House of Representatives

Private Health Insurance Incentives Amendment Bill 2004

Explanatory Memorandum

(Circulated by authority of the Minister for Health and Ageing, the Honourable Tony Abbott MP)

Schedule 1 - Changes to the Private Health Insurance Rebate for people aged 65 and over

Part 1 - Amendment of the Private Health Insurance Incentives Act 1998

Item 1: Subsections 4-10(5) and (6)

Item 1 repeals subsections 4-10(5) and (6) and substitutes new subsections 4-10(5) and (6).

New subsections (5) and (6) make changes necessary to introduce the 35% and 40% private health insurance rebate where the choice is made to make a direct claim for the rebate from Medicare offices.

New subsections (5) and (6) continue the distinction between persons who were registered or eligible to apply for registration before 1 January 1999 under the Private Health Insurance Incentives Act 1997, in respect of the policy for the financial year that began on 1 July 1998, and persons who were not.

Subsection (5) provides that if no person was so registered or eligible to apply for registration, the amount payable is the sum of the following amounts:

a.
30% of the amount of the premium paid by an individual, or by their employer as a *fringe benefit for the individual, under the policy in respect of days in the later financial year on which no person covered by the policy was aged 65 years or over;
b.
35% of the amount of the premium paid by an individual, or by their employer as a *fringe benefit for the individual, under the policy in respect of days in the later financial year on which:

at least one person covered by the policy was aged 65 years or over; and
no person covered by the policy was aged 70 years or over;

c.
40% of the amount of the premium paid by an individual, or by their employer as a *fringe benefit for the individual, under the policy in respect of days in the later financial year on which at least one person covered by the policy was aged 70 years or over.

An individual does not include an individual in the capacity of a trustee or employer: subsection 1-15(5) of the Private Health Insurance Incentives Act 1998 (the Act). A fringe benefit is defined in section 20-5 of the Act. Subsection (5) refers to 'later' financial year, because subsection 4-10(2) of the Act applies for the 1998-99 financial year.

Subsection (6) provides that if a person was so registered or eligible to apply for registration, the amount payable is the greater of:

a.
the sum of the amounts referred to in paragraphs 4-10(5)(a), (b) and (c); and
b.
the *incentive amount for the policy for the later financial year.

The phrases *fringe benefit and *incentive amount are defined in sections 20-5 and 20-10 of the Act. Subsection (6) refers to 'later' financial year, because subsection 4-10(3) of the Act applies for the 1998-99 financial year.

Item 2: After section 4-10

Item 2 inserts section 4-12.

The new section 4-12 establishes a savings provision which is intended to protect a person ('the first person') covered by a policy (and who may not otherwise be eligible in their own right for the higher rebate) where the person eligible for the higher rebate ('the entitling person') ceases to be covered by the policy.

The purpose of the savings provision is to ensure that the change in family circumstances covered by section 4-12 will not lead to an overpayment and a debt to the Government.

The section applies to a person (the first person), other than a *dependent child, if:

they were covered by an *appropriate private health insurance policy; and
due to the age of the entitling person the higher 35% or 40% rebate was payable; and
the entitling person ceases to be covered by the original policy.

The section operates to continue the first person's eligibility for the higher private health insurance rebate if the person:

is covered by an *appropriate private health insurance policy (whether the original policy or not); and
each other person (if any) covered, since the entitling person ceased to be covered by the original policy, by an *appropriate private health insurance policy that also covered the first person is a *dependent child, or a person who was covered by the original policy.

The phrases *appropriate private health insurance policy and *dependent child are defined in section 20-5 of the Act.

The savings provision does not operate if its application would result in the amount of the rebate payable being less than it would otherwise have been.

Item 3: Subsections 12-5(2A) and (3)

Item 3 repeals subsections 12-5(2A) and (3) and substitutes new subsections 12-5(2A) and (3).

New subsections (2A) and (3) make changes necessary to introduce the 35% and 40% private health insurance rebate where the choice is made to receive the rebate as a premium reduction through private health insurance funds.

New subsections (2A) and (3) continue the distinction between persons who were registered or eligible to apply for registration before 1 January 1999 under the Private Health Insurance Incentives Act 1997, in respect of the policy for the financial year that began on 1 July 1998, and persons who were not.

Subsection (2A) provides that if the financial year is a later financial year, and no person was so registered or eligible to apply for registration, the amount of the reduction is the sum of the following amounts:

c.
30% of the amount of the premium payable under the policy in respect of days in the later financial year on which no person covered by the policy was aged 65 years or over;
d.
35% of the amount of the premium payable under the policy in respect of days in the later financial year on which:

at least one person covered by the policy was aged 65 years or over; and
no person covered by the policy was aged 70 years or over;

e.
40% of the amount of the premium payable under the policy in respect of days in the later financial year on which at least one person covered by the policy was aged 70 years or over.

Subsection (2A) refers to 'later' financial year, because subsection 12-5(1B) of the Act applies for the 1998-99 financial year.

Subsection (3) provides that if the financial year is a later financial year and a person was so registered or eligible to apply for registration, the amount of the reduction is the greater of:

f.
the sum of the amounts referred to in paragraphs 12-5(2A)(a), (b) and (c); and
g.
the *incentive amount for the policy for the later financial year.

The phrase *incentive amount is defined in section 20-10 of the Act. Subsection (3) refers to 'later' financial year, because subsection 12-5(2) of the Act applies for the 1998-99 financial year.

Item 4: After section 12-5

Item 4 inserts section 12-7.

The new section 12-7 establishes a savings provision which is intended to protect a person ('the first person') covered by a policy (and who may not otherwise be eligible in their own right for the higher rebate) where the person eligible for the higher rebate ('the entitling person') ceases to be covered by the policy.

The purpose of the savings provision is to ensure that the change in family circumstances covered by section 12-7 will not lead to an overpayment and a debt to the Government.

The section applies to a person (the first person), other than a *dependent child, if:

they were covered by an *appropriate private health insurance policy; and
due to the age of the entitling person the higher 35% or 40% rebate was payable; and
the entitling person ceases to be covered by the original policy.

The section operates to continue the first person's eligibility for the higher private health insurance rebate if the person:

is covered by an *appropriate private health insurance policy (whether the original policy or not); and
each other person (if any) covered, since the entitling person ceased to be covered by the original policy, by an *appropriate private health insurance policy that also covered the first person is a *dependent child, or a person who was covered by the original policy.

The phrases *appropriate private health insurance policy and *dependent child are defined in section 20-5 of the Act.

The savings provision does not operate if its application would result in the amount of the rebate payable being less than it would otherwise have been.

Part 2 - Amendment of the Income Tax Assessment Act 1997

Item 5: Subsections 61-340(5) and (6)

Item 5 repeals subsections 61-340(5) and (6) and substitutes new subsections 61-340(5) and (6).

New subsections (5) and (6) make changes necessary to introduce the 35% and 40% private health insurance rebate where the choice is made to receive the rebate as a tax offset in annual tax returns.

New subsections (5) and (6) continue the distinction between persons who were registered or eligible to apply for registration before 1 January 1999 under the Private Health Insurance Incentives Act 1997, in respect of the policy for the financial year that began on 1 July 1998, and persons who were not.

Subsection (5) provides that if no person was so registered or eligible to apply for registration, the amount of the *tax offset is the sum of the following amounts:

h.
30% of the amount of the premium, or of the amount in respect of a premium, paid by the individual, or by their employer as a *fringe benefit for the employee, under the policy in respect of days in the later income year on which no person covered by the policy was aged 65 years or over;
i.
35% of the amount of the premium, or of the amount in respect of a premium, paid by the individual, or by their employer as a *fringe benefit for the employee, under the policy in respect of days in the later income year on which:

at least one person covered by the policy was aged 65 years or over; and
no person covered by the policy was aged 70 years or over;

j.
40% of the amount of the premium, or of the amount in respect of a premium, paid by the individual, or by their employer as a *fringe benefit for the employee, under the policy in respect of days in the later income year on which at least one person covered by the policy was aged 70 years or over.

An individual does not include an individual in the capacity of an employer: subsection 61-335(1), Income Tax Assessment Act 1997. A fringe benefit is defined in section 995-1, Income Tax Assessment Act 1997. Subsection (5) refers to 'later' income year, because subsection 61-340(2) applies for the 1998-99 income year.

Subsection (6) provides that if a person was so registered or eligible to apply for registration, the amount of the *tax offset is the greater of:

k.
the sum of the amounts referred to in paragraphs 61-340(5)(a), (b) and (c); and
l.
the incentive amount for the policy for the later income year.

Incentive amount is defined in section 61-345, Income Tax Assessment Act 1997. Subsection (6) refers to 'later' income year, because subsection 61-340(3) applies for the 1998-99 income year.

Item 6: After section 61-340

Item 6 inserts section 61-342.

The new section 61-342 establishes a savings provision which is intended to protect a person ('the first person') covered by a policy (and who may not otherwise be eligible in their own right for the higher rebate) where the person eligible for the higher tax offset ('the entitling person') ceases to be covered by the policy.

The purpose of the savings provision is to ensure that the change in family circumstances covered by section 61-340 will not lead to an overpayment and a debt to the Government.

The section applies to a person (the first person), other than a dependent child, if:

they were covered by an appropriate private health insurance policy; and
due to the age of the entitling person the higher 35% or 40% tax offset applied; and
the entitling person ceases to be covered by the original policy.

The section operates to continue the first person's eligibility for the higher tax offset if the person:

is covered by an appropriate private health insurance policy (whether the original policy or not); and
each other person (if any) covered, since the entitling person ceased to be covered by the original policy, by an appropriate private health insurance policy that also covered the first person is a dependent child, or a person who was covered by the original policy.

The savings provision does not operate if its application would result in the amount of tax offset being less than it would otherwise have been.

Part 3 - Application

Item 7: Application of amendments

Item 7 provides that the amendments made by this Schedule apply to amounts of premium, and amounts in respect of premium, paid or payable in respect of a period beginning on or after 1 April 2005.

This means the additional Rebate will apply on and from 1 April 2005.


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