Commonwealth Numbered Acts

HEALTH LEGISLATION AMENDMENT ACT 1985 No. 70, 1985 - SECT 21

21. (1) The Schedule to the Principal Act is amended-

   (a)  by omitting from paragraph (b):

     "The organization",
and substituting-

"Subject to the condition set out in paragraph (ba), the organization";

   (b)  by inserting after paragraph (b) the following paragraphs:

"(ba) Where-

        (i)    the organization offers contributors of a health benefits fund
               conducted by it lesser benefits in lieu of the benefits that
               are payable in accordance with the basic table; and

        (ii)   a contributor to the health benefits fund elects, in accordance
               with the rules of the organization, to contribute for those
               lesser benefits,
the organization will permit the contributor to contribute for benefits in
respect of the contributor and the contributor's dependants (if any) in
accordance with the basic table as modified by the election.

   (bb) The organization will permit a contributor to a health benefits fund
        conducted by the organization, being a contributor who has made an
        election of the kind referred to in the condition set out in paragraph
        (ba), to revoke the election, but may, subject to the condition set
        out in paragraph (bc), provide for a waiting period before such an
        election (whether made to the organization or to another organization)
        ceases to have effect (whether by reason of revocation or otherwise).

   (bc) Where the rules of the organization provide for a waiting period
        before an election made by a contributor, being an election of the
        kind referred to in the condition set out in paragraph (ba), ceases to
        have effect, the waiting period will not exceed-

        (i)    in relation to benefits in respect of a matter related to a
               pre-existing ailment, being an ailment included in ailments of
               a kind determined by the Minister to be ailments to which the
               condition set out in paragraph (k) applies-12 months;

        (ii)   in relation to benefits in respect of a matter related to an
               obstetric condition-9 months; or

        (iii)  in relation to benefits in respect of any other matter-2
               months.";

   (c)  by omitting from paragraph (d): "or other service"
(first occurring) and substituting- "of a kind referred to in paragraph (a) or
(d) of the definition of 'basic private table' or 'basic table' in sub-section
4 (1)";

   (d)  by omitting from paragraph (d): "or other service"
(last occurring);

   (e)  by adding at the end of paragraph (f): "(whether or not modified by an
        election of the kind referred to in the condition set out in paragraph
        (ba))";

   (f)  by inserting in paragraph (g): "(whether or not modified by an
        election of the kind referred to in the
condition set out in paragraph (ba))"
after "table" (wherever occurring);

   (g)  by inserting in paragraph (j): "(whether or not modified by an
        election of the kind referred to in the
condition set out in paragraph (ba))"
after "table";

   (h)  by omitting from sub-paragraph (j) (i): "hospital treatment or other
        service"
and substituting- "a matter";

   (j)  by omitting from sub-paragraph (j) (ii): "hospital treatment or other
        service"
and substituting- "matter";

   (k)  by inserting in paragraph (k): "(whether or not modified by an
        election of the kind referred to in the
condition set out in paragraph (ba))"
after "basic table" (first and second occurring);

   (m)  by omitting from sub-paragraphs (k) (i) and (ii): "24"
and substituting- "12";

   (n)  by omitting from paragraph (1):

"The organization"
and substituting- "Subject to the condition set out in paragraph (bb), the
organization";

   (o)  by inserting in paragraph (1): "(whether or not modified by an
        election of the kind referred to in the
condition set out in paragraph (ba))"
after "table";

   (p)  by inserting in sub-paragraphs (m) (i) and (ii): "(whether or not
        modified by an election of the kind referred to in the
condition set out in paragraph (ba))"
after "table";

   (q)  by omitting from sub-paragraph (m) (ii): "or";

   (r)  by inserting after sub-paragraph (m) (ii) the following sub-paragraph:

"(iia) whether or not the contributor is entitled to make or revoke an
election of the kind referred to in the condition set out in paragraph (ba);
or";

   (s)  by omitting from paragraph (o): "hospital treatment"
and substituting- "benefits";

   (t)  by inserting in sub-paragraph (p) (ii): "(whether or not modified by
        an election of the kind referred to in the
condition set out in paragraph (ba))"
after "basic table" (wherever occurring); and

   (u)  by omitting from paragraph (p):

"a basic table"
(last occurring) and substituting-

"the first-mentioned basic table".

(2) Until the expiration of 3 months after the day of commencement of this
section, the Schedule to the Principal Act as amended by sub-section (1) has
effect as if-

   (a)  the following paragraph were inserted after paragraph (h):



"(ha) The rules of the organization shall not provide for a waiting period
with respect to contributors for benefits in accordance with a basic table
(whether or not modified by an election of the kind referred to in the
condition set out in paragraph (ba)) otherwise than for-

        (i)    benefits in respect of a matter related to a pre-existing
               ailment, being an ailment included in ailments of a kind
               determined by the Minister to be ailments to which the
               condition set out in paragraph (k) applies; or

        (ii)   in respect of a matter related to an obstetric condition."; and

   (b)  paragraph (j) (ii) were omitted.

(3) The conditions set out in the Schedule to the Principal Act as amended by
sub-section (1) have effect in relation to the registration of an
organization, whether the registration had effect before, or has effect after,
the commencement of this section.