Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p22
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 22/56)
Character Range: 137855–140789

with some related matters (including the operation of health‑related businesses through health benefits funds).
Note: The Private Health Insurance (Prudential Supervision) Act 2015 requires private health insurers to have health benefits funds. Health benefits funds must be operated in accordance with the requirements of that Act.

131‑5  Private Health Insurance (Health Benefits Fund Policy) Rules
 (1) *Health benefits funds (and some related matters) are also dealt with in the Private Health Insurance (Health Benefits Fund Policy) Rules. The provisions of this Part indicate when a particular matter is or may be dealt with in these Rules.
Note: The Private Health Insurance (Health Benefits Fund Policy) Rules are made by the Minister under section 333‑20.
 (2) Before making Private Health Insurance (Health Benefits Fund Policy) Rules for the purposes of section 131‑15, the Minister must consult *APRA. However, a failure to consult APRA does not affect the validity of those Rules.
Note: This consultation requirement also applies to any repeal or amendment of such Rules: see subsection 33(3) of the Acts Interpretation Act 1901.

131‑10  Meaning of health benefits fund
  A health benefits fund is a fund that:
 (a) is established in the records of a private health insurer; and
 (b) relates solely to:
 (i) its *health insurance business, or a particular part of that business; or
 (ii) its health insurance business, or a particular part of that business, and some or all of its *health‑related businesses, or particular parts of those businesses.

131‑15  Meaning of health‑related business
 (1) Health‑related business is business that is any one or more of the following:
 (a) a business of providing goods or services (or both) in order to manage or prevent diseases, injuries or conditions;
 (b) a business of undertaking liability, by way of insurance, to indemnify people who are *ineligible for Medicare for costs associated with providing treatment, goods or services that:
 (i) are provided to those people in Australia; and
 (ii) are provided to manage or prevent diseases, injuries or conditions;
 (c) a business of providing a financial service to assist people insured under *complying health insurance products to meet the costs associated with treatment, goods or services that are provided to manage or prevent diseases, injuries or conditions;
 (d) any other business, or business included in a class of businesses, specified in the Private Health Insurance (Health Benefits Fund Policy) Rules for the purposes of this paragraph.
 (2) Despite subsection (1), neither of the following is health‑related business:
 (a) business that is *health insurance business; or
 (b) any other business, or business included in a class of businesses, specified in the Private Health Insurance (Health Benefits Fund Policy) Rules for the purposes of this paragraph.

131‑20  Risk equalisation jurisdictions
 (1) An