1. Name of Rules

These Rules are the Private Health Insurance (Incentives) Rules 2007.

2. Commencement

These Rules commence:

(a) if the Rules are registered before the Act commences―at the same time as the Act commences; or

(b) if the Rules are registered on or after the day on which the Act commences―on the date on which the Rules are registered,

whichever occurs first.

3. Definitions

Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the Legislative Instruments Act 2003. These terms include:

complying health insurance policy

incentive payments scheme

participant

participating insurer

premiums reduction scheme

private health insurer

standard information statement

In these rules:

30% Rebate logo means the logo described in rule 9.

Act means the Private Health Insurance Act 2007.

eligible person has the same meaning as in subsection 3 (1) of the Health Insurance Act 1973 and includes a person who is treated as an eligible person under sections 6, 6A or 7 of that Act.

Federal Government 30% Rebate on private health insurance means:

(a) the incentive payments scheme; or

(b) the premiums reduction scheme; or

private health insurance tax offset means a tax offset, under the Income Tax Assessment Act 1997, for a premium, or in respect of a premium, paid under a complying health insurance policy.

Part 2 Premiums reduction scheme

4. Application

This Part applies in relation to financial years beginning on or after 1 July 2007.

5. Registration as a participant

For the purposes of paragraph 23-15 (1) (c) of the Act, the requirements for a person applying to a private health insurer to become a participant in the premiums reduction scheme are:

(a) the person is an individual; and

(b) the person is applying in respect of a complying health insurance policy under which each person covered by the policy is an eligible person.

Note: Division 23 provides for reductions in premiums paid by a person to an insurer. The insurer may claim reimbursement of such reductions under Division 279.

6. Entitlement to incentive payment

For the purposes of paragraph 26-1 (1) (c) of the Act, the requirements for a person to be entitled to a payment are:

(a) the person is an individual; and

(b) the person is applying in respect of a complying health insurance policy under which each person covered by the policy is an eligible person.

Note: Division 26 provides for a payment to the person if the person's premium has not been reduced under Division 23.

7. Conditions of participation

(1) For the purposes of paragraph 206-1 (1) (b) of the Act, the following conditions are specified as conditions of participation in the premiums reduction scheme:

(a) on or before 15 July of each year after the commencement of the Act, the participating insurer must issue to each person who was a participant in respect of a complying health insurance policy on issue from the insurer during any time in the previous financial year, a written statement in accordance with rule 8, setting out:

(i) the amount of the premium paid for the policy during that financial year; and

(ii) the amount of the reduction, under the premiums reduction scheme, for the premium; and

(b) before the participating insurer increases the amount of the premium, the insurer must issue to each participant affected by the increase written notice of:

(i) the amount of the premium; and

(ii) the increase in the amount of the premium; and

(iii) the date when the increase takes effect; and

(iv) the fact that the dollar value of the reduction under the Federal Government 30% Rebate on private health insurance has increased; and

(v) the new amount of the reduction; and

(vi) the new amount of the premium; and

(c) the insurer must use the phrase “Federal Government 30% Rebate on private health insurance” or the 30% Rebate logo in:

(i) advertisements for the Federal Government 30% Rebate on private health insurance; and

(ii) annual statements under paragraph (a); and

(iii) written notices under paragraph (b); and

(iv) forms that are given in relation to the premiums reduction scheme; and

(v) correspondence relating to the premiums reduction scheme.

Note: Rule 9 sets out the details of the 30% Rebate logo.

8. Requirements for statements to participants

(1) A statement under paragraph 7 (1) (a) must not include, be included with or accompany:

(a) information, other than information permitted under subrule 8 (2); or

(b) a written notice of increase of premium under paragraph 7 (1) (b).

(2) For paragraph (1) (a), information which is permitted to be included in a statement under paragraph 7 (1) (a) is all or any of the following:

(a) information that relates directly to the Federal Government 30% Rebate on private health insurance;

(b) information provided in accordance with rule 6 of the Private Health Insurance (Lifetime Health Cover) Rules 2007;

(c) information about the medicare levy surcharge imposed under the Medicare Levy Act 1986 or the A New Tax System (Medicare Levy Surcharge — Fringe Benefits) Act 1999;

(d) a standard information statement;

(e) information that the Department:

(i) has provided to a participating insurer; and

(ii) has identified as being available to be included with, or to accompany, a statement under paragraph 7 (1) (a);

(f) information required to be provided by the Act or any of the Rules made under the Act.

9. 30% Rebate logo

(1) The logo for the Federal Government 30% Rebate on private health insurance is:

(2) In any reproduction of the logo:

(a) the portions other than the shaded areas of the umbrella must be black and white, as shown in subrule (1); and

(b) the shaded areas of the umbrella must be:

(i) in the case of monochrome reproduction — 60% black; and

(ii) in any other case — red (PMS 032).

Note

1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See www.frli.gov.au

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