Document ID: chunk:federal_register_of_legislation:F2019L00398:schedule:1:p5
Version: federal_register_of_legislation:F2019L00398
Segment Type: schedule
Provision Reference: sch 1 (pt 5/18)
Character Range: 12738–15844

be:
           (p)          by listing particular assets or liabilities; or
           (q)          by reference to categories of assets or liabilities; or
           (r)           by a combination of (a) and (b).
8.                      Requirements in relation to a restructure
       (1)          A private health insurer must submit to APRA with an application for approval of a restructure proposal:
           (a)          a business plan (the Business Plan) for each receiving fund covering the period of the first 36 months of operation from the restructure date including the following:
              (i)            a statement of the liabilities to become treated as incurred for the purposes of the fund and the assets of the fund at the restructure date; and
              (ii)         a budget statement for the fund for each month of the period of the Business Plan, setting out in detail:
(A)        the projected income and expenditure for the fund; and
(B)        the projected assets and liabilities at the end of each month; and
(C)        the projected solvency and capital adequacy position of the fund at the end of each month; and
              (iii)       the ratio that the projected amount of the management and administrative expenses in respect of the conduct of the fund bears to the estimated amount of premiums paid to that fund; and
              (iv)        a summary of proposed changes, if any, to the insurer's marketing plan, including strategies and costs associated with the restructuring and promotion of the fund; and
              (v)          the estimated number of policy holders of the fund at the end of each month; and
              (vi)        a summary of any proposed changes to the insurer's contractual procedures and arrangements with health service providers and other service providers; and
              (vii)     a summary of any proposed changes to benefits or premiums; and
              (viii)   particulars of any arrangements or processes necessary for the restructure to take place, including:
(A)        any proposed amendments to the insurer's constitution or rules required for the restructure to take place; and
(B)        any steps required under any other law of the Commonwealth, or State or Territory required for the restructure to take place; and
           (b)          a statement by an officer (the certification of compliance) confirming that:
              (i)            the insurer is not being wound up; and
              (ii)         the board, or other governing body, of the insurer has considered the restructure proposal and is of the view it meets, and the operation of the restructuring funds from the restructure date in accordance with the restructure will meet, the requirements of:
(A)        the Act and the PHI Act; and
(B)        any Regulations; and
(C)        the Rules; and
(c)          a report from the insurer's appointed actuary (the actuary's report) which provides the opinion of the actuary:
              (i)            that the aspects of the Business Plan which provide the information required in