Document ID: chunk:federal_register_of_legislation:F2024L00144:reg:65:p23
Version: federal_register_of_legislation:F2024L00144
Segment Type: reg
Provision Reference: reg 65 (pt 23/38)
Character Range: 103942–107419

& No Co-payments policies will reflect the total hospital treatment policies.

Non-Exclusionary Policies   Means the policy does not have any exclusions (see Exclusionary Policies). The sum of exclusionary and non-exclusionary policies will reflect the total hospital treatment policies. NB: Where a product only relates to select hospitals but covers all treatment in those hospitals the policies should be included in the non-exclusionary category.

                            Errors to avoid:

                            The majority of errors that come to APRA's attention for exclusionary policy holders are where treatment is excluded in some, but not all, settings where the product can be utilised but the policy holders are counted as exclusionary.  For example, if treatment is excluded in a private hospital but not excluded in a public hospital the member with that product should not be counted as an exclusionary policy holder.

Changes during the quarter

Start of quarter   Means the total number of policies and insured persons with Hospital Treatment Only, Hospital Treatment and General Treatment or General Treatment Only at the start of the quarter.

                   This figure should match end of quarter reported under the same categories in the previous quarter's return.

New policies/persons               Policies and insured persons joining but not transferring from another fund. This category should include:

                                        * New policies.
                                        * Reinstated policies where these policies were not included in the previous quarter's return because of suspension (note that if a policy is both suspended and reinstated within the quarter to which this return relates they should not be counted as discontinued or reinstated).
                                        * Hospital Treatment Only or General Treatment Only policies who take additional cover.
                                        * Insured persons with a General Treatment Only policy transferring to an existing Hospital Treatment policy (an increase in insured persons, not policies).
                                        * Births, or children covered under one parent's cover (increase in insured persons not policies).

Transferring from another state    Means policies and insured persons transferring from another state within this fund.

Transferring to another state      Means policies and insured persons transferring to another state.

Transferring from another Fund     Means policies and insured persons transferring from another fund but not joining. This category should include:

                                        * Policies joining as transfers from another fund.
                                        * Insured persons transferring from another fund to an existing policy (new insured persons, not new policies).
                                        * Policies with a Hospital Treatment Only policy with your fund and General Treatment Only policy with another fund who transfer the General Treatment Only policy to your fund (new Hospital and General Treatment policy).

Transferring to another policy     Means policies and insured persons transferring to another policy treatment type. Policy types being "Hospital Treatment Only", "Hospital Treatment and General Treatment" or "General Treatment Only".

Transferring from another policy   Means policies and insured persons