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:
- Private health insurer conversion to for profit status
- Approval of merger and acquisition of health benefit funds
- Responsible persons - Changes to the responsible persons (CEO, directors, senior managers, Appointed Actuary or Appointed Auditor) of the Insurer should be submitted using the following form to your APRA Responsible Supervisor
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.