Commonwealth Consolidated Acts Commonwealth Consolidated ActsNo. 85, 2015
Compilation No. 8
Compilation date: 14 October 2024
Includes amendments: Act No. 39, 2024
About this compilation
This compilation
This is a compilation of the Private Health Insurance (Prudential Supervision) Act 2015 that shows the text of the law as amended and in force on 14 October 2024 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.
Self-repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
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
Part 2--Registration of private health insurers
Division 1--Introduction
9 Simplified outline of this Part
Division 2--Prohibition of carrying on health insurance business without registration
10 Carrying on health insurance business without registration
11 Injunctions
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
Part 3--Health benefits funds
Division 1--Introduction
22 Simplified outline of this Part
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
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
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
Division 5--Termination of health benefits funds
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
Subdivision A--Preliminary
49 Purpose of Division
50 The basis of the law relating to external management
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
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
Subdivision D--Procedure relating to voluntary deeds of arrangement
58 Matters that may be included in APRA rules
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
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
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
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
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
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
Part 4--Prudential standards and directions
Division 1--Introduction
91 Simplified outline of this Part
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
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
Part 5--Other obligations of private health insurers
Division 1--Introduction
105 Simplified outline of this Part
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
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
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
Part 6--Monitoring and investigation
Division 1--Introduction
126 Simplified outline of this Part
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
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
Division 4--Other matters
148 Refusing or failing to comply with requirements
149 Self-incrimination
150 Protection from liability
Part 7--Enforceable undertakings
151 Simplified outline of this Part
152 Enforceable undertakings
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
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
Endnotes
Endnote 1--About the endnotes
Endnote 2--Abbreviation key
Endnote 3--Legislation history
Endnote 4--Amendment history
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1--About the endnotes
Endnote 2--Abbreviation key
Endnote 3--Legislation history
Endnote 4--Amendment history
Abbreviation key--Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history--Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and "(md not incorp)" is added to the amendment history.
ad = added or inserted | o = order(s) |
am = amended | Ord = Ordinance |
amdt = amendment | orig = original |
c = clause(s) | par = paragraph(s)/subparagraph(s) |
C[x] = Compilation No. x | /sub-subparagraph(s) |
Ch = Chapter(s) | pres = present |
def = definition(s) | prev = previous |
Dict = Dictionary | (prev ... ) = previously |
disallowed = disallowed by Parliament | Pt = Part(s) |
Div = Division(s) | r = regulation(s)/rule(s) |
ed = editorial change | reloc = relocated |
exp = expires/expired or ceases/ceased to have | renum = renumbered |
effect | rep = repealed |
F = Federal Register of Legislation | rs = repealed and substituted |
gaz = gazette | s = section(s)/subsection(s) |
LA = Legislation Act 2003 | Sch = Schedule(s) |
Sdiv = Subdivision(s) | |
(md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
effect | SR = Statutory Rules |
(md not incorp) = misdescribed amendment | Sub-Ch = Sub-Chapter(s) |
cannot be given effect | SubPt = Subpart(s) |
mod = modified/modification | underlining = whole or part not |
No. = Number(s) | commenced or to be commenced |
Endnote 3--Legislation history
Act | Number and year | Assent | Commencement | Application, saving and transitional provisions |
85, 2015 | 26 June 2015 | 1 July 2015 (s 2(1) item 1) |
| |
87, 2015 | 26 June 2015 | Sch 1 (item 181): 1 July 2016 (s 2(1) item 6) | Sch 2 | |
11, 2016 | 29 Feb 2016 | Sch 2 (items 308-312) and Sch 3 (item 4): 1 Mar 2017 (s 2(1) items 7, 8) | -- | |
Financial System Legislation Amendment (Resilience and Collateral Protection) Act 2016 | 43, 2016 | 4 May 2016 | Sch 1 (items 47, 48): 1 June 2016 (s 2(1) item 2) | Sch 1 (item 48) |
Private Health Insurance Legislation Amendment (Age of Dependants) Act 2021 | 60, 2021 | 29 June 2021 | Sch 1 (items 23-25): 1 Apr 2021 (s 2(1) item 1) | -- |
Financial Accountability Regime (Consequential Amendments) Act 2023 | 68, 2023 | 14 Sept 2023 | Sch 1 (items 74-84) and Sch 2 (items 1, 27): 15 Sept 2023 (s 2(1) items 2, 4) | Sch 2 (items 1, 27) |
Treasury Laws Amendment (Modernising Business Communications and Other Measures) Act 2023 | 69, 2023 | 14 Sept 2023 | Sch 1 (items 131-134): 1 Jan 2024 (s 2(1) item 3) | -- |
Administrative Review Tribunal (Consequential and Transitional Provisions No. 2) Act 2024 | 39, 2024 | 31 May 2024 | Sch 14 (items 54-61): 14 Oct 2024 (s 2(1) item 2) | -- |
Provision affected | How affected |
Part 1 |
|
Division 1 |
|
s 4..................... | am No 60, 2021 |
s 5A.................... | ad No 87, 2015 |
Part 2 |
|
Division 3 |
|
s 15.................... | am No 60, 2021 |
s 20.................... | am No 69, 2023 |
s 21.................... | am No 68, 2023 |
Part 3 |
|
Division 5 |
|
Subdivision B |
|
s 40.................... | am No 69, 2023 |
Division 6 |
|
Subdivision A |
|
s 50.................... | am No 11, 2016 |
Subdivision B |
|
s 51.................... | am No 11, 2016 |
Subdivision F |
|
s 65.................... | am No 11, 2016 |
Division 8 |
|
Subdivision B |
|
s 75.................... | am No 69, 2023 |
Subdivision D |
|
s 84.................... | am No 68, 2023 |
Part 4 |
|
Division 2 |
|
s 92.................... | am No 87, 2015 |
Division 3 |
|
s 101................... | am No 43, 2016 |
Part 5 |
|
Division 2 |
|
s 107................... | am No 68, 2023 |
s 110................... | am No 68, 2023 |
s 111................... | am No 68, 2023 |
s 112................... | am No 68, 2023 |
s 113................... | am No 68, 2023 |
Division 3 |
|
s 122................... | am No 39, 2024 |
Division 3 |
|
s 119................... | am No 68, 2023 |
s 120................... | am No 68, 2023 |
Part 9 |
|
s 168................... | am No 68, 2023; No 39, 2024 |
s 169................... | am No 39, 2024 |