Document ID: chunk:federal_register_of_legislation:F2015L01039:body:0:p1
Version: federal_register_of_legislation:F2015L01039
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Private Health Insurance (Risk Equalisation Administration) Rules 2015

I, Ian Laughlin, delegate of APRA make these Rules under subsection 333-25, for the purposes of section 318-15, of the Private Health Insurance Act 2007.

This instrument takes effect on the day item 166 of Schedule 1 to the Private Health Insurance (Prudential Supervision) (Consequential Amendments and Transitional Provisions) Act 2015 commences.

Dated: 26 June 2015

[Signed]

Ian Laughlin
Deputy Chairman

Contents
Part 1 – Preliminary
1. Name of Rules
2. Commencement
3. Interpretation
Part 2 – Requirement for records to be kept
4. General records
5. High cost claimants pool records
Part 3 – Transition
6. Transition
Part 1 – Preliminary

1.             Name of Rules
These Rules are the Private Health Insurance (Risk Equalisation Administration) Rules 2015.

2.             Commencement
These Rules commence on the day item 166 of Schedule 1 to the Private Health Insurance (Prudential Supervision) (Consequential Amendments and Transitional Provisions) Act 2015 commences.

3.             Interpretation
Note: Terms used in these Rules have the same meaning as in the Act – see section 13 of the Legislative Instruments Act 2003.  These terms include:
APRA
complying health insurance policy
cover
health benefits fund
officer
policy holder
private health insurer
risk equalisation jurisdiction
(1)          In these Rules:
Act means the Private Health Insurance Act 2007.
adult is as defined in the Act.
Business Rules means the Private Health Insurance (Health Insurance Business) Rules 2013 made under the Act.
chronic disease management program or CDMP:
(a)          has the same meaning as in the Business Rules; and
(b)          for hospital treatment, includes a program similar to a chronic disease management program as referred to in the definition of 'eligible benefit' in the Risk Equalisation Policy Rules.
fund means a health benefits fund.
general treatment is as defined in the Act.
hospital cover is as defined in the Act.
hospital‑substitute treatment is as defined in the Act.
hospital treatment is as defined in the Act.
medicare benefit is as defined in the Act.
insured person, in relation to a policy, means a person covered by the policy.
insurer means a private health insurer.
PHIAC means the Private Health Insurance Administration Council continued in existence under subsection 264-1(1) of the Act, as it existed immediately prior to the commencement of the Private Health Insurance (Prudential Supervision) Act 2015.
policy means a complying health insurance policy.
quarter means a period of 3 months ending on 31 March, 30 June, 30 September or 31 December in a year.
quarterly return means a return required under the Financial Sector (Collection of Data) Act 2001 relating to risk equalisation information.
Risk Equalisation Policy Rules means the Private Health Insurance (Risk Equalisation Policy) Rules 2007 made under the Act.
(2)          In