Commonwealth Consolidated Acts Commonwealth Consolidated ActsNote: See section 1 - 10.
In this Act:
"accessory" has the meaning given by subsection 72 - 11(3).
"adjustment factor" for an adjustment year has the meaning given by subsection 22 - 15(5E).
"adjustment year" has the meaning given by subsection 22 - 15(5D).
"adult" :
(a) when used outside Part 2 - 3--means a person who is not a * dependent person; or
(b) when used in Part 2 - 3--means a person who is not:
(i) a * dependent child; or
(ii) a * dependent non - student; or
(iii) a * dependent student.
"applicable benefits arrangement" means an applicable benefits arrangement within the meaning of the National Health Act 1953 as in force before 1 April 2007.
"approved form" is a form that meets the requirements in section 333 - 10.
"APRA" means the Australian Prudential Regulation Authority.
"APRA private health insurance duty, function or power" : see subsection 323 - 1(1A).
"Australia" , when used in a geographical sense, includes Norfolk Island, the Territory of Cocos (Keeling) Islands and the Territory of Christmas Island.
"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).
"Chief Executive Medicare" has the same meaning as in the Human Services (Medicare) Act 1973 .
"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.
"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.
cost-recovery fee has the meaning given by subsection "72" - 15(1).
"cover" has a meaning affected by section 69 - 5.
"declaration of contravention" means a declaration under section 203 - 5.
"dependent child" means a person who:
(a) is aged under 18; and
(b) does not have a partner.
"dependent non-student" means a person who:
(a) is aged between 18 and 31 (inclusive); and
(b) is not receiving full - time education at a school, college or university; and
(c) is a dependent non - student under the * rules of the private health insurer that insures the person; and
(d) does not have a partner.
"dependent person" means:
(a) a * dependent child; or
(b) a * dependent non - student; or
(c) a * dependent person with a disability; or
(d) a * dependent student.
"dependent person with a disability" means a person:
(a) who is aged 18 or over; and
(b) who is:
(i) a person with a disability within the meaning of the expression person with a disability as defined by the Private Health Insurance (Complying Product) Rules; or
(ii) a person with a disability within the meaning of the expression person with a disability as defined by the * rules of the private health insurer that insures the person.
To avoid doubt, a dependent person with a disability may have a partner.
"dependent student" means a person who:
(a) is aged between 18 and 31 (inclusive); and
(b) is receiving full - time education at a school, college or university; and
(c) is a dependent student under the * rules of the private health insurer that insures the person; and
(d) does not have a partner.
"director" has the same meaning as in the Corporations Act 2001 .
"employee health benefits scheme" is defined in section 121 - 15.
"enforceable obligation" is defined in section 185 - 5.
"family tier 1 threshold" has the meaning given by section 22 - 40.
"family tier 2 threshold" has the meaning given by section 22 - 40.
"family tier 3 threshold" has the meaning given by section 22 - 40.
"Federal Court" means the Federal Court of Australia.
"general interest charge" means the charge worked out under Part IIA of the Taxation Administration Act 1953 .
"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 person.
"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.
"human tissue product" has the meaning given by section 72 - 12.
"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).
"income for surcharge purposes" , of a person for a financial year, means the income for surcharge purposes (within the meaning of the Income Tax Assessment Act 1997 ) for the person for the * income year corresponding to the financial year.
"income year" has the meaning given by the Income Tax Assessment Act 1997 .
"indexation factor" has the meaning given by section 22 - 45.
"index number" has the meaning given by section 22 - 45.
"ineligible for Medicare" , in relation to a person, means not an eligible person within the meaning of the Health Insurance Act 1973 .
"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.
"medical device" has the meaning given by section 72 - 11.
medical devices and human tissue products levy is defined in paragraph "304" - 10(da).
"medical practitioner" means a medical practitioner within the meaning of the Health Insurance Act 1973 .
"medicare benefit" means a medicare benefit under Part II of the Health Insurance Act 1973 .
"medicare eligibility day" is defined in subsection 34 - 25(5).
"medicare program" has the same meaning as in the Human Services (Medicare) Act 1973 .
"national joint replacement register levy" is defined in paragraph 304 - 10(e).
"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.
"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" has the same meaning as in the Privacy Act 1988 .
"PHIIB" (short for Private Health Insurance Incentive Beneficiary ) has the meaning given by section 22 - 5.
"PHII benefit" (short for Private Health Insurance Incentive benefit ) has the meaning given by section 22 - 10.
"policy holder" , of a * health benefits fund, means a * holder of a policy that is * referable to the fund.
"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 information statement" is defined in section 93 - 5.
"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 (Medical Devices and Human Tissue Products) 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 established by section 20C of the Ombudsman Act 1976 .
"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 body that is registered under Division 3 of Part 2 of the Private Health Insurance (Prudential Supervision) Act 2015 .
"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).
"quarter" has the meaning given by the Income Tax Assessment Act 1997 .
"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 4 of Part 3 of the Private Health Insurance (Prudential Supervision) Act 2015 ); or
(b) the policy has been made referable to the fund under Division 4 of Part 3 of the Private Health Insurance (Prudential Supervision) Act 2015 .
"restricted access insurer" has the same meaning as in the Private Health Insurance (Prudential Supervision) Act 2015 .
"risk equalisation jurisdiction" is defined in subsection 131 - 20(1).
"risk equalisation levy" is defined in paragraph 304 - 10(d).
"Risk Equalisation Special Account" : see subsection 318 - 1(1).
"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.
"share of the PHII benefit" has the meaning given by sections 22 - 15, 22 - 20 and 22 - 25.
"singles tier 1 threshold" has the meaning given by section 22 - 35.
"singles tier 2 threshold" has the meaning given by section 22 - 35.
"singles tier 3 threshold" has the meaning given by section 22 - 35.
"tax file number" means a tax file number as defined in section 202A of the Income Tax Assessment Act 1936 .
"termination day" , in relation to the * health benefits funds of a private health insurer, is defined in subsection 149 - 20(2).
"tier 1 earner" has the meaning given by section 22 - 30.
"tier 2 earner" has the meaning given by section 22 - 30.
"tier 3 earner" has the meaning given by section 22 - 30.
"transfer" , in relation to a person, is defined in section 75 - 10.
"up to date" , in relation to a * private health 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.