’s agreement, individual members under the FundsAtWork Umbrella Funds have access to
pension backed home loan facilities. FundsAtWork offers housing guarantees for members, who need to renovate
their home, buy a house, buy land to build a house or pay off another housing loan debt. The loans are provided by
FNB or Standard Bank.
To qualify for a housing loan, a member must:
•
have a permanent job and belong to the FundsAtWork Umbrella Fund; and
•
be able to afford the monthly repayments.
When the member withdraws from the Fund the outstanding amount of the loan is deducted from the benefit before
payment to the member. If the member defaults on the payment of the loan for 90 days, while still a member of the
Fund, the bank may call up the loan.
If a member becomes disabled then the money in their retirement savings account will be used to repay the loan. If
the member took out credit life insurance the loan will be settled using the member’s retirement savings and the
credit life insurance will be paid into the member’s estate (in the case of death).
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May 2015
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Interest rates
The interest rates available from FNB are lower than the prime lending rate and depend on the size of the loan.
Standard Bank offers loans at the prime lending rate on all loan amounts.
Maximum loan amount
There are two limits. The first one depends on whether the member is on the FundsAtWork Umbrella Provident or
Pension Fund.
On the FundsAtWork Umbrella Provident Fund, 64% of the withdrawal benefit at the time of applying for the home
loan.
On the FundsAtWork Umbrella Pension Fund:
•
•
64% of a 1/3rd of the member’s withdrawal benefit (effectively 21% of the full withdrawal benefit) at the time of
applying for the home loan if the member is 50 years or older.
64% of the member’s withdrawal benefit at the time of applying for the home loan if the member is younger than
50 years.
The second limit is the amount that the member can afford to pay every month. This can be up to 25% of monthly
salary or wages after deductions. Standard Bank / FNB will check whether a member can afford to take out the
loan or not. The banks will also perform ITC credit checks.
The main rules
•
Credit life insurance is available.
•
The maximum time to repay the loan is 20 years or up to normal retirement age, whichever comes first.
•
The interest rate on the loan is linked to FNB’s or Standard Bank’s prime lending rate, which can go up and
down.
•
If the interest rate goes up, then the time to repay the loan will be increased unless the member is close to
retirement.
•
There are procedures in place to confirm that the loan will be used for housing purposes. The bank can check
what the loan has been used for.
•
When taking out a housing loan, the amount of the member’s retirement savings account, equal to the initial
value of the housing loan, plus tax, will be invested in the Trustee Choice Portfolio (currently investing in
Momentum Enhanced Factor 3). This amount remains in the Trustees Choice Portfolio for the duration of the
loan. As the loan is repaid the member has access to a second loan (after three payments) as long as
payments are not in arrears and the bank requirements are met. When the loan is repaid and the Fund receives
confirmation from the bank then the portion of the retirement savings account that was invested in the Trustee
Choice Portfolio will be invested in the same investment portfolio/s as the member’s future contribution
investments.
•
The minimum loan amount the member can apply for is R5 000.
•
The minimum monthly loan repayment is R100 for FNB and R200 for Standard Bank.
Multiply
Multiply, Momentum’s wellness and rewards programme helps members understand, track and improve their
wellness. Multiply rewards the members for participating in activities that promote their financial, physical and
lifestyle wellness; they can get fantastic discounts on Momentum products and on products and services from a
range of their partners.
Members can earn points as they participate in the Multiply programme and reach their financial and physical
wellness goals. The number of points determines their status.
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May 2015
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FundsAtWork members who join Multiply get points allocated based on their FundsAtWork membership:
For every R5 in
recurring contributions
or R1 000 Fund value
– both employer and
employee
Members receive their
retirement savings
account balance
electronically via SMS
or email
Review investment
portfolios or switch
investments online (if
applicable)
Use of FlexiCovers to
increase or decrease
insurance cover online
(if applicable)
Check beneficiary
nomination form
Event / Conditions
Points per event
Once a month
Variable per month:
Single membership:
max 250 per month,
Family membership:
max 500 per month
Single
membership
points limit
3 000
Once per year
Family
membership
points limit
6 000
6 000 for all
Momentum
products
Twice a year
400
800
800
Once a year for any
benefit
800
800
800
Only if completed for the
first time or if verified that
it is still correct. Once a
year
800
800
800
FundsAtWork Multiply benefit
As an employer, having a healthier workforce will assist to enhance your financial wellness. One of the factors
which impacts on your financial wellness and ultimately your bottom line is the productivity of your employees.
While you don’t have control over the changes in the economic conditions which may affect your business, you can
influence and improve the productivity levels of your employees.
FundsAtWork and Multiply have found a new way to reward members financially for their physical wellness by
introducing the Healthy Heart Score. This is another preventative measure that brings members even more
rewards. The Healthy Heart Score gives your employees an indication of how healthy their heart is. In addition to
being a pathway to more rewards for FundsAtWork members, it can also lead to steps being taken to improve their
health, which will in turn lead to increased productivity.
The FundsAtWork Multiply benefit is a reward which is paid into either the member’s retirement savings account,
Momentum Health HealthSaver account, or Pick n Pay smart shopper card linked to their Multiply membership. It
enables the member to boost their benefits and improve their financial wellness and yours. The more a member
improves their physical health, the more they will boost their benefits.
Please refer to the FundsAtWork Multiply benefit brochure for more information.
Cell phone and email notification to members
Part of the communication policy that the trustees have approved refers to cell phone and email notification to
members. This supports the education initiatives we have put in place for the members. Notifications are sent to
members based on events such as switches and claims.
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Your FundsAtWork quote
Note to the financial adviser
If this quote is accepted and the scheme is installed with Momentum the financial adviser will be required to furnish
Momentum with proof that they are accredited by the Financial Services Board in terms of section 7(3) of the
Financial Advisory and Intermediary Services Act, 2002 to give advice in respect of a particular product category.
Validity
This quote is valid for 90 days from the date of issue and is subject to Momentum’s standard terms, conditions and
assumptions.
Details and information provided
This quote is based on the information provided by the employer and on an expected spread of occupations. The
figures may differ if the information is different or if occupational hazards exist which were not declared for this
quote. In addition, the quote excludes members in instances where they are past the cover termination age.
Staff data must be forwarded to Momentum at commencement of cover for insurance benefits, where applicable. If
this is not forthcoming, insurance cover will cease.
Conditions for entry
•
The employer will perform the monthly contribution and claim processes via the employer portal.
•
Contributions and insurance premiums must be paid by an “automatic fund transfer“. This means that
Momentum collects the premiums after the employer has confirmed the amount on the employer portal.
•
This quote is only valid for groups of 5 to 15 members. Any scheme profile is acceptable as long as the
minimum requirements with regard to minimum membership and minimum contribution amounts apply.
•
At member level, 20% of the total contribution (i.e. employer and member) subject to a minimum of 5% of salary
must be allocated to retirement benefits. This is required in order to ensure a minimum allocation towards
retirement funding.
•
Each employer under the FundsAtWork Umbrella Fund has to form an advisory body. The advisory body will
consist of at least 2 members. The members have the right to elect at least 50% of the members of the advisory
body.
•
If the employer belongs to an industry which requires them to get an exemption from the industry or bargaining
council fund before they participate in the FundsAtWork Umbrella Fund, then this exemption must be provided
with the installation documents. If the proof of exemption is not provided then Momentum will not accept the
scheme.
Momentum reserves the right to make a final decision regarding the acceptance of any scheme and may impose
additional requirements to the above from time to time.
Rate guarantee
The rates used to calculate premiums are guaranteed for a minimum of 12 months from the commencement date.
After that Momentum may alter the premium rates on giving the policyholder one month’s written notice.
Momentum’s rates and fees are renewed annually on 1 July. Momentum will advise the financial adviser and the
employer accordingly.
Maximum cover
Momentum from time to time determines a maximum rand amount for the insurance policies. No evidence of health
and insurability is required for an amount of cover less than or equal to the maximum benefit rand amount.
Acceptance of quote
If this quote is accepted and a new scheme is installed, acceptance by Momentum will be subject to our conditions
of entry and compliance with our standard new business procedures.
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Members currently receiving disability income benefits
No allowance has been made for members currently receiving a disability income benefit to be covered for any
benefits under this quote.
If there are any members that need to be included please provide the following details:
•
•
•
•
•
•
name;
date of birth;
sex;
salary;
cause of disability; and
date of disability.
Momentum will confirm acceptance of cover in writing.
Policy details
Investment policies are fund policies issued to the Umbrella Fund. Policies for insurance benefits are issued to the
employer.
Replacement caution
If any new policy is entered into in order to replace another policy, various potential detrimental consequences may
arise, which should have been disclosed to the employer by the financial adviser concerned.
Right to cancel policy
Subject to any restriction imposed by the Income Tax Act, the policyholder may cancel the insurance transaction
and Momentum will refund all premiums paid in respect of the transaction, within 30 days of receipt of the policy
summary where applicable. However, the policyholder may not cancel the transaction if a benefit has been paid or
claimed or an insured event has already occurred.
Where applicable, Momentum will deduct any investment charges incurred in respect of the policy and adjust the
premium to take into account any negative investment experience from the time the policy was concluded until the
time of the refund of the premium.
Additionally, Momentum reserves the right to deduct reasonable time-based fees where work over-and-above the
standard has been done.
Administration
Installation requirements
On acceptance of the quotation the employer must provide the following information to Momentum:
•
Company name, registered address, and contact details. All communication from Momentum to the employer
will be sent to the email address provided. No communication will be sent via the post.
•
Name of authorised person and employer portal super-user, as well as their contact details.
•
Details of the financial adviser appointed to the scheme (if applicable).
•
Company bank account details for the purpose of collecting the contributions and premiums.
•
Advisory body details.
The employer must also provide copies of the following documents to Momentum before the installation date:
•
Acceptance of quotation and installation document; completed and signed by the managing director or financial
director or authorised signatory.
•
The managing director or financial director or authorised signatory or employer portal super-user is required to
complete the form entitled MEB085-Employer portal authorisation form.
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•
The managing director or financial director or authorised signatory and advisory body representatives are
required to complete the form entitled MEB084-FundsAtWork Umbrella Funds Advisory body change of details
form.
•
Copy of the employer’s letterhead showing the registered name of the employer, registration number and the
directors.
•
Financial adviser (key individual) accreditation from FSB website, showing relevant FSP licence categories.
The employer will be required to capture the member data on the employer portal before the payment of the first
contribution and premium. The cell phone number and email address provided for each member will be used for all
communication from Momentum to the member.
Minimum disclosure requirements in terms of Pension Funds Circular 86
All new employees joining a retirement fund must be given an explanatory booklet or pamphlet within three
months of joining. Existing members must be given a benefit statement containing the following minimum
information:•
•
•
•
•
•
•
•
•
•
•
The name of the fund and its registered address
Details of the contact person for queries
Fund reference number with the FSB
Names of trustees
Member’s name and personal details such as date of birth, pensionable salary and date of admission
Date of statement
Date of calculation of benefits
Current contribution paid by member and frequency
Current contribution paid by employer and frequency
A statement of benefits payable on normal retirement, death, disability, ill health early retirement,
withdrawal
Statements to the effect that:
o fund documents can be inspected at the registered office of the fund or at the employer and copies
can be obtained at a cost
o if the benefit statement conflicts with the rules, the rules will prevail
o procedure for internal dispute resolution and access to the Pension Funds Adjudicator
o it is important to obtain professional advice before electing benefits on cessation of membership
o benefits are subject to tax
o a note stressing the importance of updated beneficiary nominations
Members must be notified of specific events such as conversions of status of the fund, any transfers in
terms of section 14 of the Act, restructuring of the fund.
Transfers
A lump sum to which the member has become entitled on withdrawal from another approved pension or provident
fund prior to joining this Fund may be transferred to the Fund.
Claims procedure
The employer must submit withdrawal and all other claims via the employer portal. The relevant documentation can
then follow.
Momentum’s claim forms must be submitted to Momentum within the timeframes set out in the policy. Copies of
official documents, for example death certificates, identity documents etc are to be certified by a commissioner of
oaths. Only original medical reports will be accepted. Forms and accompanying documentation may be faxed.
Payment of contributions
It is the employer's responsibility to ensure that Momentum receives the contributions not later than seven days
after the end of the month for which the contributions are due. The contributions must be cleared in Momentum’s
bank account within the seven day period so that Momentum can invest the money on behalf of the members. The
employer must ensure that they “confirm” the contribution in advance on the employer portal so that the cleared
funds are in Momentum’s bank account by the seventh day. Failure to pay on time will result in the employer
becoming liable for interest on the amount that is unpaid at the due date.
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The principal officer of the Fund or any other authorised person will monitor and ensure compliance with section
13A of the Pension Funds Act. This monitoring person has to submit reports to certain persons, in the manner and
format prescribed.
The Pension Funds Act imposes personal liability on certain parties within the employer’s organisation to ensure
the timeous deduction and payment of the contributions.
•
For companies: Every director who is regularly involved in the management of the company’s overall
financial affairs can be held liable.
•
For close corporations: Every member who controls or is regularly involved in the close corporation‘s
overall financial affairs can be held liable.
•
For other employers: Every person according to whose directions or instructions the governing body or
structure of the employer acts, or who controls or is regularly involved in the management of the
employer’s overall financial affairs can be held liable.
The employer must provide the Fund with the details of the person who could be held personally liable. If the
employer fails to give this information to the Fund, all the parties listed above will be held personally liable.
This means that any person falling into any one of the above categories is legally responsible and
accountable for ensuring that both the employer and member contributions are paid to the Fund within
required timeframes.
Payment of premiums
Premiums in respect of insurance policies are due on the last day of the month. The total premium must be paid to
Momentum monthly in arrears. A period of grace of 30 days is allowed for the payment of premiums. If the full
amount of premiums due is not received by Momentum within the period of grace, all cover will automatically cease
from the last date of the month in respect of which the full amount of premiums were paid, unless it is agreed
otherwise by Momentum in writing. Interest will be charged on the overdue premium at the most recent call interest
rate charged by First National Bank for the period from the expiry of the period of grace to the date of payment of
the overdue premium.
Scheme anniversary month
Benefit statements will be issued at least annually on the scheme’s anniversary. The premiums for the insurance
benefits and the fees are reviewed in July of each year.
Employer portal
The employer controls all aspects of the monthly contribution and claim processes via the employer portal. The
employer can add members, transfer members between branches and inform Momentum when members leave
service. If a member wishes to take the withdrawal benefit in cash, Momentum will pay the member on the first day
after leaving their current employer if notification occurred in time and the member has no tax problems.
Momentum is the first retirement fund in South Africa able to make such a speedy payment.
If the financial adviser is acting on behalf of the employer then the financial adviser will be able to perform all of the
above.
Employer portal access
The employer portal enables each employer to control the monthly contribution, exit and claim processes.
The employer will be able to, amongst others, add new members, transfer members between branches, inform
Momentum when members leave and provide Momentum with the necessary automatic fund transfer instruction
each month.
Online or telephonic employer portal website training will be provided by Momentum for all users that have access
to make data changes and confirm payments or authorise payments and withdrawals. The online training process
allows Momentum to visually and verbally conduct training by using internet technology while not actually being in
the employer’s office.
The designated employer portal super-user of the employer will authorise the level of access that each user will
have and also indicate which pay point the user must have access to (where employers have more than one pay
point). There are four levels of access on the employer portal namely super-user, all changes, view only and 2nd
authoriser.
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•
Super-user: Required to notify Momentum if there are any changes to the level of access required for employer
portal users, if new users must be added or any users must be removed. The super-user will also be able to
update membership, confirmation of contributions / insurance premiums and claims.
•
All changes: Updating membership, confirmation of contributions / insurance premiums and claims.
•
View only: Request statements / reports.
•
2nd authoriser: Authorising claims loaded and / or contributions / insurance premiums. The 2nd authoriser will
not be able to make changes to the membership on the website and can’t be the same user as the person that
nd
made the changes. The 2 authoriser role is not a compulsory role, but is advisable for the employer’s risk
management.
The designated signatory is responsible to notify Momentum in writing if there are any changes to the level of
access required or to the people access must be provided to. This includes notification if any user’s access needs
to be removed.
The managing director or financial director of the employer and the employer portal super-user will be considered a
designated signatory of the employer for the purpose of authorising employer portal access. Alternatively the
managing director or financial director may appoint an authorised signatory for this purpose.
The designated signatory of the employer is required to specify a contact person for each pay point, which will be
loaded as the pay point contact on Momentum’s records and Momentum will then send reminders and
communication to this person each month regarding their contributions and premium payments. The employer must
ensure that the email address provided for the contact person is secure as confidential information will be sent to
this address. Reminders will be sent to the pay point contact person via email if no authorised user has confirmed
the employer portal in respect of the monthly reconciliation process by the reminder date (5 days before the
contribution collection date).
Employer portal terms and conditions for use
•
Access codes
The authorised user will be provided with login details (Username and User ID). They will then set up a Pin. The
login details and the Pin access details have to be treated as confidential. If the login details and / or the Pin are
shared with any other person or compromised in any way, Momentum will not be held responsible for any
unauthorised use.
•
Instructions
The authorised user is responsible for providing correct information and instructions when conducting
transactions via the employer portal and is required to hold all information viewed on the website as
confidential. All transactions and changes will automatically be updated after submission. The authorized user
must therefore ensure that all information and instructions are correct before submission. Momentum will try to
assist if notified of an incorrect instruction submitted, but will not be held responsible for any loss or damage
caused by the error.
•
Transaction options
Add employee
This function is used to capture and submit the names and personal details of eligible employees joining the
scheme. On submission, Momentum will automatically create the new member records and will expect
contributions to be paid in terms of the participating employer’s special rules and Section 13A of the Pension
Funds Act.
Update employee details
This function is used to update current monthly salaries and personal details. Once submitted, Momentum will
automatically update the selected members’ records and adjusted premiums or contributions will immediately
be reflected.
Voluntary contributions
This function is used to add or change the selected members’ voluntary contributions. Once submitted,
Momentum will automatically update the selected members’ records and payment will be collected with the
employer’s automatic fund transfer.
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Break in service
This function is used to add, update or remove a member during a break in service. The user will indicate
whether the member will be covered with or without insurance benefits during the break in service period.
Administration and commission costs will always be payable even if the member is on a break in service. Once
submitted, Momentum will automatically update the selected members’ records.
Confirm contributions
This function is used for the verification of the data that is submitted and the confirmation of contributions due
for a specific reconciliation month. By confirming the contributions, Momentum is authorised to process the
investments and collect the authorised automatic fund transfer, for the confirmed amount, from the bank
account that Momentum has been instructed to use for this purpose or expect an electronic fund transfer (EFT).
An EFT is only available if the monthly amount paid is more than R500 000 and multiple pay points can’t be
accommodated. Once confirmed successfully, Momentum will deem this as an instruction to continue with the
automatic fund transfer on the agreed upon date or where this date has passed on the day of, or after
submission of the contributions or premiums. Deductions will be done on the 1st of the following month.
Late payment interest
Contributions are paid monthly in arrears. Momentum must receive the contribution amount not later than seven
days after the end of the month for which the contributions are payable. The employer will be charged the
legislated late payment interest if the contributions are not received by Momentum within the seven day period.
To avoid this the employer must submit the “confirm contributions” screen on the employer portal a day before
the automatic fund transfer date or the last working day before, if the due date for payment falls on a public
holiday or Sunday. If paying by EFT the employer has to ensure that the contributions are in Momentum’s bank
account by the 7th day of the month following the end of the month for which contributions are due. This is a
requirement of the Pension Funds Act and the Regulations to the Pension Funds Act.
2nd authoriser facility on claims and confirm contributions (if applicable)
This facility is not compulsory for a scheme. Where it is used, Momentum will only notify and continue with the
disinvestment of a claim after the 2nd authoriser has logged on and approved each claim. Where the 2nd
authoriser facility is used for confirming contributions, the contributions and or insurance premiums will not be
finalised until the 2nd authoriser has logged onto the system and submitted and confirmed the confirm
contributions screen successfully. Momentum will not proceed with the automatic fund transfer until this has
been completed.
Claims - Withdrawal or retrenchment claims
These functions will be used to submit withdrawal or retrenchment claims. The designated employer portal user
will verify the withdrawing or retrenched members’ personal and banking details. The employer must confirm
the last working day and contribution amount due for the member for the month, and thereafter approve the
claim. Momentum is then authorised to notify the claim and automatically disinvest and process the withdrawal
or retrenchment claim.
If an instruction is given to pay the benefit to the member, payment will be made to the bank account of the
member verified by the employer on the employer portal website. If the information is incorrect the employer
must obtain proof of updated details and update the member information on the website before submitting the
claim. Momentum will not be liable for payment to the incorrect banking account been provided by the
employer.
Claims - Notifying of other claims (retirement, death, disability, funeral etc.)
This function will be used to notify Momentum of other claims to be processed. The corresponding claim forms
must be completed and submitted together with supporting documentation. Once received, these claims will be
manually processed and not via the automated system.
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Definitions and standard terms and conditions
Dependants
Dependants are the spouses and children of the member. A spouse is defined under the section called “Eligible
spouse”. Children are the natural or legally adopted children of the member and spouse.
The term child refers to:
•
a natural or legally adopted child of the member and / or the member’s spouse, up to the age of 21 if the child is
unmarried or up to the age of 25 if studying full time at a recognised educational institution or is incapable of
earning an income because of a mental or physical defect;
•
a stillborn child - a stillbirth is deemed to have occurred when a foetus dies after the 26 week of pregnancy, but
before delivery.
th
Eligible spouse
Spouse means the person with whom the member has entered into a union, which is recognised by Momentum as
a marriage in accordance with any law or custom, and includes the following:
•
a customary marriage concluded in accordance with customary law;
•
a union recognised as a marriage under the tenets of any Asiatic religion;
•
a permanent life partnership, provided that Momentum receives satisfactory proof that a permanent life
partnership had been established in which the partners to such relationship had been living together for at least
the last 6 months.
Permanent health insurance
During the initial period, a member will be regarded as disabled and entitled to their benefit from the expiry of the
waiting period if, in the reasonable opinion of Momentum, injury or illness has rendered them totally incapable of
engaging either in their own occupation with their own employer, or their own occupation with any employer, or
their own occupation or any alternative occupation with any employer, as indicated in the quote.
After the expiry of the initial period, Momentum will be entitled to assess whether or not the claimant is then
capable of engaging in an alternative occupation with any employer. If Momentum, on the basis of objective
medical evidence, regards the claimant as capable of engaging in an alternative occupation, whether or not the
claimant is able to obtain employment in such alternative occupation, the benefit will be reduced and the following
formula will apply:
(Previous earnings – Current earnings)
Current benefit
x
Previous earnings
At any stage after the payment of the benefit has started, Momentum will be entitled to re-assess the claimant.
Lump sum disability
A member will qualify for a benefit if they suffer from total and permanent disability. Total and permanent disability
is defined as:
•
the total, permanent and continuous inability, in the opinion of Momentum, of a member due to injury or illness
to engage for remuneration or profit in their own occupation or any other occupation to which they are suited or
for which they are or could reasonably be expected to become qualified by virtue of their knowledge, training,
education, ability and experience; or
•
the total, permanent and continuous inability, in the opinion of Momentum, of a member due to injury or illness
to engage for remuneration or profit in any occupation whatsoever, or the permanent impairment of a member's
mental or physical condition to such an extent that they are unable to attend to their normal bodily functions; or
•
the permanent loss by a member of the use of two limbs or the sight in both eyes or the loss of use of one limb
and the sight in one eye.
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Actively at work
The member must be at work, able to attend to all their normal duties on the first working day that their cover is
supposed to start. If they are not at work, the start of their cover will be delayed until they give us proof of their
good health or complete 8 weeks of uninterrupted service without absence from employment. This provision also
applies if a member’s cover increases because their benefit structure changed or because of a salary increase
We will not apply this actively at work clause in the following situations:
•
•
•
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if the start day of the cover or the increased cover falls on a public holiday or a weekend;
if the member is on leave, for example annual leave, maternity leave, family responsibility leave or study leave;
if the member is given permission to work off site, for example if they work from home, or
if the member gets a disability income and we agree to cover them under this policy.
Temporary absence
At the discretion of the employer the service of a member may be extended to include any period of temporary
absence from active, full time employment. After 12 consecutive months’ absence, all for the member will
automatically terminate. A member's insurance salary can’t be increased during the period of temporary absence.
Eligibility
All eligible employees must be insured as members under the scheme. The cover in respect of a member will,
subject to compliance with “actively at work” and “temporary absence” requirements, start on their entry date.
Where an employee becomes a member by the waiving of any eligibility condition, then the cover for such member
will not start until Momentum has agreed in writing.
Medical expenses
The employer will pay for the initial information and assessments required by Momentum in order to adequately
assess a disability or a dread disease claim.
Pre-existing conditions
Disability benefits
Momentum will not pay a benefit if the member has a pre-exiting condition. A member will be regarded as having a
pre-existing condition if, during the first 12 months following their entry date, in the opinion of Momentum, the
member is disabled as a result of any injury, illness or condition which the member knew about, or could
reasonably be expected to have known about or was diagnosed with or was treated for, or displayed symptoms of
within the 6 months before the member’s entry date.
Dread disease benefits
A dread disease benefit will not be paid if, during the first 24 months following the member's entry date, in the
opinion of Momentum, the dread disease occurred as a result of a condition which the member knew about, or
could reasonably be expected to have known about or was diagnosed with or was treated for, or displayed
symptoms of within the 12 months prior to their entry date.
Group life cover
No benefit will be paid if the member dies due to natural causes during the first 6 months of their membership, if
their death is the result of an injury or illness for which they received medical treatment in the 6-month period
preceding the commencement of their membership.
When a claim will not be paid (all insurance benefits)
If it is specified in the policy schedule that the pre-existing exclusion will apply, we will not pay a benefit if the
member dies due to natural causes during the first 6 months of their membership, if their death is the result of an
injury or illness for which they received medical treatment in the 6-month period before their membership started.
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We will not pay any benefit if a claim arises totally or partly, directly or indirectly out of:
•
the member actively participating in war, invasion, acts of foreign enemies, hostilities, warlike operations
(whether war is declared or not), civil war, military uprising, insurrection, rebellion, revolution, military or
usurped power, martial law, mutiny or riot or civil commotion assuming the proportions of or amounting to a
popular uprising;
•
active participation in acts of terrorism or action taken in controlling, preventing, suppressing or in any way
relating to any act of terrorism, regardless of any other cause or event contributing concurrently or in any other
sequence of the loss. In this policy terrorism means an act or the threat of an act or any preparation for an act:
o which may or may not involve violence or the use of force by any person or group (whether they are acting
alone or on behalf of or in connection with any organisation, regime or any constitutional or practicing
government);
o that is or appears to be intended to intimidate, harm or influence any government, the public, a section of
the public or to disrupt any segment of the economy, and
o that from its nature or context is or appears to be done in connection with political, social, religious,
ideological or similar cause or objectives, or
•
any nuclear reaction or nuclear radiation.
Accident cover during the medical evidence period
In addition to the above exclusions, Momentum we will also not pay the accident cover during the medical evidence
period if the claim is related to the member participating in any type of flying anywhere in any capacity, except if
they travel as a passenger only for the purpose of transport:
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in a registered passenger aircraft owned and operated by a licensed airline or air-transport company and flown
by a pilot holding a commercial pilot’s licence on a recognised route between licensed airfields, or
•
in a military passenger aircraft from one airfield to another, or
•
causing or arranging their own death, even if unintentionally.
Additional exclusions applicable to disability benefits
If a member needs to have a valid pilot’s license because of their employment, they will only qualify for a benefit if
their disability makes them totally unable to work in any other occupation to earn an income.
Where more than 15% of the members are full-time drivers and the member needs to have a valid driver’s license
because of them occupation, Momentum will not consider a disability claim unless the member’s disability makes
them totally incapable of working in any occupation to earn an income.
Maximums for all insurance benefits
The maximum benefit (including the employer’s waiver) will increase automatically from time to time unless the
employer informs Momentum to the contrary.
Cover of previous dread disease claimant
A member who previously received a dread disease benefit will not be covered unless Momentum agrees to it.
Reduced benefit due to other disability benefit payments
Momentum will limit any benefit paid in respect of a claimant who is in receipt of additional income disability
payments in order to limit over insurance.
Option to continue cover in the event of a disability claim
Where this option is specified in the quote, if the member gets an income disability benefit from an income disability
benefit policy that was arranged by the employer, the member will be seen as still being in the employer’s service.
The member’s lump sum death benefit will, subject to the other provisions of the policy, still be paid if they die
before the last day of the month in which they reach the termination age as specified in the schedule, their 65th
birthday or them receiving a withdrawal or retirement benefit from the retirement fund in which the employer
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participates, or, where the employer does not participate in a retirement fund, their early retirement or withdrawal
from employment, whichever happens first.
Combination of lump sum disability and income disability benefits
Unexpected expenses accumulate when a member becomes disabled. Replacing their salary with an income
disability benefit might not be enough to meet the member’s needs.
For this reason the employer can combine the permanent health insurance benefit (PHI) with the lump sum
disability benefit (PTD) for the same group of members to achieve the following:
•
If a member becomes disabled and after the expiry of the waiting period, a monthly income is paid while the
member remains disabled, up to the benefit maximums specified for PHI.
•
The income benefit will cease if the member recovers or reach the lower of the termination age for the benefit,
the employer’s normal retirement age and age 65, subject to certain additional terms and conditions specified
for PHI.
•
A lump sum benefit will be paid if, after the expiry of the waiting period of up to 6 months, the member is found
to be totally and permanently disabled.
Continuous assurance option (CAO)
CAO gives FundsAtWork members the opportunity to take out individual risk benefits that are similar to their group
insurance benefits with Momentum Myriad when they leave their employer.
These benefits are available without any medical underwriting except for a cotinine test.
Availability of CAO
CAO is provided automatically for Umbrella Fund schemes with insurance benefits and available as an option for
insurance only schemes.
Level of cover
•
The level of cover available to members under the individual policy must be equal to or less than that provided
under their group policy.
•
If a member has Life Eventing group life cover and lump sum disability then the lowest sum assured will be
used for the amount of cover under the individual policies.
Maximum ages a member can take up CAO
•
•
•
The member has 90 days from leaving the Umbrella Fund to take up the CAO.
Continuation of the group life cover benefit can occur at any time before normal retirement age.
Continuation of all other eligible benefits can occur up to 5 years before normal retirement age.
CAO is not available when
•
•
A member has been classified as disabled under the lump sum disability benefit.
Termination of the scheme with FundsAtWork
Matching of group benefits to individual benefits:
Group policy
Group life cover
Individual policy
Death benefit
Notes
The member decides on the term of
the benefit
Lump sum disability
Own occupation disability benefit
Own occupation disability definition
is used
Permanent health insurance
Income protector
Dread disease
Comprehensive critical illness benefit
Escalation rate will be closest match
to 0%, 5%, 7.5% or 10%
Members on both the essential and
inclusive benefit are issued with the
comprehensive critical illness benefit
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The following applies to all the individual policies
•
•
•
•
•
The level of cover is converted from a multiple or percentage of salary to a rand amount.
The level of cover remains fixed for the whole term.
Members who take up CAO will not be eligible for the Myriad Interactive benefit.
No other features that exist on the individual policy will be added when the member exercises the CAO option if
the member was not entitled to them in the group policy.
Members will get cover under the Myriad terms and conditions.
Minimum age
There is no minimum age for participation in the Umbrella Fund, except for the legislated restriction placed on
employment of a minor (i.e. the minimum age to be employed, currently 15 years of age).
Maximum age
There is no maximum age for entry into the Umbrella Fund. The maximum age for a new entrant for insurance
benefits is 64 attained. When an existing scheme is taken over, members aged above 65 will be allowed to enter,
but they will not be covered for insurance benefits.
When a member’s cover will end
A member’s cover for insurance benefits will end at the earlier of the employer’s normal retirement age or the last
day of the month in which they attain age 65. If elected by the employer, lump sum death benefit can be extended
to age 70 where the member remains in service.
For the purpose of disability benefits, the termination age is subject to a maximum of the employer’s normal
retirement age and age 65, whichever is lower.
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Standard industry policy definitions for certain dread disease conditions
From 1 September 2009 Momentum has been following an industry standard of assessing certain dread disease
(critical illness) events, to ensure that consistent and objective claims decisions are made.
The former Life Offices Association (LOA), whose members are now part of ASISA (Association for Savings &
Investment SA), set up SCIDEP (Standardised Critical Illness Definitions Project) to derive a set of standard
industry definitions.
The standard definitions apply to the following four “core” diseases, which make up between 70% and 90% of all
dread disease claims:
•
•
•
•
heart attack
cancer
stroke
coronary artery bypass graft (CABG).
All other conditions not listed above will be assessed in terms of Momentum’s standard policy definitions and terms.
In order to provide greater transparency in terms of how the above dread disease events will be assessed, ASISA
has provided a set of ‘Layman’s’ definitions to be provided to policyholders at quote stage, and a Disclosure Grid
setting out the percentages which an insurer will pay out, depending on the severity levels of the dread disease
event. The Layman’s definitions and the Disclosure Grid are set out below. Please note that the definitions are
more comprehensively defined in the policy, and should there be any discrepancy between the Layman’s
definitions and the policy conditions, the provisions of the policy will apply.
Heart attack - Layman’s description
Four levels of severity of heart attacks are defined:
•
•
•
•
Level D is the mildest and Level A the most severe.
In both levels C and D the patient recovers fully and the heart function returns to normal.
In levels A and B, more permanent damage has resulted, which means the heart function is less than 100%
after recovery.
The effect of the heart attack on heart function should be measured 6 weeks after the heart attack.
Level A: Heart attack severe impairment in function
These are heart attacks where a significant proportion of the heart muscle was damaged. The same tests are used
to measure the damage as under Level B but the results would show a more serious level of impaired function.
This person will have difficulty coping with normal activities of daily living, and will most likely not be able to work.
Level B: Heart attack with mild permanent impairment in function
This is usually a heart attack that does not recover 100% of normal function. The degree of permanent damage can
be measured by a heart sonar, an exercise tolerance test or a measurement of physical abilities. These
measurements should be performed 6 weeks after the heart attack.
A person with this level of heart damage should still be able to manage normal daily activities and even their
occupation, if the occupation does not involve strenuous physical work. However, this person’s insurability will be
adversely affected, and the future risk for a repeat cardiac event is high. Significant lifestyle adaptation and risk
factor modification are indicated.
Level C: Moderate heart attack of specified severity
In this case damage to the heart muscle is more than in Level D. In some cases a cardiologist will intervene early
and reverse the potential damage. This intervention may include administration of drugs to dissolve the blood clot
in the coronary artery/ies, balloon stretching of the coronary artery, with or without a stent.
Because the clinical methods of diagnosing this level of heart attack are unambiguous, only two of the three criteria
are required:
•
•
•
Typical chest pain or other symptoms typically associated with a heart attack.
Certain defined ECG changes. At this level the changes are more marked and more specific to a heart attack.
Elevated blood test results greater than required for Level D.
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Level D: Mild heart attack with full recovery
This is a heart attack where the ECG changes and blood test results are mildly abnormal. Therefore, all three
criteria are required, i.e.:
•
•
•
Typical chest pain or other symptoms associated with a heart attack.
Certain defined ECG changes.
An elevation in certain blood test results.
Cancer - Layman’s description
Cancer is an uncontrolled growth that spreads into the normal tissue surrounding the organ where the cancer
originates. The diagnosis must be supported by tests where a pathologist confirms the presence of cancer cells
using a microscope. Some cancers have been specifically excluded because:
•
•
The long term outcome is good and the effect on quality of life is minimal; and
Treatment is neither expensive nor extensive.
There are specific exclusions to this definition that include:
•
•
•
Cancerous cells that have not invaded the surrounding or underlying tissue.
Early cancer of the prostate gland and breast.
All cancers of the skin except cancerous moles that have invaded underlying tissue.
Staging of cancer
As a general rule there are four stages of cancer. Stage 1 cancer is defined by an invasive cancer confined to the
tissue or organ of origin. Stage 2 cancer is defined by the involvement of adjacent structures or organs. Stage 3
cancer involves spreading to regional lymph nodes. Stage 4 cancer is characterised by distant metastasis.
However, each type of cancer is staged specifically by the American Joint Committee for Cancer (AJCC). This
staging is based on the outcome of the specific cancer and does not always follow the general rule as stated
above. In order to standardise staging, ASISA used the AJCC system which is the same system used in clinical
practice by specialists who treat cancer.
Stroke - Layman’s Definition
A stroke occurs when the blood supply to a portion of the brain is obstructed and this part of the brain tissue dies. It
can also happen when there is bleeding into the brain tissue due to a weakening or abnormality of the blood vessel
wall. A common cause of the rupture of a brain blood vessel is longstanding uncontrolled high blood pressure.
The result of a stroke is usually paralysis of an arm and leg, sometimes with one half of the face affected as well. In
some cases people also lose their ability to speak. The paralysis can recover to varying degrees. Some recover
fully, whereas others may retain permanent weakness of a limb/s.
A Transient Ischaemic Attack (TIA) does not cause a stroke. It occurs when the blood supply is momentarily
interrupted, but restored before any permanent damage can occur. It usually results in one or more of the following
symptoms:
•
•
•
•
a loss of sensation;
dizziness;
lameness of a limb; or
loss of speech,
which only occur for a few minutes to hours and recovery is quick and spontaneous.
Coronary artery bypass graft (CABG) - Layman’s definition
Coronary artery bypass graft surgery, also called heart bypass or bypass surgery is a surgical procedure performed
to relieve chest pain and reduce the risk of death from heart disease.
Arteries or veins from elsewhere in the patient's body (most commonly the leg) are joined to the coronary arteries
of the heart to bypass the narrowings of the affected or diseased arteries. This improves the blood supply and
circulation to the heart muscle. The terms “single bypass”, “double bypass”, “triple bypass”, “quadruple bypass” and
“quintuple bypass” refer to the number of coronary arteries bypassed in the procedure.
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This surgery is usually performed with the heart stopped, necessitating the usage of highly specialised theatre
equipment to keep the heart and the lungs working during the course of the operation.
The grid below specifies Momentum’s percentage pay outs for each of the defined illnesses:
Dread disease benefit Disclosure Grid as measured against ASISA critical illness definitions
(severity level payments)
SEVERITY LEVEL
DEFINED
ILLNESSES
Heart attack
Coronary artery
bypass graft (CABG)
Stroke
Cancer
100%
B
Moderate
impairment
75%
100%
100%
100%
A
Most severe
Your quote in detail for new schemes with 5 to 15 members
50%
D
Almost full
recovery
50%
50%
50%
50%
50%
100%
50%
100%
10%
50%
C
Mild impairment
May 2015
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Fees and other expenses
Recoupment of costs
The employer will decide on a contribution that will apply to all members. The cost of the insurance benefits,
product fees and broker commission are deducted from the employer contributions.
The balance of the employer contributions is invested on behalf of the members. In the event that the employer
contribution is not sufficient to cover the cost of the insurance benefits, the product fees and commission, these will
be deducted from the member contribution.
Product fees
The product fees include the cost of collecting, allocating and investing contributions received on a monthly basis
from the employer, paying claims and member web access.
No additional fees are levied on the installation of a scheme, on transferring the business of an existing scheme
into the Fund or on termination of an employer’s participation. However, on liquidation of a participating employer,
liquidation fees are charged.
Fund expenses
Fund expenses are charged over and above the product fees. The fund expenses for the year 1 July 2014 to
30 June 2015 are:
Audit fee
FSB levy
Fidelity cover
Trustee fee
FundsAtWork Umbrella
Pension Fund
R0.53
R0.85
R0.06
R0.35
FundsAtWork Umbrella
Provident Fund
R0.33
R0.59
R0.03
R0.37
Valuation fee
Total per member per month
R0.32
R2.11
R0.22
R1.53
The fund expenses for the period 1 July 2015 to 30 June 2016:
Audit fee
FSB levy
Fidelity cover
Trustee fee
FundsAtWork Umbrella
Pension Fund
R0.47
R0.83
R0.00
R0.31
FundsAtWork Umbrella
Provident Fund
R0.21
R0.54
R0.00
R0.25
Valuation fee
Total per member per month
R0.29
R1.90
R0.15
R1.15
Fees for home loans
If the employer wishes to make use of the home loan guarantee facility, an ongoing fee of R17 per month will be
charged to each member who elects to take out a home loan. This excludes the bank’s normal monthly
administration fees.
Fees for Multiply
Members pay a monthly membership fee if they join Multiply. This fee varies in line with the family membership.
The cost is collected from each member’s bank account separately. Please refer to www.momentum.co.za for more
information on the Multiply fees.
Fees for Family Protector
A fee of R6.50 per month is paid for Family Protector BASE.
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Asset management fees
Asset management fees are paid to the asset manager that manages or co-ordinates the investment of the Fund’s
assets. These fees are recouped monthly by redeeming units in each member’s investment portfolio.
The following fees apply:
Portfolio
Momentum Enhanced Factor 3
Annual fee
1.30%
Scheme assets in Momentum Lifestages
Up to R25 million
R25 million to R50 million
R50 million to R100 million
R100 million to R200 million
More than R200 million
Annual fee (from 1 July 2015)
1.50%
1.25%
0.95%
0.85%
Priced per scheme
The scale works on a stepped approach, e.g. if the scheme has R35 million assets, then the fee on all R35 million
will be 1.25%.
VAT is included in the fees shown for the above-mentioned portfolios.
The investment management fees exclude performance fees and the fees for the building blocks that are net priced
(for example the Fund of Hedge Funds, the Fund of Private Equity Funds, Commodities, etc).
Please consult the fund fact sheets on www.momentum.co.za/fundsatwork for information on performance fees that
might apply on some investment portfolios from time to time.
Commission
Commission is subject to the following legislated maximum and may change from time to time:
Annual contribution
First R142 000
Next R103 000
Next R284 000
Next R1 021 000
Above R1 550 000
Percentage
7,50%
5,00%
3,00%
2,00%
1,00%
Please take note of the following:
•
Commission will be quoted as 100% of the legislated maximum scale, on a bundled basis. Unbundled
commission will not be accomodated.
•
Special first year commission may be requested on quotes where the scheme is new to the industry. The
amount is the lesser of 7,5%of the total premium payable during that period of 12 months and R5 000.
•
Commission is recouped monthly through the reconciliation process and then paid to the financial adviser. The
payment may be made annually in advance or as and when the reconciliations are processed, as set out in the
financial adviser’s Momentum broker contract.
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Tax aspects
Normal contributions
Member contributions to a pension fund are tax deductible, to a maximum of 7,5% of the member’s remuneration.
Member contributions to a provident fund are not permitted as a tax deduction, which means that an employee’s
salary is first taxed before contributions to a provident fund are deducted.
Employer contributions to a pension fund, provident fund or benefit fund are tax deductible in terms of section 11(l)
of the Income Tax Act, to a maximum of 10% of an employee’s approved remuneration or such higher amount as
the Commissioner for the South African Revenue Services (SARS) may regard as reasonable and allow. Current
departmental practice by SARS is to allow a deduction of up to 20% of remuneration. This 20% includes
contributions to a benefit fund, which is defined to include any medical scheme registered under the provisions of
the Medical Schemes Act, 1998. Put differently, the employer’s total contribution towards a pension fund, provident
fund and medical scheme is limited to 20% of the employee’s approved remuneration.
Additional voluntary contributions
Additional voluntary contributions (AVCs) are contributions made by either a member or their employer, over and
above the normal contributions, in order to secure additional benefits for the member. This may only be done if the
rules of the fund allow it.
Where a member’s normal contributions and AVCs to a pension fund are less than the allowable 7,5%, both their
normal contributions and AVCs can be claimed as a tax deduction. Any contributions in excess of the 7,5% may
only qualify as a tax deduction upon the member’s withdrawal or retirement from the fund.
Section 11(k)(ii) of the income Tax Act provides for the following deduction: "any sum contributed during the year of
assessment to any pension fund by any person who as a member of such fund, has in terms of the rules governing
such fund undertaken to pay such sum in respect of any past period which is to be reckoned as pensionable
service of that member: Provided that - (aa) the deduction to be allowed in respect of sums so paid shall not in the
year of assessment exceed the sum of R1 800."
This is often understood to mean that a member in a defined contribution pension fund will be entitled to deduct
R1 800 per annum in respect of additional voluntary contributions to that fund. SARS has however confirmed that
‘the R1 800 per annum tax deduction for arrear contributions to a pension fund is available only to the extent that
the member is so contributing pursuant to the purchase of past service in terms of the rules of the fund concerned’.
Accordingly this R1 800 can only be used if it relates to the buyback of past service.
In a provident fund, the same principle as that applying to normal contributions apply in respect of AVCs made by a
member – AVCs are not tax deductible in the year of assessment in which the contributions are made; these
contributions are also made from a member’s after tax salary.
As stated above, employer contributions up to 20% of the employee’s remuneration is tax deductible. In so far as
the employer’s normal contributions and their AVCs to a pension fund, provident fund and medical scheme in
respect of a member is less than the prescribed maximum of 20% of the employee’s approved remuneration, both
the normal contributions and AVCs will qualify as a tax deduction. Contributions in excess of the 20% will not be tax
deductible.
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In summary taxation on contributions and claims are as follows:
Employee:
Section 11(k) of
Income Tax Act
Pension funds
Provident funds
1. Current contributions which are the greater of:
7,5% of remuneration derived from retirement
funding employment, or
R1 750 per annum
No tax relief
2. Contributions for past service up to R1 800 per annum
Employer:
Section 11(l) of
Income Tax Act
On retirement,
retrenchment and
death:
Second Schedule
to Income Tax Act
On withdrawal:
Second Schedule
to Income Tax Act
Total deductible from taxable income
Maximum of 10% of employees’ approved
remuneration in respect of pension and provident
funds and medical aid schemes is deductible on a
cumulative basis
In practice, SARS allows a cumulative deduction up to
20%
Single premiums may be spread over a few years or
deducted as a lump sum
As for pension
From 1 March 2014 these benefits are taxed in accordance with the following table:
Taxable income from lump sum benefits
Not exceeding R500 000
Exceeding R500 000 but not exceeding
R700 000
Exceeding R700 000 but not exceeding
R1 050 000
Exceeding R1 050 000
Rate of tax
0% of taxable income
R0 plus 18% of taxable income
exceeding R500 000
R36 000 plus 27% of taxable
income exceeding R700 000
R130 500 plus 36% of taxable
income exceeding R1 050 000
Retirement benefits will be taxed on an accumulated basis, which means that all
withdrawal benefits received on or after 1 March 2009, retirement benefits received on or
after 1 October 2007 and severance benefits received on or after 1 March 2011 have to
be taken into account in determining the tax payable on a specific retirement benefit.
From 1 March 2014 these benefits are taxed in accordance with the following table:
Taxable income from lump sum benefits
Not exceeding R25 000
Exceeding R25 000 but not exceeding
R660 000
Exceeding R660 000 but not exceeding
R990 000
Exceeding R990 000
Rate of tax
0% of taxable income
18% of taxable income exceeding
R25 000
R114 300 plus 27% of taxable income
exceeding R660 000
R203 400 plus 36% of taxable income
exceeding R990 000
Withdrawal benefits will be taxed on an accumulated basis. This means that all withdrawal
benefits received on or after 1 March 2009, retirement benefits received on or after
1 October 2007 and severance benefits received on or after 1 March 2011 have to be
taken into account in determining the tax payable on a specific withdrawal benefit.
Note:
Annuities (pensions) are taxed as income, at the member’s marginal tax rate.
Provided by the fund (approved) vs standalone (unapproved) insurance benefits and their
taxation
Lump sum disability benefits can be provided by a retirement fund (approved benefits) or by a standalone
(unapproved) group disability scheme.
Disability income benefits are provided under a standalone (unapproved) disability income insurance scheme.
Lump sum death benefit schemes can be approved if they form part of the benefits offered in terms of the rules of
approved pension or provident funds. A standalone (unapproved) lump sum death benefit scheme constitutes a
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May 2015
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contract for the benefit of a third party, i.e. it is a group insurance contract entered into by the employer with an
insurer for the benefit of eligible employees of the employer.
Taxation Laws Amendment Act, 2011 - Taxation of standalone (unapproved) insurance benefits
Changes to the Income Tax Act (ITA) have impacted on the taxation of the premiums and proceeds in respect of an
employer owned standalone (unapproved) policy. The main changes effective 1 March 2012 which impact on
insurance policies issued by Momentum where the benefit is paid to the employer are:
•
•
Employers must ensure that the premiums paid on behalf of an employee are taxed as a fringe benefit in the
employee’s hands.
The employer can then claim a deduction for the premiums in terms of section 11(w)(i) of the ITA.
Lump sum
Employer
Member
Duty of employer
Benefit
Deduction for premiums paid
Premiums taxed as fringe benefit
Include fringe benefit for PAYE
Tax-free – exemption applies
Tax changes to the income disability benefit and the impact on retirement fund contributions
From 1 March 2015, the member will be taxed on the premium paid for an income disability benefit. However, the
premium contributed on their behalf by their employer will not be tax deductible. If they become disabled and claim,
the income disability benefit, when paid out, will not be taxed.
If the member’s retirement fund contributions are paid from their income disability benefit, they will still qualify for a
tax deduction on their contributions. However, because the income disability benefit is paid out tax free, the
member will not be getting the deduction immediately unless they receive other taxable income to which the
deductions could be applied. Currently, if the member has no other taxable income, the qualifying deductions will
be carried forward and will be deducted when the member becomes entitled to a retirement benefit or if a death
benefit becomes payable in respect of the member. Once the member retires and receives a retirement benefit, the
deductions that were carried forward will apply to all the contributions that were not previously deducted before a
tax directive is issued.
The employer is required to reflect the fringe benefit, i.e. the income disability premiums paid on behalf of the
employee on the employee’s tax certificate and IRP5.
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Statutory Disclosure in terms of the Policy Protection Rules (Long-term
Insurance Act) & Financial Advisory and Intermediary Services Act
(the FAIS Act)
1. Details about the product supplier: Corporate and Public Sector Segment
Corporate and Public Sector Segment is a division of MMI Group Limited (registration number:
1904/002186/06) a wholly owned subsidiary of MMI Holdings Limited. MMI Group Limited is registered as a
financial services provider in terms of the FAIS Act (FSP number: 6406) and is authorised to provide financial
services in respect of the financial products specified on its FAIS Licence.
MMI’s contact details are:
Physical address:
Postal address:
Telephone no:
Fax no:
Email address:
Website:
268 West Avenue, Centurion, 0157
P O Box 7400, Centurion, 0046
0860 65 75 85
012 675 3970
[email protected]
www.momentum.co.za
MMI has professional indemnity and fidelity insurance cover but not any guarantees. MMI accepts responsibility
for the actions of its representatives acting within the course and scope of their mandates, in rendering financial
services as defined in the FAIS Act. Our representatives meet the fit and proper requirements as prescribed by
the FAIS Act.
The representatives’ remuneration may partly comprise of commission which is calculated with reference to
the kind of financial product in respect of which financial services was rendered and a performance bonus
which is based on the achievement of sales targets. As employees, representatives also participate in other
employer related incentive schemes.
The representatives may provide financial services in respect of specific MMI products only and/or a variety of
products from other product suppliers when advising a client on solutions to address an identified financial
need.
The FAIS licensed compliance officer is Johnny King who may be contacted at the above postal address, by
telephone on 012 671 8989, by fax on 012 663 7357. The divisional compliance officer is Virgo Abrahams who
can be contacted on 087 742 7603 or by email:[email protected].
The FAIS complaints resolution officer is Lenelle Strohmenger who may also be contacted at the above postal
address, by telephone on 012 673 7838, by fax 086 519 8626 or by email
[email protected]. The divisional complaints officer is Sue du Plessis who may be
contacted on 087 742 9279 or by email [email protected]. All complaints should be in writing
and accompanied by any supporting documents. The complaints resolution procedure can be viewed on the
website.
Any financial services related complaints that remains unresolved or is not resolved satisfactorily may be
referred to the Ombud for Financial Services Providers (“the FAIS Ombud”). The FAIS Ombud’s contact details
can be obtained from www.faisombud.co.za.
If the complaint is product related, the complainant may be referred to the Ombudsman for Long-term Insurance
(“the Ombud”) or the Registrar of Long Term Insurance (“the Registrar”). The Ombud and the Registrar’s
contact details can be obtained from www.ombud.co.za and www.fsb.co.za respectively.
2. Your right to know the impact of the decision you elect to make
The intermediary must provide you with all relevant and appropriate information in plain and understandable
language in order for you to assess whether the product or transaction meets your needs and to assess the
possible impact of the proposed transaction on your finances, your other policies or your broader investment
portfolio.
It is very important that you are quite sure that the product or transaction meets your needs and that you feel
you have all the information you need to make an informed decision. You should also ask for information about
the flexibility of any proposed policy.
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3. Your right when being advised to replace an existing policy
You may not be advised to cancel a policy to enable you to purchase a new policy or amend an existing policy
unless:
a) The intermediary identifies the policy as a replacement policy.
b) The implications of cancellation of the policy are disclosed to you such as the influence on your benefits
under the old policy and the additional costs incurred with the replacement.
c) The insurer that issued the original policy will contact you; you are advised to discuss the matter with its
representative.
4. Your right to be informed by the insurer
The insurer will forward you documentation confirming policy details as discussed in paragraph 3 of this Notice,
which will also include:
a) The name of the insurer.
b) The product being purchased.
c) The cost in Rands of the transaction and specifically:
•
•
•
The loadings, if any;
The initial expense; and
The amount of commission and other remuneration being paid to the intermediary.
d) In the case of policies with an investment element, the ongoing expense and any other fees or charges
payable.
e) The summary in terms of section 48 of the Long-term Insurance Act, 1998.
f) The contact number and address of the complaints and compliance officers of the insurer.
(The insurer may disclose the above Information on a generic basis with additional policyholder specific
disclosure).
5. Your right to cancel the transaction
In most cases, you have a right to cancel a policy in writing within 30 days after receipt of the summary
contemplated in section 48 of the Long Term Insurance Act from the insurer. The same applies to certain
changes you may make to a policy. The insurer is obliged to confirm to you whether you have this right and to
explain how to exercise it.
Please bear in mind that you may not exercise this option if you have already claimed under the policy or if the
event, which the policy insures you against, has already happened. If the policy has an investment component,
you will carry any investment loss.
6. Important warning
Where paper forms are required, it is advisable to sign them only once they are fully completed. Feel free to
make notes regarding verbal information, and to ask for written confirmation or copies of documents.
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Conditions for use
Momentum and the FundsAtWork Umbrella Provident and Pension Funds accept no liability where information in
this document conflicts with the rules of the FundsAtWork Umbrella Provident and Pension Funds. All the rights of
the members are embodied in the rules of the FundsAtWork Umbrella Provident and Pension Funds and the
insurance policies issued to cover insurance benefits.
MMI Group Limited, a wholly owned subsidiary of MMI Holdings Limited, is an authorised financial services
provider (with FSP number 6406) as defined in the Financial Advisory and intermediary Services Act (“FAIS”). The
information included in this document does not constitute advice as defined in FAIS. Any person wishing to rely on
the information should consult an authorised financial services provider in order to do an analysis regarding the
suitability of the financial products described in this document. Every effort was made to ensure that the information
in this document is factually correct and unambiguous. MMI Group Limited will not be held liable for any direct or
indirect loss arising from the use of the information contained in this document.
Copyright
The material contained in this document is the property of Momentum and protected by copyright and intellectual
property laws. The information may not be copied, reproduced, redistributed, displayed or circulated in whole or in
part any form without the express written consent of Momentum.
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