Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-3 - REQUIREMENTS FOR COMPLYING HEALTH INSURANCE PRODUCTS  

Division 66 - Community rating requirements  

SECTION 66-5   PREMIUM REQUIREMENT  

66-5(1)    
For the purposes of paragraph 66-1(1)(d) , the premiums payable under an insurance policy for a period meet the premium requirement in this section if the amount of premiums payable under the policy for the period:

(a)    is the amount specified for the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

product subgroup to which the policy belongs in the most recent approval under section 66-10 ; or

(b)    is the proportion, for the period, of that amount; or

(c)    would be the amount mentioned in paragraph (a) or (b) except that a different amount is payable:

(i) because of the application of Part 2-3 (lifetime health cover); or

(ii) because of a discount or discounts allowed under subsection (2) , if the total percentage discount (not counting discounts available for the reason in paragraph (3)(f) ) does not exceed the percentage specified in the Private Health Insurance (Complying Product) Rules as the maximum percentage discount allowed; or

(iii) because of a combination of subparagraphs (i) and (ii) .

66-5(2)    
A discount is allowed if:

(a)    it is for a reason in subsection (3) ; and

(b)    the discount is also available for that reason under every policy in the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

product; and

(c)    if there are different percentage discounts available for that reason - the same percentage discount is available on the same basis under every policy in the product; and

(d)    any other conditions set out in the Private Health Insurance (Complying Product) Rules are met.

66-5(3)    
A discount may be for any of these reasons:

(a)    because premiums are paid at least 3 months in advance;

(b)    because premiums are paid by payroll deduction;

(c)    because premiums are paid by pre-arranged automatic transfer from an account at a bank or other financial institution;

(d)    because the persons insured under the policy have agreed to communicate with the private health insurer, and make claims under the policy, by electronic means;

(e)    because a person insured under the policy is, under the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

rules of the private health insurer, treated as belonging to a contribution group;

(ea)    because a person insured under the policy is entitled to an age-based discount in the circumstances set out in the Private Health Insurance (Complying Product) Rules;

(f)    because the insurer is not required to pay a levy in relation to the policy under a law of a State or Territory;

(g)    for a reason set out in the Private Health Insurance (Complying Product) Rules.