Document ID: chunk:federal_register_of_legislation:F2016C00820:body:0:p3
Version: federal_register_of_legislation:F2016C00820
Segment Type: other
Provision Reference: 
Character Range: 5279–8492

in a year and, in respect of calculation of amounts under these Rules, means the quarter to which the calculation relates.
quarterly return has the same meaning as in the Risk Equalisation Administration Rules.
Risk Equalisation Administration Rules means the Private Health Insurance (Risk Equalisation Administration) Rules 2015.
risk equalisation levy day has the same meaning as in the Private Health Insurance (Risk Equalisation Levy) Act 2003.
single equivalent unit for a policy means the number determined in accordance with rule 4.
Special Account means the Risk Equalisation Special Account.
State is taken to mean an area specified as a risk equalisation jurisdiction in Private Health Insurance (Health Benefits Fund Policy) Rules made under the Act, as made and in force from time to time.
           Note 1: The risk equalisation jurisdictions are the Northern Territory; New South Wales, Norfolk Island and the Australian Capital Territory; Western Australia including the Territory of Christmas Island and the Territory of Cocos (Keeling) Islands; and each of the other States.
           Note 2: Terms used in these Rules have the same meaning as in the Act.  These terms include:
           adult
           complying health insurance policy
           general treatment
           health benefits fund
           hospital-substitute treatment
           hospital treatment
           medicare benefit
           policy holder
           private health insurer
           risk equalisation levy
           risk equalisation jurisdiction
           Risk Equalisation Special Account
           rules

4.                      Single equivalent unit
(1)        If a policy falls into one of the categories of policies specified in subrule (2), the single equivalent unit for the policy is the number shown next to the category in that subrule.
(2)        The categories of policies, and single equivalent unit for each category, are
(a)                    a hospital policy under which only one person is insured―1;
(b)                    a hospital policy under which 2 adults are insured (and no-one else)―2;
(c)                    a hospital policy under which 2 or more people are insured, none of whom is an adult―1;
(d)                    a hospital policy under which 2 or more people are insured, only one of whom is an adult―1;
(e)                    a hospital policy under which 3 or more people are insured, only 2 of whom are adults―2;
(f)                     a hospital policy under which 3 or more people are insured, at least 3 of whom are adults―2.
           Note: Hospital policy means a policy which covers any hospital treatment―see subrule 3 (1).

5.                      Eligible benefits
(1)        Eligible benefit means a benefit paid by an insurer under a policy for any of the following:
(a)                    the following components of general treatment provided as part of a chronic disease management program:
(i)                     the planning and coordination services described in paragraphs (b) and (c) of the definition of chronic disease management program in the Business Rules; and
(ii)                   allied health services, as defined in the Business