Document ID: chunk:federal_register_of_legislation:F2016C00820:body:0:p5
Version: federal_register_of_legislation:F2016C00820
Segment Type: other
Provision Reference: 
Character Range: 11012–13734

to:
(a)                    the age of each insured person in respect of whom an eligible benefit is paid in that quarter; and
(b)                    the mean number for that quarter of single equivalent units for that fund, being the number determined by adding the number of such units on the last day of the previous quarter and the number of such units on the last day of the quarter for which the levy is being calculated, and halving the result; and
(c)                    the amount of eligible benefit paid in that quarter and in the preceding 3 quarters; and
(d)                    any adjustment amount.
(3)        To work out the amount of levy in respect of a current quarter:
(a)                    an amount calculated in accordance with subrule (4) is first to be notionally allocated to a pool called the age based pool (ABP); and
(b)                    if the amount of gross benefit not notionally allocated to the ABP in accordance with subrule (4), or subrule 7(4) of the old rules, as appropriate, in the current and preceding 3 quarters is greater than the designated threshold, a second amount is to be notionally allocated to a pool called the high cost claimants pool (HCCP).
(4)        The amount to be notionally allocated to the ABP in a quarter is to be calculated in accordance with the formula pC, where:
(a)                    p is the percentage of the eligible benefit paid having regard to the age cohort, as specified in the table in subrule (5), into which the insured person falls on the day or days on which the insured person receives the treatment to which the eligible benefit relates; and
(b)                    C is the gross benefit in the current quarter.
(5)        The age cohorts are as specified in the following table:

Age cohorts
Age          % of eligible benefits included in pool
0-54          0.0%
55-59         15%
60-64         42.5%
65-69         60%
70-74         70%
75-79         76%
80-84         78%
85+           82%

(6)        Where an insured person receives treatment over a number of days such that the age of the insured person on the day or days on which that person receives the treatment falls within more than one age cohort, the amount to be notionally allocated to the ABP must be allocated proportionately in accordance with the number of days during which the insured person was in each age cohort.
           Note:   For example, Mr X, a 59-year-old insured person whose birthday is on 24 January is admitted to hospital on January 19.  Mr X is discharged from the hospital on 29 January.  Mr X's gross benefit is $10,000.  In this case, as half the time in which Mr X was receiving treatment was spent while he was 59 years old and the other