National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999
I, MICHAEL RICHARD LEWIS WOOLDRIDGE, Minister for Health and Aged Care, make this Determination under subsection 73BA (4) of the National Health Act 1953.
Dated 12 October 1999.
MICHAEL WOOLDRIDGE
Minister for Health and Aged Care
National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999
made under the
National Health Act 1953
Contents
Page
1 Name of Determination
2 Commencement
3 Definitions
4 Maximum percentage of discount
5 Commissions, etc
6 Discounts include some reduced contribution rates
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1 Name of Determination
This Determination is the National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999.
2 Commencement
This Determination commences on the same day as Schedule 1 to the Health Legislation Amendment Act (No. 2) 1999.
3 Definitions
In this Determination:
Act means the National Health Act 1953.
ancillary health benefits has the meaning given by subsection 67 (4) of the Act.
Note Expressions used in this Determination that are defined in the Act have the same meaning in this Determination as they have in the Act, including:
- applicable benefits arrangement
4 Maximum percentage of discount
For subsection 73BA (4) of the Act, the maximum percentage of discount that an organisation may offer to contributors on their rate of contribution is 12% of the undiscounted rate of contribution available to all contributors.
5 Commissions, etc
For working out the percentage of discount offered by an organisation to contributors for a period, the discounted rate is taken to include:
(a) any commission, brokerage fee, inducement or other sum payable for the period for having the contribution paid in a payment circumstance mentioned in subparagraph (s) (i), (ii), (iii) or (iv) of Schedule 1 to the Act; and
(b) if, during the period, the organisation waives a requirement under the applicable benefits arrangement or table of ancillary benefits for the contributor to bear an excess or to make a co-payment under an election mentioned in subparagraph (ba) (ii) of Schedule 1 to the Act — the amount by which the contributions for that arrangement or table are less than the contributions for an arrangement or table that is not substantially different except for the requirement.
6 Discounts include some reduced contribution rates
(1) A difference between the rate of contribution offered by an organisation for an applicable benefits arrangement or a table of ancillary benefits and the rate of contribution offered by the organisation for another arrangement or table is taken to be a discount unless there is a substantial difference between:
(a) the level, or range, of benefits available under the arrangements or tables; or
(b) the level of excess applicable to some or all of the benefits (including a difference arising from the imposition of an excess).
(2) The highest rate of contribution under arrangements or tables mentioned in subsection (1) is taken to be the undiscounted rate of contribution and the other rates are taken to be discounted rates of that rate.
Overview
The National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999 was enacted to provide clarity and regulation around the maximum allowable discount that organisations can offer to contributors on their health insurance contributions under the National Health Act 1953. This Determination was made by MICHAEL RICHARD LEWIS WOOLDRIDGE, the Minister for Health and Aged Care, under subsection 73BA(4) of the Act. It was introduced to address the need for a standardised limit on discounts to ensure fairness and transparency in the health insurance contributions process, thereby supporting the policy objective of maintaining equitable health coverage across all contributors. The Determination commenced on the same day as Schedule 1 to the Health Legislation Amendment Act (No. 2) 1999, setting a clear framework for how discounts can be applied within the health benefits system.
Scope and Application
The National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999 applies to organisations that offer health benefits to contributors, as defined under the National Health Act 1953. This includes entities such as private health insurance providers, employers offering private health cover as part of an employee benefits package, and other bodies that facilitate contributions towards health benefits. The Determination specifies the maximum allowable discount on the undiscounted rate of contribution that these organisations may offer to contributors, setting this maximum at 12%. It applies nationally, aligning with the provisions of the National Health Act 1953 which is a Commonwealth Act, thereby ensuring uniform application across Australia.
The scope of this Determination extends to any contributions made under applicable benefits arrangements or tables of ancillary benefits, provided these do not significantly differ in terms of benefit levels or excesses. Notably, the Determination encompasses various forms of discounts, including commissions, brokerage fees, and inducements, as well as any waivers of excess or co-payment requirements. However, the Determination does not explicitly mention any exclusions or exemptions beyond those defined in the Act itself. The application of the Determination can be further detailed or modified through subordinate instruments, which would need to be consistent with the overarching provisions of the National Health Act 1953.
Key Provisions
The National Health (Maximum Percentage of Discounting of Contributions to Organisations) Determination 1999 (the Determination) is a legislative instrument that sets out the maximum percentage of discount that organisations may offer to contributors on their rate of contribution under the National Health Act 1953. The Determination commences on the same day as Schedule 1 to the Health Legislation Amendment Act (No. 2) 1999. The primary provision of the Determination is that the maximum percentage of discount an organisation may offer to contributors is 12% of the undiscounted rate of contribution available to all contributors (section 4). This provision is crucial as it regulates the extent to which organisations can reduce contributions, thereby ensuring a level playing field and preventing excessive discounts that could undermine the financial stability of health funds.
The Determination imposes several obligations on the parties it governs. Organisations must ensure that the discount offered to contributors does not exceed the 12% limit specified in the Determination. Additionally, when calculating the percentage of discount, organisations must include any commission, brokerage fee, inducement, or other sum payable for having the contribution paid in specific payment circumstances (section 5). This includes situations where the organisation waives a requirement for the contributor to bear an excess or make a co-payment under certain conditions. These obligations are essential for maintaining transparency and fairness in the discounting process.
Failure to comply with the provisions of the Determination can result in significant consequences. While the Determination does not explicitly outline offences or penalties, non-compliance could lead to legal challenges under the National Health Act 1953 or other relevant legislation. Organisations that exceed the maximum discount percentage could face scrutiny from regulatory bodies and potential financial penalties. In severe cases, persistent non-compliance might result in the revocation of the organisation's licence to operate within the health sector. The Determination thus serves as a regulatory framework that organisations must adhere to in order to avoid legal and financial repercussions.