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Private Health Insurance Bill 2007

Part 4-3 Registration

Division 126 Registration

126-1   What this Part is about

The Private Health Insurance Administration Council has the power, on application, to register as private health insurers bodies that are registered bodies for the purposes of the Corporations Law.

126-5   The Private Health Insurance (Registration) Rules

                   Registration is also dealt with in the Private Health Insurance (Registration) Rules. The provisions of this Part indicate when a particular matter is or may be dealt with in these Rules.

Note:          The Private Health Insurance (Registration) Rules are made by the Minister under section 333-20.

126-10   Applying for registration

             (1)  A body that is:

                     (a)  a company within the meaning of the Corporations Act 2001 , or a registered body within the meaning of that Act; and

                     (b)  a * constitutional corporation;

may apply to the Council for registration as a private health insurer.

             (2)  The application:

                     (a)  must be in the * approved form; and

                     (b)  must be accompanied by a copy of the * rules according to which the applicant proposes to conduct the day-to-day operation of its * health insurance business (including any * health-related business that it proposes to conduct through any of its * health benefits funds); and

                     (c)  if the applicant is seeking to be * registered as a for profit insurer—must state that fact; and

                     (d)  if the applicant is seeking to be registered as a * restricted access insurer—must state that fact.

             (3)  The applicant must also give a copy of its * rules to the Secretary of the Department.

126-15   Requesting further information

                   The Council may, within 90 days after the application is made, give the applicant written notice requiring the applicant to give the Council such further information relating to the application as is specified in the notice.

126-20   Deciding the application

             (1)  The Council may:

                     (a)  grant the application, subject to such terms and conditions as the Council thinks fit; or

                     (b)  refuse the application.

Note:          Refusals of applications, and granting of applications subject to terms and conditions, are reviewable under Part 6-9.

             (2)  In deciding the application, the Council must consider:

                     (a)  whether the applicant will be able to comply with the obligations imposed by or under this Act on private health insurers; and

                     (b)  such other matters as the Private Health Insurance (Registration) Rules require the Council to consider.

             (3)  In deciding the application, the Council may consider such other matters as it thinks fit, other than matters that the Private Health Insurance (Registration) Rules prohibit the Council from considering.

             (4)  The Council must refuse the application if the * rules of the applicant permit * improper discrimination. For the purposes of this subsection, the Council must consult the Secretary of the Department.

             (5)  If the Council grants the application:

                     (a)  the applicant is taken to have been * registered as a private health insurer under this Part with effect from the date specified by the Council in granting the application (which may be a date that occurred before the application was made); and

                     (b)  if the Council grants the application subject to terms and conditions—the registration is taken to be subject to those terms and conditions from the date on which the applicant is notified of the granting of the application; and

                     (c)  if the applicant sought to be * registered as a for profit insurer—the registration is taken to be registration of the applicant as a for profit insurer; and

                     (d)  if the applicant sought to be registered as a * restricted access insurer—subject to subsection (6), the registration is taken to be registration of the applicant as a restricted access insurer.

             (6)  The registration cannot be taken to be registration as a * restricted access insurer unless the insurer’s constitution:

                     (a)  describes the * restricted access group to whom the insurer’s * complying health insurance products are, or will be, available; and

                     (b)  prohibits the insurer from issuing a complying health insurance product to a person who does not belong to the group; and

                     (c)  prohibits the insurer from ceasing to insure a person for the reason that the person has ceased to belong to the group.

             (7)  A restricted access group is a group of people who all belong to a particular group, based on whether they:

                     (a)  are or were employed in a particular profession, trade, industry or calling; or

                     (b)  are or were employed by a particular employer or by an employer who belongs to a particular class of employers; or

                     (c)  are or were members of a particular profession, professional association or union; or

                     (d)  are or were members of the Defence Force or part of the Defence Force; or

                     (e)  are or were part of any group described in the Private Health Insurance (Registration) Rules.

The partners and * dependent children of people who belong to such a group are also taken to belong to that group.

126-25   Notifying the decision

             (1)  If the Council grants the application, the Council must:

                     (a)  notify the applicant in writing of the grant, and of the terms and conditions (if any) to which the grant is subject; and

                     (b)  within 7 days after granting the application, notify the Secretary in writing of the grant; and

                     (c)  within one month after granting the application, publish in the Gazette a notification of the grant setting out:

                              (i)  the applicant’s name; and

                             (ii)  the date of effect of the applicant’s registration; and

                            (iii)  the terms and conditions (if any) to which the grant is subject.

             (2)  If the Council refuses the application, the Council must:

                     (a)  notify the applicant in writing of the refusal; and

                     (b)  within 7 days after refusing the application, notify the Secretary in writing of the refusal; and

                     (c)  within one month after refusing the application, publish in the Gazette a notification of the refusal.

126-30   Council can be taken to refuse application

                   The Council is taken, for the purposes of Part 6-9, to have refused the application if the Council does not notify the applicant of its decision on the application:

                     (a)  within 90 days after the application was made; or

                     (b)  within 90 days after a copy of the applicant’s * rules was given to the Secretary of the Department; or

                     (c)  if the Council had given the applicant a notice under section 126-15 requiring the applicant to give further information relating to the application—within 90 days after the applicant gives that information to the Council;

whichever is latest.

126-35   Council to maintain record of registrations etc.

             (1)  The Council must maintain on its website an up to date record that contains:

                     (a)  the names of all private health insurers; and

                     (b)  in relation to each private health insurer:

                              (i)  its address, telephone number and website address; and

                             (ii)  the States and Territories in which it operates; and

                            (iii)  if the insurer is registered as a * restricted access insurer—the * restricted access group to whom the insurer’s * complying health insurance products are, or will be, available.

             (2)  The Council must give to a person, in writing, such information from the record as the person requests.

126-40   Changing registration status

             (1)  A private health insurer that:

                     (a)  because of paragraph 126-20(5)(c) or subsection (2) of this section, is * registered as a for profit insurer; and

                     (b)  notifies the Council, in the * approved form, that it does not wish to be registered as a for profit insurer;

is taken, from the day after the day on which the Council receives the notice, not to be registered as a for profit insurer for the purposes of this Act.

             (2)  A private health insurer that:

                     (a)  because of subsection (1) or otherwise, is not * registered as a for profit insurer; and

                     (b)  notifies the Council, in the * approved form, that it wishes to be registered as a for profit insurer;

is taken, from the day after the day on which the Council receives the notice, to be registered as a for profit insurer for the purposes of this Act.

             (3)  If a private health insurer is taken under this section to be, or not to be, * registered as a for profit insurer, the Council must, as soon as practicable and in writing, notify accordingly:

                     (a)  the Secretary of the Department; and

                     (b)  the Private Health Insurance Ombudsman; and

                     (c)  the Commissioner of Taxation.

             (4)  A private health insurer that:

                     (a)  because of paragraph 126-20(5)(d) or subsection (5) of this section, is * registered as a * restricted access insurer; and

                     (b)  notifies the Council, in the * approved form, that it does not wish to be registered as a restricted access insurer;

is taken, from the day after the day on which the Council receives the notice, not to be registered as a restricted access insurer for the purposes of this Act.

             (5)  Subject to subsection 126-20(6), a private health insurer that:

                     (a)  because of subsection (4) or otherwise, is not * registered as a * restricted access insurer; and

                     (b)  notifies the Council, in the * approved form, that it wishes to be registered as a restricted access insurer;

is taken, from the day after the day on which the Council receives the notice, to be registered as a restricted access insurer for the purposes of this Act.

             (6)  If a private health insurer is taken under this section to be, or not to be, * registered as a * restricted access insurer, the Council must, as soon as practicable and in writing, notify accordingly:

                     (a)  the Secretary of the Department; and

                     (b)  the Private Health Insurance Ombudsman.

126-45   Cancellation of registration

             (1)  The Council must cancel the registration of a private health insurer if:

                     (a)  the insurer has not conducted * health insurance business during the preceding 12 months; or

                     (b)  the insurer’s * health benefits funds have been terminated under Division 149.

             (2)  The Council must:

                     (a)  notify the insurer in writing of the cancellation; and

                     (b)  within 7 days after the cancellation, notify the Secretary in writing of the cancellation; and

                     (c)  within one month after the cancellation, publish in the Gazette a notification of the cancellation.