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Private Health Insurance (Prudential Supervision) Act 2015
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Administered by
Department of the Treasury
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C2023C00251 (C06)
15 September 2023
-
31 December 2023
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Part 1—Introduction
Division 1—Preliminary
1 Short title
2 Commencement
3 Simplified outline of this Act
4 Interpretation
5 General administration of Act
5A Norfolk Island
Division 2—Constitutional matters
6 Act binds the Crown
7 Act not to apply to State insurance within that State
8 Compensation for acquisition of property
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Part 2—Registration of private health insurers
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Division 1—Introduction
9 Simplified outline of this Part
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Division 2—Prohibition of carrying on health insurance business without registration
10 Carrying on health insurance business without registration
11 Injunctions
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Division 3—Registration
12 Applying for registration
13 Requiring further information
14 Criteria for registration
15 Deciding the application
16 Notifying the decision
17 APRA can be taken to refuse application
18 APRA to ensure that up to date record of information about private health insurers is publicly available
19 Changing registration status
20 Conversion to for profit status
21 Cancellation of registration
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Part 3—Health benefits funds
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Division 1—Introduction
22 Simplified outline of this Part
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Division 2—The requirement to have health benefits funds
23 Private health insurers must have health benefits funds
24 Notifying APRA when health benefits funds are established
25 Inclusion of health related businesses in health benefits funds
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Division 3—The operation of health benefits funds
26 Assets of health benefits funds
27 Payments to health benefits funds
28 Expenditure and application of health benefits funds
29 Effect of non compliance with section 28
30 Investment of health benefits funds
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Division 4—Restructure, merger and acquisition of health benefits funds
31 Restriction on restructure, merger or acquisition of health benefits funds
32 Restructure of health benefits funds
33 Merger and acquisition of health benefits funds
34 Consent of policy holders not required
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Division 5—Termination of health benefits funds
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Subdivision A—Approving the termination of health benefits funds
35 Applying for termination
36 Requiring further information
37 Deciding the application
38 APRA can be taken to have refused to approve termination
Subdivision B—Conducting the termination of health benefits funds
39 The basis of the law relating to termination
40 Conduct of funds during termination process
41 Insurers etc. to give reports to APRA
42 Terminating managers displace management of funds
Subdivision C—Ending the termination of health benefits funds
43 Power to end termination
Subdivision D—Completing the termination of health benefits funds
44 Completion of the termination process
45 Distribution of remaining assets after completion of the termination process
46 Liability of officers of insurers for loss to terminated funds
47 Reporting by terminating manager
48 Applying for winding up
Division 6—External management of health benefits funds
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Subdivision A—Preliminary
49 Purpose of Division
50 The basis of the law relating to external management
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Subdivision B—Appointment of external managers
51 APRA may appoint external managers
52 Preconditions for appointment of external managers
53 External managers to displace management of funds
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Subdivision C—Duties and powers of external managers
54 Duties of external managers
55 Additional powers of external managers
56 Protection of property during external management
57 Rights of chargee, owner or lessor of property of fund under external management
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Subdivision D—Procedure relating to voluntary deeds of arrangement
58 Matters that may be included in APRA rules
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Subdivision E—External managers’ reports to APRA
59 External managers to give reports to APRA
60 Dealing with reports given to APRA
61 Federal Court orders in respect of schemes of arrangement
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Subdivision F—Miscellaneous
62 When an external management begins and ends
63 Effect of things done during external management of health benefits funds
64 Disclaimer of onerous property
65 Application of provisions of Corporations Act
Division 7—Ordering the termination of health benefits funds
66 Applications by external managers to the Federal Court
67 Orders made on applications for appointments of terminating managers
68 Notice of appointments
69 Application of other provisions if Federal Court orders appointment of a terminating manager
Division 8—External managers and terminating managers
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Subdivision A—Powers of managers
70 Powers of managers
71 Officers etc. not to perform functions etc. while fund is under management
72 Managers act as agents of private health insurers
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Subdivision B—Information concerning, and records and property of, health benefits funds
73 Directors etc. to help managers
74 Managers’ rights to certain records
75 Only manager can deal with property of fund under management
76 Order for compensation where officer involved in void transaction
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Subdivision C—Provisions incidental to appointment of managers
77 Remuneration and allowances of managers
78 Directions to managers
79 Termination of appointments of managers
80 Acts of managers valid etc.
81 Indemnity
82 Qualified privilege
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Subdivision D—Miscellaneous
83 Time for doing act does not run while act prevented by this Division or other provisions
84 Continued application of other provisions of Act
85 Modifications of this Act in relation to health benefits funds under management
86 Order of Federal Court to be binding on all persons
87 APRA rules dealing with various matters
Division 9—Duties and liabilities of directors etc.
88 Notices to remedy contraventions
89 Liability of directors in relation to non compliance with notices
90 APRA may sue in the name of private health insurers
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Part 4—Prudential standards and directions
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Division 1—Introduction
91 Simplified outline of this Part
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Division 2—Prudential standards
92 Prudential standards
93 Additional matters in relation to standards that are not legislative instruments
94 Compliance with prudential standards
95 Notice of contravention of prudential standards or of other matters that materially affect financial position
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Division 3—Directions
96 APRA’s power to give directions
97 The kinds of direction that may be given
98 Power to comply with a direction
99 Varying or revoking a direction
100 When a direction ceases to have effect
101 Direction not grounds for denial of obligations
102 Supply of information about directions
103 Secrecy requirements
104 Non compliance with a direction
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Part 5—Other obligations of private health insurers
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Division 1—Introduction
105 Simplified outline of this Part
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Division 2—Appointed actuaries
106 Appointment
107 Terminating an appointment as actuary
108 Notification of appointment etc.
109 Role of appointed actuary
110 Actuary’s obligations to inform of matters etc.
111 Appointed actuary may give information or documents to APRA
112 Duty of appointed actuary to give information or documents when required
113 Qualified privilege of appointed actuary
114 Referring matters to professional associations for actuaries
115 APRA may direct removal of actuary
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Division 3—Disqualified persons
116 Private health insurers not to allow disqualified persons to act as officers or appointed actuaries
117 Disqualified persons must not act for private health insurers
118 Effect of non compliance
119 Who is a disqualified person?
120 Court power of disqualification
121 Court power to revoke or vary a disqualification etc.
122 Privilege against exposure to penalty—disqualification under section 120
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Division 4—Miscellaneous
123 Restrictions on payment of pecuniary penalties etc.
124 Giving APRA copies of reports made to policy holders
125 Notifying APRA of name and contact details of officers
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Part 6—Monitoring and investigation
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Division 1—Introduction
126 Simplified outline of this Part
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Division 2—Monitoring
127 Purposes for which powers may be exercised etc.
128 Power to require private health insurer to provide information and reports
129 Power to require production of documents
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Division 3—Investigation
130 Investigation of private health insurers by inspectors
131 Identity cards for inspectors
132 Powers of inspectors
133 Person may be represented by lawyer when being examined
134 Access to premises
135 General provisions relating to obtaining consent to enter premises
136 Investigation warrants
137 Announcement before entry under investigation warrant
138 Inspector to be in possession of investigation warrant
139 Details of warrant etc. to be given to occupier
140 Right to observe execution of warrant
141 Responsibility to provide facilities and assistance
142 Concealing etc. documents
143 Reports of inspectors
144 Dissemination of reports
145 Liability for publishing reports etc.
146 Powers of magistrates
147 Delegation by inspectors
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Division 4—Other matters
148 Refusing or failing to comply with requirements
149 Self incrimination
150 Protection from liability
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Part 7—Enforceable undertakings
151 Simplified outline of this Part
152 Enforceable undertakings
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Part 8—Remedies in the Federal Court
153 Simplified outline of this Part
154 APRA may apply to the Federal Court
155 Declarations of contravention
156 Civil penalty order
157 Compensation order
158 Other order
159 Civil evidence and procedure rules for declarations and orders
160 Civil proceedings after criminal proceedings
161 Criminal proceedings during civil proceedings
162 Criminal proceedings after civil proceedings
163 Evidence given in proceedings for penalty not admissible in criminal proceedings
164 APRA may require person to assist
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Part 9—Miscellaneous
165 Simplified outline of this Part
166 Relief from liability
167 Annual publication of information relating to health benefits funds
168 Review of decisions
169 Statements to accompany notification of decisions
170 Approvals, determinations etc. by APRA
171 Powers of Federal Court
172 Approved forms, and giving documents not required to be in approved forms
173 Delegation by Minister
174 APRA rules
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Endnotes
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history