Commonwealth Numbered Acts Commonwealth Numbered ActsNote: See section 1‑10.
In this Act:
"ADI" (authorised deposit-taking institution) means a corporation that is an ADI for the purposes of the Banking Act 1959 .
"adult" means a person who is not a * dependent child.
"applicable benefits arrangement" means an applicable benefits arrangement within the meaning of the National Health Act 1953 as in force before 1 April 2007.
"application provision" is defined in subsection 217-80(2).
"applied Corporations Act provision" is defined in subsection 217-80(3).
"appointed actuary" , of a private health insurer, means the person holding an appointment by the insurer under section 160-1.
"approved form" is a form that meets the requirements in section 333-10.
"assets" , of a * health benefits fund, is defined in subsections 137-1(3) to (4A).
"authorised disclosure" is defined in subsection 323-1(3).
"authorised officer" is defined in subsection 313-1(1).
"base rate" is defined in subsection 34-1(2).
"capital adequacy direction" means a direction given under section 143-20, and includes such a direction as varied under that section.
"capital adequacy standard" means a standard established under section 143-5.
"census day" , for a levy, is defined in subsection 310-1(2).
"Chief Executive Officer" means the Chief Executive Officer of the Council referred to in section 273-1.
"chief executive officer" , of a private health insurer, is the person who is primarily and directly responsible to the * directors of the insurer for the general and overall management of the insurer.
"collapsed insurer levy" is defined in paragraph 304-10(a).
"Commissioner" means the Commissioner of Private Health Insurance Administration referred to in paragraph 267-1(1)(a).
"complaints levy" is defined in paragraph 304-10(b).
"complying health insurance policy" is defined in section 63-10.
"complying health insurance product" is defined in section 63-5.
"constitutional corporation" means a corporation to which paragraph 51(xx) of the Constitution applies.
"Council" means the Private Health Insurance Administration Council continued in existence under Part 6-3.
"Council administration levy" is defined in paragraph 304-10(c).
"Council-supervised obligation" is defined in section 185-10.
"cover" has a meaning affected by section 69-5.
"declaration of contravention" means a declaration under section 203-5.
"dependent child" means a person:
(a) who is:
(i) aged under 18; or
(ii) a dependent child under the * rules of the private health insurer that insures the person; and
(b) who is not aged 25 or over; and
(c) who does not have a partner.
"Deputy Commissioner" means the * member (if any) appointed under subsection 267-5(2) to be the Deputy Commissioner.
"director" has the same meaning as in the Corporations Act 2001 .
"disqualified person" is defined in section 166-15.
"employee health benefits scheme" is defined in section 121-15.
"enforceable obligation" is defined in section 185-5.
"external management" means management under Division 217 and Part 6-5.
"external manager" , in relation to a * health benefits fund, means a person appointed under section 217-10 as the external manager of the fund.
"Federal Court" means the Federal Court of Australia.
"fringe benefit" means:
(a) a fringe benefit as defined by subsection 136(1) of the Fringe Benefits Tax Assessment Act 1986 ; and
(b) a benefit that would be a fringe benefit (as defined by subsection 136(1) of that Act) if paragraphs (d) and (e) of the definition of employer in that subsection of that Act were omitted.
"general treatment" is defined in section 121-10.
"gold card" is defined in subsection 34-15(3).
"health benefits fund" is defined in section 131-10.
"health care provider" means:
(a) a person who provides goods or services as, or as part of, * hospital treatment or * general treatment; or
(b) a person who manufactures or supplies goods provided as, or as part of, hospital treatment or general treatment.
"health insurance business" is defined in Division 121.
"health-related business" is defined in section 131-15.
"holder" , of an insurance policy, means a person who is insured under the policy and who is not a * dependent child.
"hospital" is defined in subsection 121-5(5).
"hospital cover" is defined in section 34-15.
"hospital-substitute treatment" is defined in section 69-10.
"hospital treatment" is defined in section 121-5.
"improper discrimination" :
(a) in relation to an insurer who is not a * restricted access insurer--has the meaning given by subsection 55‑5(2); and
(b) in relation to a restricted access insurer--has the meaning given by subsection 55‑5(2) as affected by subsection 55‑5(3).
"incentive amount" is defined in section 23-5.
"incentive payments scheme" means the scheme provided for by Division 26.
"ineligible for Medicare" , in relation to a person, means not an eligible person within the meaning of the Health Insurance Act 1973 .
"inspector" means a person appointed as an inspector under section214-1, and (except in section 214-40) includes a person exercising powers under a delegation under section 214-40.
"insurance" is defined in section 5-1.
"late payment penalty" means a late payment penalty incurred under section 307-5 in respect of a * private health insurance levy.
"levy-related document" is defined in subsection 313-1(3).
"lifetime health cover base day" is defined in section 34-25.
"makes a capital payment" is defined in subsection 137-5(3).
"manager" , in relation to a * health benefits fund, means an * external manager or * terminating manager of the fund.
"medical practitioner" means a medical practitioner within the meaning of the Health Insurance Act 1973 .
"Medicare Australia CEO" means the Chief Executive Officer of Medicare Australia.
"medicare benefit" means a medicare benefit under Part II of the Health Insurance Act 1973 .
"medicare eligibility day" is defined in subsection 34-25(3).
"member" means a member of the Council and includes the * Commissioner.
"net asset position" , of a * health benefits fund, means the difference between:
(a) the * assets of the fund; and
(b) the * policy liabilities and other liabilities of the fund that the private health insurer conducting the fund has incurred for the purposes of the fund.
"new arrival" is defined in subsection 34-25(2).
"occupier" , of * premises, includes:
(a) the person in charge or control, or apparently in charge or control, of the premises; or
(b) a person who represents, or apparently represents, that person.
"officer" , of a private health insurer, means:
(a) a * director of the insurer; or
(b) a * chief executive officer of the insurer; or
(c) a person who makes, or participates in making, decisions that affect the whole, or a substantial part, of the business of the insurer.
"officer" , of a subject of a complaint under Division 241 or an investigation under Division 244, means:
(a) if the subject is an individual--the individual; or
(b) if the subject is a private health insurer--a person who is an * officer of the insurer; or
(c) if the subject is a company within the meaning of the Corporations Act 2001 --a * director of the company; or
(d) if the subject is an incorporated association--a member of the management committee of the association; or
(e) if the subject is an unincorporated entity--a member of the governing body of the entity; or
(f) if the subject is a partnership--a partner in the partnership.
old Schedule 2 is defined in subsection 34-10(5).
"overseas" has a meaning affected by section 34-30.
"participant" , in relation to the * premiums reduction scheme, means:
(a) a person who is registered as a participant in the scheme under subsection 23‑15(3); or
(b) a person who has applied to be registered as a participant in the scheme under subsection 23‑15(1) and whose application has not been refused.
"participating insurer" means:
(a) a private health insurer approved by the Minister under subsection 279‑5(2); or
(b) a private health insurer that has applied under subsection 279‑5(1) to be approved and whose application has not been rejected.
"permitted days without hospital cover" is defined in section 34-20.
"personal information" means information or an opinion (including information or an opinion forming part of a database), whether true or not, and whether recorded in a material form or not, about an individual whose identity is apparent, or can reasonably be ascertained, from the information or opinion.
"policy group" , of a * health benefits fund, is defined in subsection 146-1(5).
"policy holder" , of a * health benefits fund, means a * holder of a policy that is * referable to the fund.
"policy liability" of a private health insurer means:
(a) a liability that has arisen under an insurance policy; or
(b) a liability that, subject to the terms and conditions of an insurance policy, will arise on the happening of an event, or at a time, specified in the policy.
"pre-existing condition" is defined in section 75-15.
"premises" includes the following:
(a) a structure, building, vehicle or vessel;
(b) a place (whether enclosed or built on);
(c) a part of a thing referred to in paragraph (a) or (b).
"premiums reduction scheme" means the scheme provided for by Division 23.
"private health insurance arrangement" includes any of the following:
(a) a * private health insurance policy or a * product;
(b) an agreement or arrangement between a private health insurer and a * health care provider;
(c) an agreement or arrangement between a private health insurer and another person (other than a health care provider) that relates to insurance in relation to * hospital treatment or * general treatment;
(d) an agreement or arrangement between two or more health care providers that relates to insurance in relation to hospital treatment or general treatment;
(e) Private Health Insurance (Complying Product) Rules made for the purposes of item 1 or 5 of the table in subsection 72‑1(2);
(f) Private Health Insurance (Prostheses) Rules made for the purposes of item 4 of the table in subsection 72‑1(2);
(g) an arrangement between a private health insurer and a * private health insurance broker;
(h) an arrangement between a private health insurance broker and a person seeking to become insured under a private health insurance policy.
"private health insurance broker" means a person:
(a) who deals (otherwise than by carrying on * health insurance business) in insurance policies that * cover * hospital treatment or * general treatment or both; and
(b) who acts on behalf of persons seeking to become insured under those policies.
"private health insurance levy" is defined in section 304-10.
"Private Health Insurance Ombudsman" means the Private Health Insurance Ombudsman appointed for the purposes of Part 6-2.
"private health insurance policy" means an insurance policy that * covers * hospital treatment or * general treatment or both (whether or not it also covers any other treatment or provides a benefit for anything else).
"private health insurer" means a person registered under Part 4-3.
"product" is defined in subsection 63-5(2).
"product subgroup" is defined in subsection 63-5(2A).
"protected information" is defined in subsection 323-1(2).
"prudential direction" means a direction given under section 163-15.
"prudential matters" is defined in subsection 163-1(2).
"prudential standard" means a standard established under subsection 163-1(1).
"records" , of a subject of a complaint under Division 241 or an investigation under Division 244, includes any of the following that are in the possession, or under the control, of the subject:
(a) the constitution and * rules of the subject, if the subject is a private health insurer;
(b) the internal training manuals and related documents of the subject;
(c) any documents relevant to a * private health insurance arrangement to which the subject is a party or that applies to the subject;
(d) to the extent that the complaint or investigation relates to the subject's dealings with a particular person--the subject's records relating to its dealings with that particular person including correspondence, internal memoranda, emails, and recordings of taped conversations;
whenever those records came into existence.
"referable" : an insurance policy is referable to a * health benefits fund if:
(a) the fund is identified under paragraph 93‑15(c) as the fund to which the policy is referable (and the policy has not been made referable to another * health benefits fund under Division 146); or
(b) the policy has been made referable to the fund under Division 146.
"registered as a for profit insurer" means a private health insurer that is registered under Part 4-3 as a for profit insurer.
"responsible insurer" means:
(a) for a * health benefits fund that is under * external management--the private health insurer that was conducting the fund prior to the appointment of the * external manager of the fund; or
(b) for a health benefits fund that is under * terminating management--the private health insurer that was conducting the fund prior to the appointment of the * terminating manager of the fund.
"restricted access group" is defined in subsection 126-20(7).
"restricted access insurer" means a private health insurer that is registered under Part 4-3 as a restricted access insurer.
"risk equalisation jurisdiction" is defined in subsection 146-1(6).
"risk equalisation levy" is defined in paragraph 304-10(d).
"Risk Equalisation Trust Fund" means the Private Health Insurance Risk Equalisation Trust Fund continued in existence under Part 6-7.
"rules" , of a private health insurer, means the body of rules established by the insurer that relate to the day-to-day operation of the insurer's * health insurance business and (if any) * health-related business.
"schedule fee" means the Schedule fee within the meaning of Part II of the Health Insurance Act 1973 .
"search powers" means powers to search for, inspect, take extracts from, and make copies of, documents.
"senior manager" of a private health insurer means a person who has or exercises any of the senior management responsibilities (within the meaning of the * prudential standards) for the insurer.
"solvency direction" means a direction given under section 140-20, and includes such a direction as varied under that section.
"solvency standard" means a standard established under section 140-5.
"standard information statement" is defined in section 93-5.
"tax file number" means a tax file number as defined in section 202A of the Income Tax Assessment Act 1936 .
"terminating management" means management under Division 149 and Part 6-5.
"terminating manager" , in relation to the * health benefits funds of a private health insurer, means a person appointed under paragraph 149-10(2)(a) or Division 220 as the terminating manager of the funds.
"termination day" , in relation to the * health benefits funds of a private health insurer, is defined in subsection 149-20(2).
"transfer" , in relation to a person, is defined in section 75-10.
"up to date" , in relation to a * standard information statement, is defined in subsection 93-1(2).
"voluntary deed of arrangement" means:
(a) a deed of arrangement agreed on at a meeting of a kind referred to in section 217‑45; or
(b) such a deed as varied in accordance with the Health Benefits Fund Enforcement Rules.
"waiting period" is defined in section 75-5.
[ Minister's second reading speech made in--
House of Representatives on 7 December 2006
Senate on 26 February 2007 ]
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