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Legislation

Note: This page is a representation of information published on the PHIAC website prior to 1 July 2015. This information is provided for reference and research purposes only. 

There are various Acts and Rules dealing with private health insurance. The primary piece of legislation is the Private Health Insurance Act 2007. The legislation is supported by Rules which can be made by the Private Health insurance Administration Council (the Council) or by the Minister for Health (the Minister).

Legislation

Legislation consists of laws made by the Parliament or by people who are given delegated powers by the Parliament to make laws. Broadly, there are two kinds of legislation: Acts and subordinate legislation.

Primary Legislation: the Acts

Acts are laws enacted by Parliament. The Council draws its regulatory powers from the Private Health Insurance Act 2007.

Subordinate Legislation: the Rules

Private Health Insurance (PHI) Rules may be made either by the Minister or the Council under sections 333-20 and 333-25 of the Private Health Insurance Act 2007 (the Act).

The following table provides links to the key pieces of legislation which impact on the day-to-day operations of the Council and the private health insurance industry. The remaining rules made by the Minister can be found in Comlaw under "private health insurance rules."

 

​Area Legal and Supporting Documents​ Source​ Details​

 

Private Health Insurance

Private Health Insurance Act 2007 ​The Parliament ​Primary legislation. Provides incentives for people to have private health insurance; sets out rules governing products, imposes requirements about the conduct of health insurance business, and details the powers and functions of the regulators of the PHI sector.
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 ​The Parliament ​Provides for the transition from the past regulatory regime under the National Health Act 1953 and amends related legislation to reflect the changes in the definition of insurers and the products they offer to the Act.

 

Council​

Private Health Insurance (Council) Rules 2007 ​The Minister ​These Rules relate to the public information functions of the Council, and the periods of appointment for the Commissioner of Private Health Insurance Administration, Deputy Commissioner and members of the Council.
Private Health Insurance (Council Administration Levy) Act 2003 ​The Parliament ​Provides for the Minister to make rules to specify the rate of the Council Administration Levy. This levy is imposed on insurers to meet the general administration costs of the Council.
Private Health Insurance (Collapsed Insurer Levy) Act 2003 ​The Parliament ​This levy may be imposed to meet a collapsed insurer’s liabilities to policy holders that it is unable to meet itself.
Private Health Insurance (Levy Administration) Rules 2010 ​The Minister ​Deals with the administration of private health insurance levies.
Private Health Insurance (Council Administration Levy) Rules 2007 ​The Minister ​Specifically deals with the calculation and collection of the Council Administration Levy.

​Insurer Obligations

 

​ ​ ​
Private Health Insurance (Health Benefits Fund Administration) Rules 2007 The Council​ ​Specifies requirements for the operation of health benefits funds, including asset usage, restructures, and mergers and acquisitions.The rules also establish risk equalisation jurisdictions and establish solvency and capital adequacy standards.
Regulatory Impact Statement ​The Council
Private Health Insurance (Insurer Obligations) Rules 2009

Explanatory Statement

​The Council ​These Rules establish prudential standards for private health insurers including: governance, appointed actuary requirements, reporting, disclosure and outsourcing requirements. A breach of a prudential standard is a breach of a Council-supervised obligation. This may trigger the Council’s enforcement powers.
Regulatory Impact Statement ​The Council

 

​Risk Equalisation

Private Health Insurance (Risk Equalisation Policy) Rules 2007 ​The Minister ​Explain how the Risk Equalisation Trust Fund (RETF) is to operate, including the methodology for working out the amount to be paid into or out of the Fund by each insurer. The rules also provide the method for calculating adjustment amounts where there has been an error in the amount paid into or out of the Fund.
Private Health Insurance (Risk Equalisation Administration) Rules 2007

Explanatory Statement

​The Council ​Sets out the requirements relating to the administration of the RETF and the Risk Equalisation Levy, including the records to be kept by insurers
Private Health Insurance (Risk Equalisation Levy) Act 2003 ​The Parliament ​Provides for the imposition of the Risk Equalisation Levy on private health insurers to ensure that no insurer is unduly impacted by costly claims because of the risk profile of their members.
Private Health Insurance (Risk Equalisation Levy) Rules 2007 ​The Minister ​The rules specify the risk equalisation levy days for a financial year as being the 21st day of the second month of each quarter.