sd502 revised august 12 by QQ83Sg

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									help, their address is: 11 Belgrave Road London, SW1V 1RB (Telephone: 0845            To the employee - complete PART A of this form and return it to your salaries and wages
601 2923) or visit their website www.pensionsadvisoryservice.org.uk                   department. They will complete Part B and retain it for their records.

                                                                                      Notes
Important                                                                                      When your employer gets this form they will stop taking pension contributions
                                                                                                from the first day of the next pay period.
Please be aware that benefits for membership after 2015 may change as a                        This is NOT an application form for a refund of contributions.
result of proposed Government reforms to public sector occupational schemes.                   Please read the Leaving Early and Transferring Out Factsheet in the Member's
All changes to the Regulations governing the HSC Pension Scheme are subject                     Guides section of our website www.hscpensions.hscni.net or your employer
to approval. Further information is available on our website.                                   can download a copy for you

Think Carefully!                                                                      Part A to be completed by the Employee. Please use
                                                                                      CAPITAL letters
If you leave or do not join the HSC Pension Scheme you will be giving up much
more than a good pension.                                                             Surname                                       Home address

From The Day You Join                                                                 Former Surname(if applicable)

Life assurance cover and family benefits if you die.                                  Other names
                                                                                                                                    Post code
Other Information to Consider                                                         Date of birth                                 Employer name
                                                                                            /             /
If you leave the Scheme you will still have to pay into a Personal Pension,           Job                                           Payroll number                   Gender
Stakeholder Pension or the State Second Pension Scheme.                                                                                                        M                    F

If you compare these alternatives with the Scheme you will see that in terms of       Is this your first job in the HSC?                                       Y                    N
value for money the Scheme is hard to beat, and its benefits are guaranteed.          Is this the first time you have chosen to leave or not
                                                                                      join the HSC Pension Scheme?                                             Y                    N
Most informed opinion recognises that employees will nearly always be better          Reason for leaving:
off if they belong to their employer’s occupational pension scheme.

If you have decided that you don’t want to be in the Scheme, please complete          Declaration
part A of the tear-off section of this leaflet and hand it to your Pension Officer.   I have read the information that comes with this form and the Members Guide to the HSC Pension
You should also read the Leaving Early and Transferring out Factsheet in the          Scheme.
Member's Guides section of our website http://www.hscpensions.hscni.net or
your employer can download a copy for you, which tells you how you can deal           I have used the calculator on the HSC Pension Service website at www.hscpensions.hscni.net
                                                                                      which outlines the impact on my pay and the scheme benefits I am giving up if I opt out.
with any pension rights you have earned so far.
                                                                                      Having considered this information, I can confirm that I do not wish to become or remain a member
                                                                                      of the scheme.
If you do opt out of the Scheme after your first pay period HSC Pension service
may have to refund any contributions you have paid on receipt of a claim form         I understand that I am giving up my rights to any further benefits from the scheme in this
REF1.                                                                                 employment. This includes:-
                                                                                               Life assurance cover and family benefits which would be payable if I died whilst still a
                                                                                                scheme member, and
                                                                                               Any additional membership to give me bigger pension benefits if I had to retire early
                                                                                                because of ill health.

                                                                                      I further understand that unless I am absent from duty for any reason I may apply to join or re-join
                                                                                      the scheme at any time subject to the scheme rules.

                                                                                      Signed                                              Date
Please keep a copy of this form for your reference
PART B to be completed by the EMPLOYING AUTHORITY


Date current period of employment
started
                                                                                       Application to leave the HSC Pension Scheme - (SD502)
NI number
                                                                                       The benefits payable from the HSC Pension Scheme are valuable and anyone
Whole-time or part-time                              Whole-time     Part-time          considering opting out of the scheme should think very carefully before making
                                                                                       such an important decision. Before you decide, please look at the extensive
Salary (if practitioner or sessional, fill in    £                         --          member information on our website at http://www.hscpensions.hscni.net and the
if possible)                                                                           Opt out Calculator, also available on our website or talk to your employer.
Job capacity code
                                                                                       Some general points to help you decide
EA/GP code
                                                                                           • HSC Pension Scheme benefits are fully guaranteed by the Government.
Did you receive the SD502 from the                                                         • As a Scheme member you pay a contribution towards your pension based
                                                         Yes – Please refund the
employee before the end of the first                                                       on your pensionable pay. Your HSC employer also contributes 13.3% of
                                                contributions locally. Then sign and
pay period?                                                                                your salary towards your pension.
                                                date this form and retain for your
                                                                                           • Contributions are taken from your pay before tax so you receive tax relief
                                                records.
                                                                                           on any amount you pay. You may also pay a lower rate of National
                                                                                           Insurance. This can reduce the actual amount that you pay to between
                                                       No – We will pay any refund
                                                                                           approximately 4.0% and 6.5% depending on your contribution rate, earnings
                                                due when we receive the claim form
                                                                                           level and personal rate of tax.
                                                AW18
                                                                                       Benefits of the Scheme
    What is the employee’s last day of
    scheme membership
                                                                                           • An annual pension payable for life. If you are a member of the 1995
                                                                                           Section you will also get a tax free retirement lump sum.
                                                                                           • You may be able to give up some of your pension to get a bigger lump
                                                                                           sum. You will receive £12 of lump sum for every £1 of pension you give up.
                                                                                           This is usually tax free.
                                                Signed
                                                                                           • Ill health benefits if you become too ill to work.
Sign and date this form and retain it for
                                                                                           • Lump sum and pension benefits for your dependants in the event of your
your records. Please do not return it to
                                                                                           death, including children’s pensions.
HSC Pension Service.
                                                                                       Additional Advice

                                                                                       If you are in any doubt about which pension arrangements will be the best for
EA/GP Stamp                           Date                                             you, you may wish to seek financial advice. Before you ask for advice, make
                                                                                       sure you know which type of financial adviser you are dealing with. Most
                                                                                       financial advisers will charge for their advice.

                                                                                       Alternatively, if you wish to consult The Pensions Advisory Service (TPAS) for

                                                                                                                                                             SD502 06/12

								
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