Commonwealth Consolidated Acts

PRIVATE HEALTH INSURANCE (PRUDENTIAL SUPERVISION) ACT 2015

TABLE OF PROVISIONS

           Long Title

   PART 1--INTRODUCTION

           Division 1--Preliminary

   1.      Short title  
   2.      Commencement  
   3.      Simplified outline of this Act  
   4.      Interpretation  
   5.      General administration of Act  
   5A.     Norfolk Island  

           Division 2--Constitutional matters

   6.      Act binds the Crown  
   7.      Act not to apply to State insurance within that State  
   8.      Compensation for acquisition of property  

   PART 2--REGISTRATION--OF PRIVATE HEALTH INSURERS

           Division 1--Introduction

   9.      Simplified outline of this Part  

           Division 2--Prohibition of carrying on health insurance business without registration

   10.     Carrying on health insurance business without registration  
   11.     Injunctions  

           Division 3--Registration

   12.     Applying for registration  
   13.     Requiring further information  
   14.     Criteria for registration  
   15.     Deciding the application  
   16.     Notifying the decision  
   17.     APRA can be taken to refuse application  
   18.     APRA to ensure that up - to - date record of information about private health insurers is publicly available  
   19.     Changing registration status  
   20.     Conversion to for profit status  
   21.     Cancellation of registration  

   PART 3--HEALTH--BENEFITS FUNDS

           Division 1--Introduction

   22.     Simplified outline of this Part  

           Division 2--The requirement to have health benefits funds

   23.     Private health insurers must have health benefits funds  
   24.     Notifying APRA when health benefits funds are established  
   25.     Inclusion of health - related businesses in health benefits funds  

           Division 3--The operation of health benefits funds

   26.     Assets of health benefits funds  
   27.     Payments to health benefits funds  
   28.     Expenditure and application of health benefits funds  
   29.     Effect of non - compliance with section 28  
   30.     Investment of health benefits funds  

           Division 4--Restructure, merger and acquisition of health benefits funds

   31.     Restriction on restructure, merger or acquisition of health benefits funds  
   32.     Restructure of health benefits funds  
   33.     Merger and acquisition of health benefits funds  
   34.     Consent of policy holders not required  

           Division 5--Termination of health benefits funds

              Subdivision A--Approving the termination of health benefits funds

   35.     Applying for termination  
   36.     Requiring further information  
   37.     Deciding the application  
   38.     APRA can be taken to have refused to approve termination  

              Subdivision B--Conducting the termination of health benefits funds

   39.     The basis of the law relating to termination  
   40.     Conduct of funds during termination process  
   41.     Insurers etc. to give reports to APRA  
   42.     Terminating managers displace management of funds  

              Subdivision C--Ending the termination of health benefits funds

   43.     Power to end termination  

              Subdivision D--Completing the termination of health benefits funds

   44.     Completion of the termination process  
   45.     Distribution of remaining assets after completion of the termination process  
   46.     Liability of officers of insurers for loss to terminated funds  
   47.     Reporting by terminating manager  
   48.     Applying for winding up  

           Division 6--External management of health benefits funds

              Subdivision A--Preliminary

   49.     Purpose of Division  
   50.     The basis of the law relating to external management  

              Subdivision B--Appointment of external managers

   51.     APRA may appoint external managers  
   52.     Preconditions for appointment of external managers  
   53.     External managers to displace management of funds  

              Subdivision C--Duties and powers of external managers

   54.     Duties of external managers  
   55.     Additional powers of external managers  
   56.     Protection of property during external management  
   57.     Rights of chargee, owner or lessor of property of fund under external management  

              Subdivision D--Procedure relating to voluntary deeds of arrangement

   58.     Matters that may be included in APRA rules  

              Subdivision E--External managers' reports to APRA

   59.     External managers to give reports to APRA  
   60.     Dealing with reports given to APRA  
   61.     Federal Court orders in respect of schemes of arrangement  

              Subdivision F--Miscellaneous

   62.     When an external management begins and ends  
   63.     Effect of things done during external management of health benefits funds  
   64.     Disclaimer of onerous property  
   65.     Application of provisions of Corporations Act  

           Division 7--Ordering the termination of health benefits funds

   66.     Applications by external managers to the Federal Court  
   67.     Orders made on applications for appointments of terminating managers  
   68.     Notice of appointments  
   69.     Application of other provisions if Federal Court orders appointment of a terminating manager  

           Division 8--External managers and terminating managers

              Subdivision A--Powers of managers

   70.     Powers of managers  
   71.     Officers etc. not to perform functions etc. while fund is under management  
   72.     Managers act as agents of private health insurers  

              Subdivision B--Information concerning, and records and property of, health benefits funds

   73.     Directors etc. to help managers  
   74.     Managers' rights to certain records  
   75.     Only manager can deal with property of fund under management  
   76.     Order for compensation where officer involved in void transaction  

              Subdivision C--Provisions incidental to appointment of managers

   77.     Remuneration and allowances of managers  
   78.     Directions to managers  
   79.     Termination of appointments of managers  
   80.     Acts of managers valid etc.  
   81.     Indemnity  
   82.     Qualified privilege  

              Subdivision D--Miscellaneous

   83.     Time for doing act does not run while act prevented by this Division or other provisions  
   84.     Continued application of other provisions of Act  
   85.     Modifications of this Act in relation to health benefits funds under management  
   86.     Order of Federal Court to be binding on all persons  
   87.     APRA rules dealing with various matters  

           Division 9--Duties and liabilities of directors etc.

   88.     Notices to remedy contraventions  
   89.     Liability of directors in relation to non - compliance with notices  
   90.     APRA may sue in the name of private health insurers  

   PART 4--PRUDENTIAL--STANDARDS AND DIRECTIONS

           Division 1--Introduction

   91.     Simplified outline of this Part  

           Division 2--Prudential standards

   92.     Prudential standards  
   93.     Additional matters in relation to standards that are not legislative instruments  
   94.     Compliance with prudential standards  
   95.     Notice of contravention of prudential standards or of other matters that materially affect financial position  

           Division 3--Directions

   96.     APRA's power to give directions  
   97.     The kinds of direction that may be given  
   98.     Power to comply with a direction  
   99.     Varying or revoking a direction  
   100.    When a direction ceases to have effect  
   101.    Direction not grounds for denial of obligations  
   102.    Supply of information about directions  
   103.    Secrecy requirements  
   104.    Non - compliance with a direction  

   PART 5--OTHER--OBLIGATIONS OF PRIVATE HEALTH INSURERS

           Division 1--Introduction

   105.    Simplified outline of this Part  

           Division 2--Appointed actuaries

   106.    Appointment  
   107.    Terminating an appointment as actuary  
   108.    Notification of appointment etc.  
   109.    Role of appointed actuary  
   110.    Actuary's obligations to inform of matters etc.  
   111.    Appointed actuary may give information or documents to APRA  
   112.    Duty of appointed actuary to give information or documents when required  
   113.    Qualified privilege of appointed actuary  
   114.    Referring matters to professional associations for actuaries  
   115.    APRA may direct removal of actuary  

           Division 3--Disqualified persons

   116.    Private health insurers not to allow disqualified persons to act as officers or appointed actuaries  
   117.    Disqualified persons must not act for private health insurers  
   118.    Effect of non - compliance  
   119.    Who is a disqualified person ?  
   120.    Court power of disqualification  
   121.    Court power to revoke or vary a disqualification etc.  
   122.    Privilege against exposure to penalty--disqualification under section 120  

           Division 4--Miscellaneous

   123.    Restrictions on payment of pecuniary penalties etc.  
   124.    Giving APRA copies of reports made to policy holders  
   125.    Notifying APRA of name and contact details of officers  

   PART 6--MONITORING--AND INVESTIGATION

           Division 1--Introduction

   126.    Simplified outline of this Part  

           Division 2--Monitoring

   127.    Purposes for which powers may be exercised etc.  
   128.    Power to require private health insurer to provide information and reports  
   129.    Power to require production of documents  

           Division 3--Investigation

   130.    Investigation of private health insurers by inspectors  
   131.    Identity cards for inspectors  
   132.    Powers of inspectors  
   133.    Person may be represented by lawyer when being examined  
   134.    Access to premises  
   135.    General provisions relating to obtaining consent to enter premises  
   136.    Investigation warrants  
   137.    Announcement before entry under investigation warrant  
   138.    Inspector to be in possession of investigation warrant  
   139.    Details of warrant etc. to be given to occupier  
   140.    Right to observe execution of warrant  
   141.    Responsibility to provide facilities and assistance  
   142.    Concealing etc. documents  
   143.    Reports of inspectors  
   144.    Dissemination of reports  
   145.    Liability for publishing reports etc.  
   146.    Powers of magistrates  
   147.    Delegation by inspectors  

           Division 4--Other matters

   148.    Refusing or failing to comply with requirements  
   149.    Self - incrimination  
   150.    Protection from liability  

   PART 7--ENFORCEABLE--UNDERTAKINGS

   151.    Simplified outline of this Part  
   152.    Enforceable undertakings  

   PART 8--REMEDIES--IN THE FEDERAL COURT

   153.    Simplified outline of this Part  
   154.    APRA may apply to the Federal Court  
   155.    Declarations of contravention  
   156.    Civil penalty order  
   157.    Compensation order  
   158.    Other order  
   159.    Civil evidence and procedure rules for declarations and orders  
   160.    Civil proceedings after criminal proceedings  
   161.    Criminal proceedings during civil proceedings  
   162.    Criminal proceedings after civil proceedings  
   163.    Evidence given in proceedings for penalty not admissible in criminal proceedings  
   164.    APRA may require person to assist  

   PART 9--MISCELLANEOUS

   165.    Simplified outline of this Part  
   166.    Relief from liability  
   167.    Annual publication of information relating to health benefits funds  
   168.    Review of decisions  
   169.    Statements to accompany notification of decisions  
   170.    Approvals, determinations etc. by APRA  
   171.    Powers of Federal Court  
   172.    Approved forms, and giving documents not required to be in approved forms  
   173.    Delegation by Minister  
   174.    APRA rules