National Health (Loyalty Bonus Scheme) Guidelines 1999 (Cth)

National Health (Loyalty Bonus Scheme) Guidelines 1999

I, MICHAEL WOOLDRIDGE, Minister for Health and Aged Care, make these Guidelines under subsection 73BA (2A) of the National Health Act 1953.

Dated 13 October 1999.

MICHAEL WOOLDRIDGE
Minister for Health and Aged Care

National Health (Loyalty Bonus Scheme) Guidelines 1999

made under the

National Health Act 1953

Contents

Page

Part 1        Preliminary

1  Name of Guidelines   4

2  Commencement   4

3  Interpretation   4

4  Application   5

Part 2        Circumstances in which an organization can offer a loyalty bonus

5  Loyalty bonus to be based on membership duration              6

6  Ascertaining membership duration   6

7  Circumstances affecting calculation of membership duration  6

8  Circumstances not affecting membership continuity              7

9  Eligibility for loyalty bonus   8

10  Notice   8

Part 3        Types of loyalty bonuses

11  Uniformity   9

Part 1                 Preliminary

1. Name of Guidelines

These Guidelines are the National Health (Loyalty Bonus Scheme) Guidelines 1999.

1. Commencement

These Guidelines commence on 20 October 1999.

1. Interpretation

(1)   In these Guidelines:

Act means the National Health Act 1953.

fund means a health benefits fund conducted by an organization.

loyalty bonus means financial benefits, goods or services offered under a loyalty bonus scheme, within the meaning of section 73BA of the Act.

specified change, for a contributor, means a change in the contributor’s kind of membership:

(a)    from single to couple, family or single parent; or

(b)    from couple to family, single parent or single; or

(c)    from family to single parent, single or couple; or

(d)    from single parent to single, couple or family.

(2)For these Guidelines, a continuous period of contributions to a fund is not broken by:

(a)    a specified change; or

(b)    a lapse in contributions, if the rules of the fund make provision, of consistent application to all contributors, recognising continuity despite lapses in contributions.

1. Application

These Guidelines apply to rules of an organization that permit the implementation of a scheme of the kind to which paragraph (ma) of Schedule 1 to the Act applies.

Part 2                 Circumstances in which an organization can offer a loyalty bonus

1. Loyalty bonus to be based on membership duration

For subsection 73BA (2A) of the Act, a loyalty bonus may be offered by an organization only in the circumstance described in paragraph (ma) of Schedule 1 to the Act.

1. Ascertaining membership duration

(1)   An organization’s rules dealing with the calculation of the duration of a contributor’s membership of the fund conducted by the organization must comply with subsection (2).

(2)   To the extent that the rules determine eligibility of a person, or a class of persons, to receive a loyalty bonus because of the period of time over which contributions have been paid:

(a)    commencement of membership of the fund must be taken to occur when the first contribution in a continuous period of contributions to the fund is paid by, or on behalf of, the contributor in relation to any applicable benefits arrangement of the organization; and

(b)    rules that affect determination of continuity of membership of a contributor must apply consistently to all contributors.

1. Circumstances affecting calculation of membership duration

(1)   An organization may make rules that affect the calculation of the duration of a contributor’s membership of a fund by taking into account the following circumstances:

(a)    the contributor suspends, with the organization’s agreement, his or her contributions to the fund;

(b)    the contributor, having temporarily ceased contributions to the fund concerned in order to contribute to the fund of a different organization, resumes contributions to the fund concerned;

(c)    the contributor has a record of previous contributions to another fund;

(d)    the contributor contributes only to a table of ancillary health benefits.

(2)   An organization may make rules about the extent to which the organization takes into account, for the calculation of the duration of a contributor’s membership of a fund, the contributor’s membership before a specified change by the contributor.

For example

While a change by a contributor from single membership to couple, family or single parent membership does not break a continuous period of contribution by the contributor, the rules may provide for the way in which the duration of that membership is to be calculated in this circumstance.

(3)   A rule made under subsection (1) or (2) must:

(a)    apply consistently to all contributors; and

(b)    state how the duration of a contributor’s membership is to be calculated in the circumstance.

(4)   Any amendment of a rule that affects the calculation of the duration of a contributor’s membership of a fund must not affect the calculation of the duration of the contributor’s membership before the amendment takes effect.

1. Circumstances not affecting membership continuity

For these Guidelines, continuity of membership of a person in an organization must not be affected by:

(a)    a contributor having discontinued contributions to an applicable benefits arrangement of the organization, or a table of ancillary health benefits offered by the organization, for the purpose of enabling contributions to be made to a different arrangement or table offered by the organization; or

(b) a period of unpaid contributions to which paragraph (g) of Schedule 1 to the Act applies and for which payment is made as provided in subparagraph (g) (i) of Schedule 1 to the Act.

1. Eligibility for loyalty bonus

Eligibility of a person to receive a loyalty bonus from an organization cannot be affected by rules that allow the organization to exclude the person because contributions have been made to the fund by, or on behalf of, the person, for longer than a specified period.

1. Notice

An organization that operates a loyalty bonus scheme must give each contributor to the health benefits fund conducted by the organization notice of the existence of its rules relating to the scheme, and information on how to obtain a copy of those rules.

Part 3                 Types of loyalty bonuses

1. Uniformity

(1)   The type of loyalty bonus that can be offered by an organization is unlimited except that each person eligible to receive the loyalty bonus must be offered the same type, or the same choice of types, as each other eligible person.

(2)   However:

(a)    loyalty bonuses for contributors to a particular applicable benefits arrangement, or a particular table of ancillary health benefits, need not be the same as loyalty bonuses for dependants of contributors; and

(b)    loyalty bonuses relating to a particular applicable benefits arrangement, or a particular table of ancillary health benefits, need not be the same as loyalty bonuses relating to another applicable benefits arrangement or table of ancillary health benefits.