Coordination of benefits model regulation. 7.3.8 CSC shall not accept employee contributions, contributions by an employer or transfer amounts, including those referred to at Rule 2.4.1, for the purpose of them being credited to the non-member spouse interest account. 6.3.5 Where CSC accepts a request to reconsider one of its decisions in relation to PSSAP, CSC, unless under Rule 6.3.4 it has decided in favour of the person seeking reconsideration, must: (a) if CSC has delegated to a Reconsideration Advisory Committee CSCs power to determine the matter, refer the request to the Committee for review and to exercise that power and in that event the Committee must review the decision and determine the matter in accordance with the delegated power by: (b) itself review the decision and decide whether to affirm the decision, vary the decision, substitute another decision or set the decision aside, after considering the recommendation of a Reconsideration Advisory Committee, if any, if, at its discretion, it has referred the request to the Committee for review and to make a recommendation in relation to the decision; after first obtaining, if appropriate, the recommendation of an Assessment Panel, and the Committee or CSC, as the case requires, may, at its discretion, refund the fee paid. Inquiries regarding having your site assessed as a part of this program can be made toPSSAP@API.org. 4.2.10 Any amount paid by a life insurance company to CSC in response to a claim against a policy providing supplementary death and invalidity cover must be paid into the PSSAP Fund and is credited to the persons personal accumulation account. Social Security follows English common law that finds that a person attains an age on the day before the . 4.3.3 The basic income protection cover of an ordinary employer-sponsored member ceases on the earliest of: (a) the day, or a day after the day, that the ordinary employer-sponsored member ceases to be an ordinary employer-sponsored member, that is specified in the basic income protection cover policy for the purpose of this paragraph; (b) the date the ordinary employer-sponsored member notifies CSC that they no longer wish to have basic income protection cover; (d) where, under Rule 4.3.6, a premium payable for basic income protection cover has not been paid on the day on which the premium became payable and the terms of the basic income protection cover policy provide for cover to end when premiums cease, the day after the day on which the cover ends due to non-payment of premiums; and. Also, where an ordinary employer-sponsored member ceases to be employed by one designated employer but immediately afterwards becomes an employee of another designated employer, the person does not cease to be an ordinary employer-sponsored member. When You Look For Resources You Find Them, Offshore Seismic Surveys: Safety, Science, and Research, API Occupational Safety and Health Standards, Oil Spill & Emergency Preparedness and Response. You can keep track of birthdays with free birthday templates for calendars or lists. (c) in relation to the adoption of a child by the person. The birthday rule says primary coverage comes from the plan of the parent whose birthday falls first in the year. (b) must be paid directly to the ordinary employer-sponsored member as a non-commutable income stream. 6.4 CSC must determine an investment strategy and policy of the PSSAP Fund as soon as possible after 1July 2005 and thereafter regularly review such a strategy and policy, and, where it considers it necessary or desirable, change its existing investment strategy or policy. 2.2.9 Within one month of the end of each quarter, each designated employer must, in respect of an ordinary employer-sponsored member to whom Rule 2.2.2(b) applies or has applied at any time during the quarter, inform the member and CSC in writing of the total amount of basic employer contributions and additional employer contributions paid to the PSSAP Fund in the quarter expressed: (b) as a percentage of the ordinary time earnings of the ordinary employer-sponsored member for the quarter. Note:This Rule allows employers to make contributions for or on behalf of an employee in addition to any amounts the employer is required to pay as basic employer contributions. The Commonwealth Super Scheme (CSS), the PSS's predecessor, was closed to new members in 1990 when the PSS opened. Retirement benefits can begin the first month a person is age 62 throughout the entire month. But if separate policies are maintained, youll want to make sure you understand how the child will be covered immediately after the birth or adoption, even if you intend to only add the child to one parents policy. The birthday rule is used to determine how coordination of benefits work when a child is covered by both parents' health insurance policies. 1. 7.1.1 Subject to this Part, where an interest in the PSSAP Fund becomes subject to a payment split under the Family Law Act 1975: (a) CSC shall have the same powers and duties in relation to the interest as a trustee has under Part 7A of the SIS Regulations in relation to a relevant accumulation interest; (b) a non-member spouse in relation to the interest has the same rights in relation to benefits connected with the interest as the non-member spouse would have in relation to benefits connected with the interest if Part 7A of the SIS Regulations applied in relation to the interest; and. What Does EPA Say About Water Contamination? AU BNF1 Form Versions. is to be known as the Public Sector Superannuation Accumulation Plan; is for the benefit of persons who will be members of PSSAP; and, (b) establish and vest in the Australian Reward Investment Alliance (formerly known at the PSS Board) established under section 20 of the. (90 Votes) AU BNF1 2018. Applications for roll-over or transfer of benefits. 7.3.1 Subject to the provisions of this Division, CSC may, in creating a non-member spouse interest, determine terms and conditions for the non-member spouse interest. This compilation was prepared on 16 March 2012 taking into account the Sixth Amending Deed 2012, Prepared by the Office of Legislative Drafting and Publishing, Attorney-Generals Department, Canberra, 1. The inquirer asks whether the birthday rule would apply in determining which group plan is primary. Note:Where part of a benefit is paid to a person under Rule 3.1.3 or Rule 3.1.4, the remainder of the benefit must be retained in the personal accumulation account of the PSSAP member or rolled-over or transferred to another superannuation entity. 4.2.3 CSC may allow the ordinary employer-sponsored member to choose the policy providing the supplementary death and invalidity cover if CSC has taken out more than one policy. If a child is covered under both parents health plans, a provision known as the birthday rule comes into play, guiding how the coordination of benefits will work. Figure 1: PSSAP membership, 2011-12 to 2015-16 has the same meaning as in the Income Tax Assessment Act 1997. in relation to an ordinary employer-sponsored member means leave of absence taken: (a) in relation to the birth of a child of the person; or, (b) because the persons pregnancy ended for reasons other than birth; or. The Compass platform provides organization-wide access to all the API standards and specifications needed to ensure safety, compliance and interoperability. Because some words and phrases have a special meaning when used in the Rules they have been explained below or in the Trust Deed. (See RS 00201.001C.) Verywell Health's content is for informational and educational purposes only. Where a staff member does not make a superannuation choice election they will become a member of the default superannuation fund, which in most cases will be the PSSap. in relation to a PSSAP member means the amount specified in Rule5.1.4. means, in respect of an ordinary employer-sponsored member, contributions made by the designated employer of that member under Rule 2.2.4. means an Agency within the meaning of the Public Service Act 1999. has the same meaning as in the Superannuation Contributions Tax (Assessment and Collection) Act 1997. means an AWA within the meaning of clause 1 of Schedule 7A to the Workplace Relations Act 1996, as continued in existence as a transitional instrument under the Fair Work (Transitional Provisions and Consequential Amendments) Act 2009. means insurance coverage provided in respect of an ordinary employer-sponsored member under Division 1 of Part 4 of the Rules for death and permanent invalidity. (d) an amount payable in respect of the person under the Superannuation (Government Co-contribution for Low Income Earners) Act 2003. provided the method of payment complies with Rule 2.4.2. means a "enterprise agreement" within the meaning of section 12 of the Fair Work Act 2009. former . The headings in this Deed are for the convenience of reference only and shall not affect its interpretation. Each Part is further divided into Divisions addressing unique groupings within the Part and each Division is made up of Rules containing specific provisions. 2.3.5 CSC may determine the way in which employee contributions and eligible spouse contributions must be paid to CSC. (b) the designated employer of the ordinary employer-sponsored member. Payment of benefits to a PSSAP member on compassionate and financial hardship grounds. Medicare: How it works with other insurance, Key difference between Medicare and Medicaid, Best home and auto insurance bundle companies, A complete guide to short-term health insurance, Guide to domestic partner health insurance, can you stay on your parents insurance after age 26. replace or be interpreted as industry standards or recognized and generally accepted good engineering practices; provide a definitive, required, and/or prioritized list of site requirements; provide a detailed review of OSHA PSM requirements; or. As a side note, its important to understand that new dependent coverage is not necessarily provided if the new parent is covered under their own parents health insurance. means the termination of the employment of an ordinary employer-sponsored member on the ground that they are unable to perform their duties because of any mental or physical condition. Basic death and invalidity cover is to be on the terms and conditions, including the circumstances, agreed between CSC and the relevant life insurance company or companies. Rights and restrictions applying to a non-member spouse interest, CSC may determine terms and conditions for non member spouse interest. The first spouses birthday is August 15, 1990 and the second spouses birthday is December 10, 1988. Applying for supplementary death and invalidity cover. Then the secondary insurer steps in and picks up some or all of the remaining out-of-pocket costs that the primary insurance didnt pay (i.e., the deductible, copay, or coinsurance, or costs for specific services that arent covered under the primary plan but that are covered under the secondary plan). Subject to the SIS Act, CSC may adjust the repaid, returned or refunded contributions for: (a) insurance premiums paid from the persons personal accumulation account during the period the contributions were held in the PSSAP Fund; (b) interest (if any) in respect of the fund earnings or fund losses for the period the contributions were held in the PSSAP Fund; and. Kaiser Family Foundation. Note:A PSSAP member includes an ordinary employer-sponsored member. Regulations 6.33 and 6.34 of the SIS Regulations set out that a trustee must roll-over or transfer an amount as soon as possible or within a timeframe allowed under the SIS Regulations, in response to a request from a scheme member. We understand that life is ever changing and full of unexpected moments, so weve designed a flexible insurance to cover you through it all. Amounts paid by an insurer in response to a claim are paid to the PSSAP Fund for payment to the ordinary employer-sponsored member or directly to the ordinary employer-sponsored member but are not credited to their personal accumulation account. Also, each plan has its own copays and deductibles, and one plan will not usually cover these costs for the other, leaving parents on the hook for copayments and deductibles for each plan. The Birthday Rule is widely adopted by the health insurance industry. 7.3.5 CSC may determine when and how a non-member spouse may make or change an election about their choice of investment strategy. Schedule 22 of the Fair Work (Transitional Provisions and Consequential Amendments) Act 2009 commenced on the same day as Part 24 of the Fair Work Act 2009. | Terms & Conditions | Privacy, Mechanical Integrity (focused on fixed equipment), Hydrofluoric Acid (HF) Alkylation/API RP-751, Pipeline Strategic Data Tracking System (PSDTS). Whats the Difference Between Wastewater Disposal and Fracking? Lets say a parent gets a divorce, remarries and their new spouse lists their stepchild on their healthcare policy. 4.4.6 The ordinary employer-sponsored member may vary the amount of supplementary income protection cover at any time before the cover ceases to be applicable, provided the relevant life insurance company is prepared to provide the varied cover. With the birthday rule, the primary insurance provider pays first, operating as if it is the sole insurance payer. Note:Among other things, Rule 5.5.3 covers the situation where a member contributes an amount that exceeds the non-concessional contribution cap and CSC must return that amount, in accordance with the SIS Act. 3.1.14 Subject to the SIS Act, a roll-over application must be made in a form acceptable to CSC and must include any supporting evidence of entitlement to the benefit required by CSC. CSC must redirect incorrectly paid amounts and correct personal accumulation accounts. Instead, it is a set of guidelines that might trip you up if you have kids and you arent paying attention to your health insurance plan the birthday rule is an informal procedure that the health insurance industry has widely adopted for the coordination of benefits when children are listed as dependents on both parents group health plans. For example, if the mothers plan has covered the child longer than the fathers plan, then the mothers plan is the primary policy. You cannot fool these assessors they have done your job for 30 years. The notification is to include a statement of reasons for the decision. for the purposes of reconsidering decisions of CSC under Part6 of the Rules, includes: (a) making, suspending, revoking or refusing to make an order or determination; (b) giving, suspending, revoking or refusing to give a certificate, direction, approval, consent or permission; (c) issuing, suspending, revoking or refusing to issue an authority or other instrument; (d) imposing a condition or restriction; (e) making a declaration, demand or requirement; (f) retaining, or refusing to deliver up, an article; and. See Rules 3.4.3 and 3.4.4. Its not always wise to keep both a primary and secondary plan. 6.2 Moneys standing to the credit of the PSSAP Fund which are, in the opinion of CSC, moneys that are not for the time being required for the purpose of making payments out of the PSSAP Fund under the Act and the Deed shall, so far as is practicable, be invested by CSC in accordance with the Act and the Deed, but CSC shall so manage the PSSAP Fund that moneys that are from time to time required to pay benefits that are payable out of the PSSAP Fund are available for that purpose. Personal accumulation accounts, investment earnings and losses, superannuation surcharge and member investment choice. This underscores the risks of not knowing how the birthday rule can impact coverage. Review my Super Ranking. 4.4.3 CSC may allow the ordinary employer-sponsored member to choose the policy providing the supplementary income protection cover if CSC has taken out more than one policy. 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