Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Private Health Insurance Bill 2007

Bill home page  


Download WordDownload Word


Download PDFDownload PDF

2004-2005-2006-2007

 

The Parliament of the

Commonwealth of Australia

 

THE SENATE

 

 

 

Private Health Insurance Bill 2006

 

 

(1)     Clause 23-10, page 10 (line 26), omit “policy to which subsection (1) applied”, substitute “ * complying health insurance policy”.

[clarification]

(2)     Clause 23-10, page 10 (line 28), omit “amount payable”, substitute “reduction”.

[technical correction]

(3)     Clause 26-5, page 17 (line 6), omit “policy to which subsection (1) applied”, substitute “ * complying health insurance policy”.

[clarification]

(4)     Heading to clause 50-5, page 31 (lines 18 to 20), omit the heading, substitute:

50-5   Private Health Insurance Rules relevant to this Chapter

[Private Health Insurance (Benefit Requirements) Rules]

(5)     Clause 50-5, page 31 (line 23), after “Rules,”, insert “the Private Health Insurance (Benefit Requirements) Rules,”.

[Private Health Insurance (Benefit Requirements) Rules]

(6)     Clause 55-5, page 32 (line 26), omit “paragraph 66-10(2)(a)”, substitute “subsection 66-10(2)”.

[product subgroups]

(7)     Clause 63-1, page 35 (line 5), before “A private”, insert “(1)”.

[Rules may exclude health insurance business from complying product requirements]

(8)     Clause 63-1, page 35 (after line 7), at the end of the clause, add:

             (2)  However, subsection (1) does not apply in relation to * health insurance business of a kind that the Private Health Insurance (Complying Product) Rules specify is excluded from subsection (1).

[Rules may exclude health insurance business from complying product requirements]

(9)     Clause 63-5, page 35 (after line 16), after subclause (2), insert:

          (2A)  A product subgroup , of a * product, is all the insurance policies in the product:

                     (a)  under which the addresses of the people insured, as known to the private health insurer, are located in the same * risk equalisation jurisdiction; and

                     (b)  under which the same kind of insured group (within the meaning of the Private Health Insurance (Complying Product) Rules) is insured.

          (2B)  The Private Health Insurance (Complying Product) Rules may specify insured groups for the purposes of paragraph (2A)(b). An insured group may be specified by reference to any or all of the number of people in the group, the kind of people in the group, or any other matter. A group may consist of only one person.

[product subgroups]

(10)   Clause 66-5, page 37 (lines 27 to 29), omit paragraph (a), substitute:

                     (a)  is the amount specified for the * product subgroup to which the policy belongs in the most recent approval under section 66-10; or

[product subgroups]

(11)   Clause 66-5, page 38 (line 3), omit subparagraph (1)(c)(ii), substitute:

                             (ii)  because of a discount or discounts allowed under subsection (2), if the total percentage discount (not counting discounts available for the reason in paragraph (3)(f)) does not exceed the percentage specified in the Private Health Insurance (Complying Product) Rules as the maximum percentage discount allowed; or

[allowable discounts on premiums]

(12)   Clause 66-5, page 38 (lines 5 to 19), omit subclause (2), substitute:

             (2)  A discount is allowed if:

                     (a)  it is for a reason in subsection (3); and

                     (b)  the discount is also available for that reason under every policy in the * product; and

                     (c)  if there are different percentage discounts available for that reason—the same percentage discount is available on the same basis under every policy in the product; and

                     (d)  any other conditions set out in the Private Health Insurance (Complying Product) Rules are met.

             (3)  A discount may be for any of these reasons:

                     (a)  because premiums are paid at least 3 months in advance;

                     (b)  because premiums are paid by payroll deduction;

                     (c)  because premiums are paid by pre-arranged automatic transfer from an account at a bank or other financial institution;

                     (d)  because the persons insured under the policy have agreed to communicate with the private health insurer, and make claims under the policy, by electronic means;

                     (e)  because a person insured under the policy is, under the * rules of the private health insurer, treated as belonging to a contribution group;

                      (f)  because the insurer is not required to pay a levy in relation to the policy under a law of a State or Territory;

                     (g)  for a reason set out in the Private Health Insurance (Complying Product) Rules.

[allowable discounts on premiums]

(13)   Clause 66-10, page 38 (line 27) to page 39 (line 9), omit subclause (2), substitute:

             (2)  The application may propose different changes for policies in the * product, but the proposed changed amount must be the same for each policy in the product that belongs to the same * product subgroup.

[product subgroups]

(14)   Clause 66-10, page 39 (lines 20 to 22), omit subclause (5).

[product subgroups]

(15)   Clause 69-1, page 41 (lines 4 to 10), omit subclause (1), substitute:

             (1)  An insurance policy meets the coverage requirements in this Division if:

                     (a)  the only treatments the policy * covers are:

                              (i)  specified treatments that are * hospital treatment; or

                             (ii)  specified treatments that are hospital treatment and specified treatments that are * general treatment; or

                            (iii)  specified treatments that are general treatment but none that are hospital-substitute treatment; and

                     (b)  if the policy provides a benefit for anything else—the provision of the benefit is authorised by the Private Health Insurance (Complying Product) Rules.

[expanding coverage of complying health insurance products]

(16)   Clause 69-1, page 41 (line 11), omit “subsection (1)”, substitute “paragraph (1)(a)”.

[expanding coverage of complying health insurance products]

(17)   Clause 69-1, page 41 (line 14), omit “subsection (1)”, substitute “paragraph (1)(a)”.

[expanding coverage of complying health insurance products]

(18)   Page 41 (after line 27), at the end of Division 69, add:

69-10   Meaning of hospital-substitute treatment

                   Hospital-substitute treatment means * general treatment that:

                     (a)  substitutes for an episode of * hospital treatment; and

                     (b)  is any of, or any combination of, nursing, medical, surgical, podiatric surgical, diagnostic, therapeutic, prosthetic, pharmacological, pathology or other services or goods intended to manage a disease, injury or condition; and

                     (c)  is not specified in the Private Health Insurance (Complying Product) Rules as a treatment that is excluded from this definition.

[relocation of definition of hospital-substitute treatment]

(19)   Clause 72-1, page 43 (cell at table item 1, 3rd column), omit the cell, substitute:

at least the amount set out, or worked out using the method set out, in the Private Health Insurance (Benefit Requirements) Rules as the minimum benefit, or method for working out the minimum benefit, for that treatment.

[method for working out minimum benefit; Private Health Insurance (Benefit Requirements) Rules]

(20)   Clause 72-1, page 44 (cell at table item 4, 3rd column), omit the cell, substitute:

(a) at least the amount set out, or worked out using the method set out, in the Private Health Insurance (Prostheses) Rules as the minimum benefit, or method for working out the minimum benefit, for the prosthesis; and

(b) if the Private Health Insurance (Prostheses) Rules set out an amount, or a method for working out an amount, as the maximum benefit, or method for working out the maximum benefit, for the prosthesis—no more than that amount or the amount worked out using that method.

[method for working out minimum benefit]

(21)   Clause 72-1, page 44 (table item 5), omit the table item, substitute:

5

any treatment for which the Private Health Insurance (Benefit Requirements) Rules specify there must be a benefit.

at least the amount set out, or worked out using the method set out, in the Private Health Insurance (Benefit Requirements) Rules as the minimum benefit, or method for working out the minimum benefit, for that treatment.

[method for working out minimum benefit; Private Health Insurance (Benefit Requirements) Rules]

(22)   Clause 72-1, page 44 (lines 1 and 2), omit “a policy holder with, or arranges for a policy holder”, substitute “an insured person with, or arranges for an insured person”.

[insured persons]

(23)   Clause 72-15, page 46 (line 25), omit “14 days”, substitute “28 days”.

[deadline for paying ongoing listing fees]

(24)   Page 46 (after line 30), at the end of Division 72, add:

72-20   Other matters

                   The Private Health Insurance (Prostheses) Rules may, in relation to application fees, initial listing fees or ongoing listing fees imposed under the Private Health Insurance (Prostheses Application and Listing Fees) Act 2007 , provide for, or for matters relating to, any or all of the following:

                     (a)  methods for payment;

                     (b)  extending the time for payment;

                     (c)  refunding or otherwise applying overpayments.

[administration of prostheses application and listing fees]

(25)   Clause 75-1, page 47 (lines 23 and 24), omit “a policy holder with, or arranges for a policy holder”, substitute “an insured person with, or arranges for an insured person”.

[insured persons]

(26)   Clause 78-1, page 51 (lines 18 and 19), omit “a policy holder with, or arranges for a policy holder”, substitute “an insured person with, or arranges for an insured person”.

[insured persons]

(27)   Clause 84-1, page 53 (line 14), after “treatment”, insert “or provides a benefit for anything else”.

[expanding coverage of complying health insurance products]

(28)   Clause 93-1, page 58 (line 6), after “each”, insert “ * product subgroup of each”.

[product subgroups]

(29)   Clause 93-1, page 58 (line 8), after “each”, insert “product subgroup of each”.

[product subgroups]

(30)   Clause 93-1, page 58 (after line 9), after subclause (1), insert:

          (1A)  A single * standard information statement may be the standard information statement for more than one * product subgroup of a * complying health insurance product if the premiums payable under policies in the subgroups the statement covers are the same.

[product subgroups]

(31)   Clause 93-1, page 58 (line 10), after “for a”, insert “ * product subgroup of a”.

[product subgroups]

(32)   Clause 93-1, page 58 (line 14), after “for a”, insert “ * product subgroup of a”.

[product subgroups]

(33)   Clause 93-1, page 58 (line 18), after “for a”, insert “ * product subgroup of a”.

[product subgroups]

(34)   Clause 93-5, page 58 (line 25), after “for a”, insert “ * product subgroup of a”.

[product subgroups]

(35)   Clause 93-5, page 58 (line 26), after “the product”, insert “subgroup”.

[product subgroups]

(36)   Clause 93-10, page 59 (line 10), omit “product”, substitute “ * product subgroup that is likely to apply to the person”.

[product subgroups]

(37)   Clause 93-10, page 59 (line 13), after “statement”, insert “for that subgroup”.

[product subgroups]

(38)   Clause 93-15, page 59 (line 19), omit “that the policy is in”, substitute “subgroup that the policy belongs to”.

[product subgroups]

(39)   Clause 93-20, page 60 (lines 4 and 5), omit “that the policy is in”, substitute “subgroup that the policy belongs to”.

[product subgroups]

(40)   Clause 93-20, page 60 (line 10), omit “statement”, substitute “statements”.

[product subgroups]

(41)   Clause 93-20, page 60 (line 16), after “statement”, insert “for the * product subgroup that the policy belongs to”.

[product subgroups]

(42)   Clause 93-20, page 60 (lines 23 to 30), omit subclause (4) (including the note), substitute:

             (4)  If a private health insurer changes the * health benefits fund to which a * complying health insurance policy of the insurer is * referable, the insurer must ensure that:

                     (a)  before the change takes effect, an * adult insured under the policy is given a statement identifying the health benefits fund to which the policy will be referable as a result of the change; or

                     (b)  within 2 weeks after the change takes effect, an adult insured under the policy is given a statement identifying the health benefits fund to which the policy is referable as a result of the change.

Note:          The health benefits fund to which a policy is referable may change in accordance with Division 146.

[notifying changes of health benefits funds]

(43)   Clause 96-1, page 62 (line 11), omit “statement”, substitute “statements”.

[product subgroups]

(44)   Clause 96-1, page 62 (lines 12 and 13), omit “an * up to date copy of the statement”, substitute “ * up to date copies of the statements”.

[product subgroups]

(45)   Clause 96-5, page 62 (lines 16 to 18), omit “a copy of the * standard information statement for a * complying health insurance product of the insurer is”, substitute “copies of the * standard information statements for a * complying health insurance product of the insurer are”.

[product subgroups]

(46)   Clause 96-10, page 62 (lines 26 and 27), omit “statement for a * complying health insurance product of the insurer is updated, a copy of the updated statement is”, substitute “statements for a * complying health insurance product of the insurer are updated, copies of the updated statements are”.

[product subgroups]

(47)   Clause 99-1, page 65 (after line 24), after subclause (2), insert:

          (2A)  A private health insurer must not request a certificate except in the circumstances set out in subsection (2).

[transfer certificate]

(48)   Clause 121-5, page 75 (line 16), omit “ * policy holders of”, substitute “persons insured under * complying health insurance products that are * referable to”.

[insured persons]

(49)   Clause 121-5, page 75 (after line 16), after paragraph (7)(e), insert:

                    (ea)  if the Minister is deciding whether to revoke such a declaration—any contravention of conditions to which the declaration is subject; and

[conditions on declarations of hospitals]

(50)   Page 75 (after line 21), after clause 121-5, insert:

121-7   Conditions on declarations of hospitals

             (1)  A declaration under paragraph 121-5(6)(a) that a facility is a hospital is subject to:

                     (a)  any conditions specified under subsection (2); and

                     (b)  any conditions that the Minister specifies under subsection (3) in relation to the facility.

Note:          Decisions by the Minister to specify conditions in relation to particular facilities are reviewable under Part 6-9.

             (2)  The Private Health Insurance (Health Insurance Business) Rules may specify conditions to which declarations under paragraph 121-5(6)(a) are subject. Any conditions so specified apply to all such declarations, whether or not the declarations were made before the conditions were so specified.

             (3)  The Minister may specify:

                     (a)  in a declaration under paragraph 121-5(6)(a) relating to a facility; or

                     (b)  in a written notice given to a facility for which such a declaration is already in force;

conditions, or additional conditions, to which the declaration is subject.

             (4)  A contravention of a condition to which a declaration under paragraph 121-5(6)(a) is subject does not cause the declaration to cease to have effect.

Note:          Contraventions are taken into consideration in deciding whether to revoke a declaration.

[conditions on declarations of hospitals]

(51)   Clause 126-40, page 83 (line 30) to page 84 (line 7), omit subclause (2), substitute:

             (2)  If:

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

                     (b)  the Council approves under section 126-42 an application by the insurer for the insurer to convert to being registered as a for profit insurer;

the insurer is taken, from the day specified in the Council’s approval, to be registered as a for profit insurer for the purposes of this Act.

[conversion to for profit status]

(52)   Page 84 (after line 34), after clause 126-40, insert:

126-42   Conversion to for profit status

             (1)  A private health insurer may apply to the Council for approval to convert to being * registered as a for profit insurer.

             (2)  The application:

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

                     (b)  must include a conversion scheme that is:

                              (i)  in the approved form; and

                             (ii)  accompanied by such further information as is specified in the Private Health Insurance (Registration) Rules; and

                     (c)  must be given to the Council at least 90 days before the day specified in the application as the day on which the insurer proposes that it become * registered as a for profit insurer.

             (3)  The Council must approve the application if the Council is satisfied, within 30 days after the application was made, that the conversion scheme would not in substance involve the demutualisation of the insurer.

             (4)  If subsection (3) does not apply:

                     (a)  the Council must, at least 45 days before the day specified in the application, cause a notice of the application to be published in a national newspaper, or in a newspaper circulating in each jurisdiction where the insurer has its registered office or carries on business; and

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

             (5)  If subsection (3) does not apply, the Council must approve the application if:

                     (a)  the insurer has complied with subsection (2) in relation to the application, and given to the Council such further information as the Council has required under paragraph (4)(b); and

                     (b)  the Council is satisfied that the conversion scheme would not result in a financial benefit to any person who is not a * policy holder of, or another person insured through, a * health benefits fund conducted by the insurer; and

                     (c)  the Council is satisfied that the conversion scheme would not result in financial benefits from the scheme being distributed inequitably between such policy holders and insured persons.

             (6)  The Private Health Insurance (Registration) Rules may provide for criteria for deciding, for the purposes of subsection (3), whether a conversion scheme would not in substance involve the demutualisation of the insurer.

             (7)  The Council must cause the insurer to be notified in writing of the Council’s decision on the application.

Note:          Refusals of applications are reviewable under Part 6-9.

[conversion to for profit status]

(53)   Clause 137-1, page 90 (after line 21), after subclause (4), insert:

          (4A)  The assets of a * health benefits fund:

                     (a)  include assets that, in accordance with a restructure or arrangement approved under Division 146, are to be assets of the fund; but

                     (b)  do not include assets that, in accordance with such a restructure or arrangement, are no longer to be assets of the fund.

[restructure, merger and acquisition of health benefits funds]

(54)   Clause 137-10, page 92 (lines 7 to 9), omit subparagraph (2)(a)(i), substitute:

                              (i)  meeting * policy liabilities and other liabilities, or expenses, incurred for the purposes of the business of the fund (including policy liabilities and other liabilities that are treated, in accordance with a restructure or arrangement approved under Division 146, as policy liabilities and other liabilities incurred for the purposes of the fund); or

[restructure, merger and acquisition of health benefits funds]

(55)   Clause 137-10, page 92 (after line 12), at the end of paragraph (2)(a), add:

                            (iv)  a purpose specified in the Private Health Insurance (Health Benefits Fund Policy) Rules for the purposes of this subparagraph; or

[expenditure and application of health benefits funds]

(56)   Clause 137-10, page 92 (line 19), omit “other” (second occurring).

[expenditure and application of health benefits funds]

(57)   Clause 140-20, page 99 (line 16), omit “organisation”, substitute “insurer”.

[solvency directions]

(58)   Clause 140-20, page 99 (line 26), omit “issuing”, substitute “giving”.

[solvency directions]

(59)   Clause 143-20, page 104 (line 18), omit “organisation”, substitute “insurer”.

[capital adequacy directions]

(60)   Clause 143-20, page 104 (line 30), omit “issuing”, substitute “giving”.

[capital adequacy directions]

(61)   Clause 146-1, page 106 (lines 5 to 15), omit subclause (1), substitute:

             (1)  A private health insurer may restructure its * health benefits funds so that insurance policies that are * referable to a health benefits fund (a transferring fund ) of the insurer become referable to one or more other health benefits funds ( receiving funds ) of the insurer (whether existing or proposed) if:

                     (a)  the insurance policies concerned are all of the policies that, immediately before the restructure, were referable to the transferring fund and belonged to one or more * policy groups of that fund; and

                     (b)  the insurer applies to the Council, in the * approved form, for approval of the restructure; and

                     (c)  the Council approves the restructure in writing; and

                     (d)  the insurer complies with any requirements that the Private Health Insurance (Health Benefits Fund Administration) Rules impose on the insurer in relation to the restructure.

[restructure of health benefits funds]

(62)   Clause 146-1, page 106 (line 17), after “if”, insert “, and only if,”.

[restructure of health benefits funds]

(63)   Clause 146-1, page 106 (lines 18 and 19), omit paragraph (2)(a), substitute:

                     (a)  the * assets and liabilities that would be transferred to the receiving fund or funds represent a reasonable estimate of what would, immediately before the restructure, be the * net asset position of the transferring fund; and

                    (aa)  if there is more than one receiving fund—those assets and liabilities would be fairly distributed between the receiving funds; and

[restructure of health benefits funds]

(64)   Clause 146-1, page 106 (after line 21), after subclause (2), insert:

          (2A)  For the purposes of paragraph (2)(a), in working out the * net asset position of the transferring fund, disregard the net asset position of the fund to the extent that it relates to insurance policies that do not belong to a * policy group referred to in paragraph (1)(a).

[restructure of health benefits funds]

(65)   Clause 146-1, page 106 (lines 25 and 26), omit “(a transferring fund )”.

[restructure of health benefits funds]

(66)   Clause 146-1, page 106 (line 31), omit “(a receiving fund )”.

[restructure of health benefits funds]

(67)   Clause 146-1, page 107 (after line 5), after paragraph (4)(a), insert:

                    (aa)  how to work out reasonable estimates of the kind referred to in paragraph (2)(a);

                   (ab)  criteria for deciding, for the purposes of paragraph (2)(aa), whether assets and liabilities would be fairly distributed;

[restructure of health benefits funds]

(68)   Clause 146-1, page 107 (lines 12 and 13), omit subparagraph (4)(c)(ii), substitute:

                             (ii)  * policy liabilities and other liabilities incurred for the purposes of a transferring fund becoming treated as policy liabilities and other liabilities incurred for the purposes of a receiving fund or funds;

[restructure of health benefits funds]

(69)   Clause 146-5, page 108 (line 1) to page 109 (line 21), omit the clause, substitute:

146-5   Merger and acquisition of health benefits funds

             (1)  A private health insurer (the transferee insurer ) may enter into an arrangement with one or more other private health insurers ( transferor insurers ) under which:

                     (a)  insurance policies that are * referable to a * health benefits fund or funds ( transferring funds ) of the transferor insurer or transferor insurers become referable to a health benefits fund or funds ( receiving funds ) of the transferee insurer; and

                     (b)  in relation to each of the transferring funds, the insurance policies concerned are:

                              (i)  all of the insurance policies that are referable to the transferring fund; or

                             (ii)  all of the insurance policies that are referable to the transferring fund and that belong to one or more * policy groups of the fund.

             (2)  However, the arrangement must not take effect unless:

                     (a)  the insurers referred to in subsection (1) apply jointly to the Council, in the * approved form, for approval of the arrangement; and

                     (b)  the Council approves the arrangement in writing; and

                     (c)  the insurers comply with any requirements that the Private Health Insurance (Health Benefits Fund Administration) Rules impose on the insurers in relation to the arrangement.

             (3)  The Council must approve the arrangement if, and only if, it is satisfied that:

                     (a)  the * assets and liabilities that would be transferred, under the arrangement, to the receiving fund or funds represent a reasonable estimate of what would, immediately before the restructure, be:

                              (i)  if there is only one transferring fund—the * net asset position of the fund; or

                             (ii)  if there is more than one transferring fund—the sum of the net asset positions of each of the funds; and

                     (b)  if, under the arrangement, there would be more than one receiving fund—those assets and liabilities would be fairly distributed between the receiving funds; and

                     (c)  if subparagraph (1)(b)(i) applies to any transferring fund—the net asset position of the fund immediately after the arrangement takes effect will not be greater than zero; and

                     (d)  the arrangement will not result in any breach of the * solvency standard or the * capital adequacy standard if it takes effect.

Note:          Refusals to approve transfers are reviewable under Part 6-9.

             (4)  For the purposes of paragraph (3)(a), in working out the * net asset position of a transferring fund to which subparagraph (1)(b)(ii) applies, disregard the net asset position of the fund to the extent that it relates to insurance policies that do not belong to a * policy group referred to in that subparagraph.

             (5)  The Private Health Insurance (Health Benefits Fund Administration) Rules may provide for the following:

                     (a)  criteria for approving or refusing to approve applications under this section;

                     (b)  how to work out reasonable estimates of the kind referred to in paragraph (3)(a);

                     (c)  criteria for deciding, for the purposes of paragraph (3)(b), whether assets and liabilities would be fairly distributed;

                     (d)  requirements to notify interested persons of the outcomes of such applications;

                     (e)  matters connected with how arrangements take effect, including the following:

                              (i)  insurance policies becoming * referable to a * health benefits fund or funds of the transferee insurer;

                             (ii)  * policy liabilities and other liabilities incurred for the purposes of a health benefits fund or funds of a transferor insurer becoming treated as policy liabilities and other liabilities incurred for the purposes of a health benefits fund or funds of the transferee insurer;

                            (iii)  * assets of a health benefits fund or funds of a transferor insurer becoming assets of a health benefits fund or funds of the transferee insurer;

                            (iv)  the timing of arrangements;

                      (f)  requirements for private health insurers to give the Council information following arrangements taking effect.

             (6)  The transferee insurer must, within 28 days after the arrangement takes effect, notify the Council of the arrangement. The notice must comply with any requirements specified in the Private Health Insurance (Health Benefits Fund Administration) Rules.

             (7)  For the purposes of this Act, an insurance policy that becomes * referable to a * health benefits fund of the transferee insurer as a result of the arrangement is treated, after the arrangement takes effect, as if it were an insurance policy issued by the transferee insurer.

[merger and acquisition of health benefits funds]

(70)   Page 109 (after line 21), at the end of Division 146, add:

146-10   Consent of policy holders not required

                   The consent of the * policy holders of a * health benefits fund is not required for any:

                     (a)  restructuring health benefits funds as provided for in section 146-1; or

                     (b)  entering into arrangements of a kind referred to in section 146-5, or implementing such arrangements;

unless the constitution of the private health insurer conducting the fund provides otherwise.

[restructure, merger and acquisition of health benefits funds]

(71)   Page 109, at the end of Division 146 (after proposed clause 146-10), add:

146-15   Other laws not overridden

                   This Division does not affect the operation of any other law of the Commonwealth, a State or a Territory in relation to:

                     (a)  restructuring * health benefits funds as provided for in section 146-1; or

                     (b)  entering into arrangements of a kind referred to in section 146-5, or implementing such arrangements.

[restructure, merger and acquisition of health benefits funds]

(72)   Clause 149-45, page 114 (line 26), omit “amount”, substitute “value”.

[technical correction]

(73)   Clause 149-55, page 115 (lines 13 to 21), omit the clause, substitute:

149-55   Report of terminating manager

             (1)  The * terminating manager may, at any time, make a written report to the Council on the termination of the * health benefits funds of a private health insurer, and must make such a report as soon as practicable after the termination of the funds.

             (2)  The report may include a recommendation that an application be made under section 149-60 for the winding up of the insurer.

[winding up health benefits funds]

(74)   Clause 149-60, page 115 (lines 23 to 32), omit subclause (1), substitute:

             (1)  If the * terminating manager’s report under section 149-55 includes a recommendation that an application be made under this section for the winding up of a private health insurer, the Council, or the terminating manager, may apply to the Federal Court for an order that the insurer be wound up.

[winding up health benefits funds]

(75)   Clause 149-60, page 116 (after line 2), after subclause (2), insert:

          (2A)  On an application under subsection (1), the Federal Court may make an order that the insurer be wound up if the Court is satisfied that it is in the financial interests of the * policy holders of the * health benefits funds conducted by the insurer that such an order be made.

[winding up health benefits funds]

(76)   Clause 163-10, page 127 (line 23), omit “ * policy holder of”, substitute “person insured under a * complying health insurance product that is * referable to”.

[insured persons]

(77)   Clause 169-5, page 133 (line 19), omit “The report”, substitute “Any such accounts or statements”.

[technical correction]

(78)   Clause 169-15, page 134 (line 24), omit “before”, substitute “not more than 28 days after”.

[deadline for notifying change of CEO]

(79)   Clause 172-5, page 136 (after line 12), at the end of the clause, add:

Note:          Medical practitioners may, in dealings with private health insurers, be able to take advantage of the collective bargaining provisions of Subdivision B of Division 2 of Part VII of the Trade Practices Act 1974 .

[collective bargaining]

(80)   Clause 172-10, page 136 (line 15), omit “ * policy holders of”, substitute “persons insured under * complying health insurance products that are * referable to”.

[insured persons]

(81)   Clause 200-1, page 151 (line 10), omit “the insurer”, substitute “a private health insurer”.

[technical correction]

(82)   Clause 217-10, page 172 (line 23), omit “the * policy holder”, substitute “a * policy holder”.

[technical correction]

(83)   Clause 217-35, page 175 (line 14), omit “administrator”, substitute “ * external manager”.

[external management of health benefits funds]

(84)   Clause 217-35, page 175 (line 16), omit “administrator”, substitute “external manager”.

[external management of health benefits funds]

(85)   Page 181 (after line 25), at the end of Division 217, add:

217-80   Application of provisions of Corporations Act

Regulations etc. under the Corporations Act

             (1)  A reference in an * application provision to an * applied Corporations Act provision includes (unless the contrary intention appears) a reference to any regulations or other instruments in force for the purposes of that provision, or any of those provisions, of the Corporations Act 2001 .

Note:          So, for example, a provision of this Act that applies a particular provision of the Corporations Act 2001 also applies any regulations that have effect for the purposes of that provision (unless a contrary intention appears).

             (2)  An application provision is a provision of this Division that:

                     (a)  provides for the application of a provision, or a group of provisions (including a Chapter, Part, Division or Subdivision), of the Corporations Act 2001 ; or

                     (b)  refers to a provision, or group of provisions, of the Corporations Act 2001 as so applied.

             (3)  An applied Corporations Act provision is a provision, or a provision in a group of provisions, of the Corporations Act 2001 that is applied as mentioned in paragraph (2)(a).

Modifications under the Private Health Insurance (Health Benefits Fund Enforcement) Rules

             (4)  If an * application provision contains a power for the Private Health Insurance (Health Benefits Fund Enforcement) Rules to modify an * applied Corporations Act provision:

                     (a)  the power extends to modifying any regulations or other instruments, in force for the purposes of that provision of the Corporations Act 2001 , that are applied as a result of subsection (1); and

                     (b)  the modifications (whether of the applied Corporations Act provision or of regulations or instruments referred to in paragraph (a)) that may be made include omissions, additions and substitutions.

             (5)  The fact that provision is made in this Act for a specific modification of one or more * applied Corporations Act provisions does not imply that further modifications of that provision, or any of those provisions, consistent with that specific modification, should not be made by the Private Health Insurance (Health Benefits Fund Enforcement) Rules.

Corporations Act definitions and interpretation principles

             (6)  The definitions and interpretation principles that have effect in or under the Corporations Act 2001 have the same effect in relation to:

                     (a)  an * applied Corporations Act provision; or

                     (b)  a provision of regulations or another instrument that is applied as a result of subsection (1);

as that provision applies for the purposes of a provision of this Division, unless a contrary intention appears in an * application provision or in a modification made by the Private Health Insurance (Health Benefits Fund Enforcement) Rules.

Things that may be done under regulations under the Corporations Act

             (7)  If an * applied Corporations Act provision allows something to be done in or by regulations, then:

                     (a)  the Private Health Insurance (Health Benefits Fund Enforcement) Rules may do that thing for the purposes of the applied Corporations Act provision; and

                     (b)  if they do, any regulations or instruments that are applied as a result of subsection (1) are ineffective, for the purposes of this Division, to the extent that they are inconsistent with the provisions of the Private Health Insurance (Health Benefits Fund Enforcement) Rules that do that thing.

[application of provisions of Corporations Act]

(86)   Clause 250-1, page 208 (line 15), after “subsection (1)”, insert “or (2)”.

[technical correction]

(87)   Clause 261-5, page 218 (lines 11 and 12), omit “ * External management and * terminating management of * health benefits funds”, substitute “The Private Health Insurance Administration Council”.

[technical correction]

(88)   Clause 290-10, page 252 (line 22), after “fund”, insert “power”.

[technical correction]

(89)   Page 268 (after line 31), at the end of Division 307, add:

307-30   Other matters

                   The Private Health Insurance (Levy Administration) Rules may, in relation to * private health insurance levy or * late payment penalty, provide for, or for matters relating to, any or all of the following:

                     (a)  methods for payment;

                     (b)  extending the time for payment;

                     (c)  refunding or otherwise applying overpayments.

[administration of levies]

(90)   Clause 328-5, page 284 (after table item 4), insert:

4A

To specify a condition, in relation to a particular facility, to which a declaration that a facility is a * hospital is subject

paragraph 121-7(1)(b)

 

[conditions on declarations of hospitals]

(91)   Clause 328-5, page 284 (after table item 6), insert:

6A

To refuse an application for approval for a private health insurer to convert to being * registered as a for profit insurer

subsection 126-42(5)

 

[conversion to for profit status]

(92)   Clause 333-20, page 291 (line 8), before “The”, insert “(1)”.

[Private Health Insurance Rules]

(93)   Clause 333-20, page 291 (table item 3), omit “, section 188-1 and definition of hospital-substitute treatment in the Dictionary in Schedule 1”, substitute “and section 188-1”.

[relocation of definition of hospital-substitute treatment]

(94)   Clause 333-20, page 291 (after table item 3), insert:

3A

Private Health Insurance (Benefit Requirements) Rules

Part 3-3

[Private Health Insurance (Benefit Requirements) Rules]

(95)   Clause 333-20, page 292 (after line 1), at the end of the clause, add:

             (2)  If, under this Act, Private Health Insurance Rules made by the Minister may modify a provision of this Act or another Act (including by modifying the effect, or the requirements, of such a provision), the Rules may do so by adding, omitting or substituting provisions (including effects or requirements of provisions).

[modifications by Private Health Insurance Rules]

(96)   Clause 333-25, page 293 (after line 6), at the end of the clause, add:

             (3)  If, under this Act, Private Health Insurance Rules made by the Council may modify a provision of this Act or another Act (including by modifying the effect, or the requirements, of such a provision), the Rules may do so by adding, omitting or substituting provisions (including effects or requirements of provisions).

[modifications by Private Health Insurance Rules]

(97)   Schedule 1, page 294 (after line 12), after the definition of applicable benefits arrangement , insert:

application provision is defined in subsection 217-80(2).

[application of provisions of Corporations Act]

(98)   Schedule 1, page 294 (before line 13), before the definition of appointed actuary , insert:

applied Corporations Act provision is defined in subsection 217-80(3).

[application of provisions of Corporations Act]

(99)   Schedule 1, page 294 (lines 17 and 18), omit “subsections 137-1(3) and (4)”, substitute “subsections 137-1(3) to (4A)”.

[restructure of health benefits funds]

(100) Schedule 1, page 297 (lines 6 to 14), omit the definition of hospital-substitute treatment , substitute:

hospital-substitute treatment is defined in section 69-10.

[relocation of definition of hospital-substitute treatment]

(101) Schedule 1, page 298 (after line 17), after the definition of member , insert:

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.

[restructure, merger and acquisition of health benefits funds]

(102) Schedule 1, page 301 (line 22), after “treatment”, insert “or provides a benefit for anything else”.

[expanding coverage of complying health insurance products]

(103) Schedule 1, page 301 (after line 24), after the definition of product , insert:

product subgroup is defined in subsection 63-5(2A).

[product subgroups]

(104) Schedule 1, page 302 (line 27), omit the definition of relevant amount .

[product subgroups]