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APRA releases quarterly private health insurance statistics for December 2020

Tuesday 23 February 2021

The Australian Prudential Regulation Authority (APRA) has released its quarterly private health insurance (PHI) publications for the December 2020 quarter.

The publications provide industry aggregate summaries of key financial and membership statistics for the private health insurance industry. 

Year to December 2020

The COVID-19 driven operating environment had a material effect on the industry’s performance in the year ending December 2020, with negligible premium growth and weaker investment earnings leading to a decline in profitability. Net margins fell (down 2.0 percentage points to 1.9 per cent) in the year to December 2020, mainly due to the deferral of the April 2020 premium increases and other concessions provided to policyholders. Investment earnings were significantly weaker than in the previous 12 months reflecting the negative impacts of the COVID-19 driven market volatility in the earlier part of the year. Reflecting these, industry net profit after tax fell 61.2 per cent to $558.2 million.

Hospital treatment membership increased by 103,179 persons. Older Australians taking out hospital membership was consistent with this longer-term industry trend, with membership in the 50+ age group increasing by 78,200 persons. Increased membership among younger people (aged 20 to 49) was more subdued over the period, rising by 14,639 persons in the year to December 2020. Despite the overall membership increase, hospital coverage as a share of the population fell slightly to 43.9 per cent (44.0 per cent at December 2019), continuing a longer-term decline in private health insurance coverage for younger people. 

Key performance statistics for the industry in the year ended:


December     2019

December 2020

Change (annual)

Premium revenue

$24.8 bn

$25.0 bn


Fund benefits (claims)

$21.6 bn

$22.1 bn


Gross margin




Net margin




Net investment income

$635.4 m

$269.4 m


Net profit after tax

$1.4 bn

$0.6 bn


December 2020 Quarter

The COVID-19 driven operating environment continued to impact private health insurers in the December 2020 quarter, with hospital utilisation remaining below pre-COVID levels contributing to limited claims growth (up 1.6 per cent to $5.7 billion)1. Meanwhile, an increase in premium revenue (up 4.0%) following the October 2020 price increase and stronger investment earnings due to stronger performance by equities led to an increase in profits during the quarter. 

The stronger growth in premium revenue compared to benefit claims resulted in an improvement in gross margins. While net margins also improved in the quarter, with management expenses growing broadly in line with premiums, they remained below pre-COVID levels. 

The industry also reported a small increase in membership levels, with hospital membership growing by 34,801 persons after increasing by 104,106 persons in the previous quarter.

Key performance statistics for the industry in the quarter:


September 2020

December 2020

Change (quarterly)

Premium revenue

$6.2 bn

$6.5 bn


Fund benefits (claims)

$5.6 bn

$5.7 bn


Gross margin




Net margin




Net investment income

$99.3 m

$219.8 m


Net profit after tax

$111.9 m

$341.9 m


Copies of the December 2020 quarterly publications are available on APRA’s website at: Quarterly private health insurance statistics.


1 Deferred claims liability (DCL) increased by about $100 million to $1.8 billion in the December quarter 2020. In the absence of any further COVID-19 driven restrictions on health services, the DCL is expected to reduce over 2021.

For more information

Email or mail to

Manager, External Data Reporting – Data Analytics and Insights
Australian Prudential Regulation Authority
GPO Box 9836, Sydney NSW 2001

Looking for discontinued publications?

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