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PRIVATE HEALTH INSURANCE (PRUDENTIAL SUPERVISION) ACT 2015 - SECT 4

Interpretation

  (1)   In this Act:

"ADI" means an authorised deposit - taking institution within the meaning of the Banking Act 1959 .

"application provision" : see subsection   65(2).

"applied Corporations Act provision" : see subsection   65(3).

"appointed actuary" of a private health insurer means the person appointed as the actuary of the insurer in accordance with Division   2 of Part   5.

"approved form" : see section   172.

"APRA" means the Australian Prudential Regulation Authority.

"APRA rules" : see subsection   174(1).

"APRA staff member" has the same meaning as in the Australian Prudential Regulation Authority Act 1998 .

"assets" of a health benefits fund: see section   26.

"chief executive officer" of a private health insurer means the person who is primarily and directly responsible to the directors of the insurer for the general and overall management of the insurer.

"civil penalty order" : see subsection   156(2).

"complying health insurance policy" has the same meaning as in the Private Health Insurance Act 2007 .

"complying health insurance product" has the same meaning as in the Private Health Insurance Act 2007 .

"constitutional corporation" means a corporation to which paragraph   51(xx) of the Constitution applies.

"cover" , in relation to an insurance policy, has the same meaning as in the Private Health Insurance Act 2007 .

"declaration of contravention" means a declaration under subsection   155(1).

"dependent person" has the same meaning as in the Private Health Insurance Act 2007 .

"director" has the same meaning as in the Corporations Act 2001 .

"disqualified person" : see sections   119 and 121.

"enforceable obligation" means any of the following:

  (a)   a provision of this Act;

  (b)   a direction given under this Act;

  (c)   a provision of the risk equalisation levy legislation;

  (d)   if the registration of a private health insurer is subject to terms and conditions (see subsection   15(1))--those terms and conditions;

  (e)   in the case of a restricted access insurer--a provision included in the insurer's constitution or rules in order to comply with subsection   15(3).

Note:   References to this Act include prudential standards and APRA rules (see the definition of this Act in this subsection).

"external administration" means administration or control (however described) by an external administrator.

"external administrator" means:

  (a)   any of the following, within the meaning of the Corporations Act 2001 :

  (i)   a liquidator or provisional liquidator;

  (ii)   a receiver, manager, managing controller, receiver and manager or other controller;

  (iii)   an administrator or a scheme manager; or

  (b)   a person who performs a similar role to a person referred to in subparagraph   (a)(i), (ii) or (iii), whether under a law of the Commonwealth, or of a State or Territory, or otherwise;

but does not include an external manager or terminating manager.

"external management" means management, by an external manager, under Divisions   6 and 8 of Part   3.

"external manager" , in relation to a health benefits fund, means a person appointed under section   51 as the external manager of the fund.

"Federal Court" means the Federal Court of Australia.

"for profit insurer" means a private health insurer that is registered under Division   3 of Part   2 as a for profit insurer.

"health benefits fund" has the same meaning as in the Private Health Insurance Act 2007 .

"Health Department" means the Department administered by the Health Minister.

"health insurance business" has the same meaning as in the Private Health Insurance Act 2007 .

"Health Minister" means the Minister administering the Private Health Insurance Act 2007 .

"health-related business" has the same meaning as in the Private Health Insurance Act 2007 .

"Health Secretary" means the Secretary of the Health Department.

"improper discrimination" has the same meaning as in the Private Health Insurance Act 2007 .

"inspector" means a person appointed under section   130 to be an inspector.

"insurance" has the same meaning as in paragraph   51(xiv) of the Constitution.

"investigation warrant" : see subsection   136(1).

"lawyer" means a duly qualified legal practitioner and, in relation to a person, means such a practitioner acting for the person.

"makes a permitted capital payment" : see subsection   27(3).

"manager" , in relation to a health benefits fund, means an external manager or terminating manager of the fund.

"net asset position" of a health benefits fund means the difference between:

  (a)   the assets of the fund; and

  (b)   the policy liabilities and other liabilities of the fund that the private health insurer conducting the fund has incurred for the purposes of the fund.

"officer" of a private health insurer means:

  (a)   a director of the insurer; or

  (b)   a chief executive officer of the insurer; or

  (c)   any other person who has or exercises senior management responsibilities (within the meaning of prudential standards) for the insurer.

"penalty" includes forfeiture or punishment.

"personal information" has the same meaning as in the Privacy Act 1988.

"policy group" of a health benefits fund: see subsection   32(7).

"policy holder" of a health benefits fund has the same meaning as in the Private Health Insurance Act 2007 .

"policy liability" of a private health insurer means:

  (a)   a liability that has arisen under an insurance policy; or

  (b)   a liability that, subject to the terms and conditions of an insurance policy, will arise on the happening of an event, or at a time, specified in the policy.

"premises" includes the following:

  (a)   a structure, building, vehicle, vessel or aircraft;

  (b)   a place (whether or not enclosed or built on);

  (c)   a part of a thing referred to in paragraph   (a) or (b).

"Private Health Insurance Ombudsman" has the same meaning as in the Private Health Insurance Act 2007 .

"private health insurer" means a body that is registered under Division   3 of Part   2.

"proceeding" means:

  (a)   a proceeding in a court; or

  (b)   a proceeding or hearing before, or an examination by or before, a tribunal;

whether the proceeding, hearing or examination is of a civil, administrative, criminal, disciplinary or other nature.

"prudential matters" : see subsection   92(2).

"prudential standards" : see subsection   92(1).

"referable" has the same meaning as in the Private Health Insurance Act 2007 .

"responsible insurer" means:

  (a)   for a health benefits fund that is under external management--the private health insurer that was conducting the fund prior to the appointment of the external manager of the fund; or

  (b)   for a health benefits fund that is under terminating management--the private health insurer that was conducting the fund prior to the appointment of the terminating manager of the fund.

"restricted access group" : see subsection   15(4).

"restricted access insurer" means a private health insurer that is registered under Division   3 of Part   2 as a restricted access insurer.

"risk equalisation jurisdiction" has the same meaning as in the Private Health Insurance Act 2007 .

"risk equalisation levy legislation" means any of the following:

  (a)   the Private Health Insurance (Risk Equalisation Levy) Act 2003 ;

  (b)   the provisions of the Private Health Insurance Act 2007 , as they apply in relation to:

  (i)   levy imposed under the Private Health Insurance (Risk Equalisation Levy) Act 2003 ; or

  (ii)   the Risk Equalisation Special Account.

"Risk Equalisation Special Account" has the same meaning as in the Private Health Insurance Act 2007 .

"rules" of a private health insurer has the same meaning as in the Private Health Insurance Act 2007 .

"search powers" means powers to search for, inspect, take extracts from, and make copies of, documents.

"State insurance" has the same meaning as in paragraph   51(xiv) of the Constitution.

"statutory functions and duties" of an actuary of a private health insurer: see subsection   107(2).

"terminating management" means management, by a terminating manager, under Divisions   5 and 8 of Part   3.

"terminating manager" , in relation to the health benefits funds of a private health insurer, means a person appointed under Division   5 or 7 of Part   3 as the terminating manager of the funds.

"termination day" , in relation to the health benefits funds of a private health insurer: see subsection   40(2).

"this Act" includes prudential standards and APRA rules.

"voluntary deed of arrangement" means:

  (a)   a deed of arrangement agreed on at a meeting of a kind referred to in section   58; or

  (b)   such a deed as varied in accordance with APRA rules made for the purpose of this paragraph.

  (2)   To avoid doubt, a reference in this Act to another Act includes a reference to any regulations, rules, standards or other instruments made, and to any conditions imposed, under that other Act.

Note:   For example:

(a)   a reference to the Private Health Insurance Act 2007 includes a reference to rules made under that Act; and

(b)   a reference to the Financial Sector (Collection of Data) Act 2001 includes a reference to reporting standards made under that Act.



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