Document ID: chunk:federal_register_of_legislation:F2024C01114:schedule:7:p5
Version: federal_register_of_legislation:F2024C01114
Segment Type: schedule
Provision Reference: sch 7 (pt 5/5)
Character Range: 16182–18968

any of the following:
           (a) incentive payment;
           (b) promotional payment;
           (c) rebate; and
           (d) any other inducement whatsoever,

     made available by the insurer to another person, including to an insured person, in respect of the payment of the premium for the policy, including to induce a person to purchase or maintain a policy.

      (5) For the purposes of this rule, disregard:
           (a) a brokerage fee or commission paid in respect of the policy; and
           (b) the cost of any discount, product, service, waiver or other thing (promotion) offered to a person at the time the person first purchases a policy from the insurer if:
              (i) the cost of the promotion does not exceed 12% of the full premium, for a year, for the policy purchased; and
              (ii) the promotion is provided in the first year after the person purchases the policy; and
           (c) any age‑based discount that might apply in relation to the policy (see Part 2A).

     7. Benefits authorised to be provided under a policy

      (1) In this rule, specified benefit means a benefit specified in subrule (3).

      (2) If a person was entitled to a specified benefit under an applicable benefits arrangement or a table of ancillary health benefits in force at the commencement of the Act, the provision of the same specified benefit under the person's policy is authorised for the purposes of paragraph 69‑1 (1) (b) of the Act as long as the person's policy continues to cover the same specified treatments and provide the same specified benefits.

           Note: Section 10 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the status of existing applicable benefits arrangements and tables of ancillary benefits at the commencement of the Act.

      (3) The specified benefits for this rule are:
           (a) benefits paid in connection with the birth of a baby;
           (b) funeral benefits;
           (c) disability benefits.

      (4) In this rule, ancillary health benefit means ancillary health benefits within the meaning of section 67 the National Health Act 1953 as in force immediately before the commencement of the Act.

     8. Complying products―coverage requirements

      (1) For subsection 69‑1 (2) of the Act, a policy of a kind specified in the following table must also cover any treatment as specified in the table.

Coverage requirements
Item                   Kind of policy                                                                                                                                                                                                                                         Treatments the policy must cover