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Return Forms & Audit Guidance

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. 

 

Compliance: Statistical and Financial Reporting

As the regulator of private health insurance, PHIAC exercises a range of auditing activities to monitor the industry and exercise its supervision powers. The information collection function of the Council is to obtain from each private health insurer regular reports about the insurer's operations, including reports supported by actuarial certification. This involves collecting and analysing statistical and financial reports provided by the industry on a quarterly and annual basis or by direction of the Council more often. To check when the next report is due, consult the Calendar of key Industry reporting and activity dates.

Reporting Forms

To help industry members and auditors with the reporting obligations and ensure consistency and accuracy in the audits, PHIAC provides templates, data definition and guidance.

Separate guidance information is provided for the PHIAC 1 and PHIAC 2 Quarterly Returns. PHIAC 1 relates to statistical information. PHIAC 2 relates to financial information. A template of the audit certificate, to be signed-off by the auditor, is also provided.

The information collected is used for PHIAC to provide quarterly statistics on membership, coverage and others. Check the Industry Statistics section for more information.

Further information on the audit process and the annual reporting requirements can be found in the PHIAC 12/14 circular.

Reporting Document Due Date Templates and Guidance Notes
Quarterly Reporting
PHIAC 1 Statistical data on memberships, claims, benefits paid and risk equalisation 28 April
28 July
28 October
28 January
XLTemplate
XML Template  XSD Schema fo XML Validation
Guidance for completion Data Definition
PHIAC1 Cell Cross Check
PHIAC 2 Financial and Capital Data 28 April
28 July
28 October
28 January
XLTemplate
XMLTemplate XSD Schema for XML
PHIAC 2 Guidance Note
PHIAC 3 Statistical data on prosthetic benefits 28 April
28 July
28 October
28 January
XLTemplate
XMLTemplate  XSD Schema for XML
PHIAC 4 Medical specialty block grouping information 28 April
28 July
28 October
28 January
XLTemplate
XML Template XSD Schema for XML
Annual Reporting
Circular  30 September 2013–14 End of Year Reporting Requirements

PHIAC 1

Audit Statistical Reporting

30 September Audit Guidance
Audit Guidance – Area to focus

PHIAC 2 

Audit and Data Financial Reporting

30 September XLTemplate
XMLTemplate XSD Schema for XML Audit Guidance