EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Private Health Insurance Act 2007
Private Health Insurance (Complying Product) Amendment Rules 2008 (No.4)
Section 333-20 of the Private Health Insurance Act 2007 (the Act) provides that the Minister may make Private Health Insurance (Complying Product) Rules providing for matters required or permitted by Chapter 3 of the Act to be provided; or necessary or convenient to be provided in order to carry out or give effect to the Act.
The Private Health Insurance (Complying Product) Amendment Rules 2008 (No.4) (the Amendment Rules) commence on 1 January 2009, or if registered after that date, on the day following their registration on the Federal Register of Legislative Instruments. The Amendment Rules amend the Private Health Insurance (Complying Product) Rules 2008 (No. 2) (the Rules), which commenced on 1 July 2008, and were subsequently amended by the Private Health Insurance (Complying Product) Amendment Rules 2008 (No. 2) as of
20 September 2008, and the Private Health Insurance (Complying Product) Amendment Rules 2008 (No. 3) as of 8 December 2008.
Part 3-4 of the Act sets out private health insurers obligations relating to complying health insurance products. Division 93 of Part 3-4 of the Act sets out the requirement for all private health insurers to provide standard information statements (SIS). An SIS provides key information about complying health insurance products, including restrictions and exclusions, and is in the form set out in the Rules.
The Amendment Rules amend Schedules 2, 3 and 4 of the Rules, which relate to SISs. The amendments introduce a third symbol (an asterisk) in the ‘Cover’ column on the general treatment and combined treatment SISs, and an explanation field to enable the SIS to accurately identify general treatment services for products that require a consumer to choose which general treatment services they want covered, from a range of services able to be covered by that product (products with ‘mix and match’ features).
Details of the amendments to the Rules are set out in the Attachment.
The Office of Best Practice Regulation has advised that a Regulation Impact Statement is not required.
Consultation
The Department has consulted the Private Health Insurance Ombudsman (PHIO) on this issue. The PHIO maintains the consumer website www.privatehealth.gov.au which also holds the information contained in SISs. The PHIO web administrator, Human Solutions, will make the system changes on the website that will facilitate the amendment to the Rules.
The Department has also consulted the Private Health Insurance Administration Council, BUPA Australia, HBF Health Funds Inc, the Health Insurance Restricted Membership Association of Australia and the Australian Health Insurance Association. All stakeholders were supportive of the proposed changes.
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
DECEMBER 2008
ATTACHMENT
DETAILS OF THE PRIVATE HEALTH INSURANCE (COMPLYING PRODUCT) AMENDMENT RULES 2008 (No.4)
1. Name of Rules
Rule 1 provides that the title of the Amendment Rules is the Private Health Insurance (Complying Product) Amendment Rules 2008 (No.4).
2. Commencement
Rule 2 provides that the Amendment Rules are to commence on 1 January 2009, or if registered after that date, on the day following their registration on the Federal Register of Legislative Instruments (FRLI).
3. Amendments
Rule 3 provides that the Schedule to the Amendment Rules amends the Private Health Insurance (Complying Product) Rules 2008 (No.2).
Schedule 1 – Amendments
[1] Schedule 4 – Standard information statements: permitted content
This schedule provides for the permitted content for all statements as set out in Part 3 of the Rules.
Schedule 4, Part 3 – general treatment has been amended to add:
- ‘ (see note below)’ to the ‘Covered’ column in the ‘Permitted Content’ field, between the lines ‘ (service is not covered)’ and ‘n/a (for ambulance where it is covered by the state government)’; and
- ‘ <Special features of the product>’ and four blank lines for free text describing the features of the product, above the ‘Health Care Programs and Other Features’ box.
The addition ‘* <Special features of the product>’ and four blank lines for free text are linked to the ‘Permitted Content’ field of the ‘Covered’ column. It will remain invisible unless an asterisk is entered in the ‘Permitted Content’ field of the ‘Covered’ column. An asterisk automatically activates this addition and prompts health insurers to describe the special features of their product.
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