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Forms for private health insurers

This page is for forms required under the Private Health Insurance (Prudential Supervision) Act 2015, the Private Health Insurance (Prudential Supervision) Rules 2019 and the Private Health Insurance Prudential Standards in respect of regulated private health insurers.

Private health insurance licensing forms

If you wish to apply for a new private health insurance licence you must apply using the following forms(s)/guidance material:

Applicants must also consider all relevant private health insurance legislation, APRA rules, Prudential Standards and Prudential Practice Guides as part of their application.

 

Other application/notification forms

Please contact your APRA Responsible Supervisor to discuss making any private health insurance notification and application form lodgements with APRA in relation to the following:

The form below is effective until 1 July 2019:

The form below is effective from 1 July 2019: 

  • Change of Registration Status
  • Establishment of Health Benefits Fund
  • Restructure of Health Benefits Fund
  • Termination of Health Benefits Fund
  • Breach Reporting

Note: APRA is still updating the forms and guidance required under the newly enacted legislative framework for the prudential supervision of the private health insurance industry.

Copies of the previous forms used prior to 1 July 2015 for this industry, issued by the Private Health Insurance Administration Council (PHIAC), are available for background guidance only at Australian Government archive.