Document ID: chunk:federal_register_of_legislation:F2024L00144:reg:65:p2
Version: federal_register_of_legislation:F2024L00144
Segment Type: reg
Provision Reference: reg 65 (pt 2/38)
Character Range: 42758–46570

end of the quarter[3]. State amounts as zero if there are no such persons in the jurisdiction. If a benefit is paid[4] to or on behalf of an insured person during a quarter and the person changes his or her principal place of residence to another risk equalisation jurisdiction during the quarter, the

 person's principal place of residence is the place at which the person resides at the end of the quarter.

In the case of a policy group with two or more policy holders whose addresses are not in the same risk equalisation jurisdiction the health insurer has 20 days, from the date of notification, to make a determination as to which state/s to report the policy holders and persons. Otherwise the policy holders and dependants should be reported in the state which corresponds to the address of the first person named in the policy records of the health insurer.

Dependants should be reported in the same state as the policy holder. In the case of a dependant residing in a different state to the policy holder/s they should be reported in the state of the first named policy holder unless the health insurer has made a different determination as described in the preceding paragraph.

Insured adults are referred to in the Act as policy holders. Health insurers will be required to keep details of each policy holder.

Part 1 Polices and Insured Persons

The data in this part is to be reported as at the end of the quarter being reported.

     1. In sections 1 to 7, defined below, report the number of policies and the number of insured persons that are covered by the type of product. These are entered by type of cover and type of policy. It is not expected that health insurers will have to identify policy holders with more than one type of policy. New joins should be reported when the policy commences. This is the date from which the health insurer provides cover, which is not necessarily the same as when the policy becomes financial or when it is entered into the health insurer's system.

       (a)          Type of cover includes single, family, single parent, couple, 2+ persons no adults, 3+ adults. These should be reported on the HRF 601.1 according to the Private Health Insurance (Complying Product) Rules 2015 (the Rules):

Description of insured groups from the Rules                                                                                                                                                                                                                                                                                                         Mapped to HRF 601.1
  (a) for policies other than a non-student policy or a policy referred to in paragraph (c), the insured groups are:
    (i)      only one person;                                                                                                                                                                                                                                                                                                                        Single
    (ii)     2 adults (and no-one else);                                                                                                                                                                                                                                                                                                             Couple
    (iii)    2 or more people, none of whom is an adult;                                                                                                                                                                                                                                                                                             2+ persons no adults
    (iv)    2 or