Document ID: chunk:federal_register_of_legislation:C2025C00097:section:5:p8
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 5 (pt 8/56)
Character Range: 101944–104703

higher co‑payment continues to apply under the new policy to a person who *transferred to the policy is no longer than the *waiting period allowed under section 75‑1 for a benefit for that treatment.
 (5) In working out:
 (a) for the purposes of subsection (2) or (4), whether a treatment was *covered under an old policy; or
 (b) for the purposes of subsection (3), whether the amount of a benefit under a new policy during a period is less than the amount it would be during another period;
disregard the existence or otherwise of contracts between the insurer in relation to either of the policies and particular *health care providers or groups of health care providers.
 (5A) An insurance policy meets the requirement in this subsection if:
 (a) the policy forms part of a *complying health insurance product or belongs to a *product subgroup of a complying  health insurance product; and
 (b) the *product or product subgroup is being terminated by the private health insurer, and as a consequence, an *adult insured under the policy is to be transferred to a new policy; and
 (c) the insurer informs the adult insured under the policy, in writing, of the matters set out in the Private Health Insurance (Complying Product) Rules; and
 (d) the adult insured under the policy is informed of those matters a reasonable time before the transfer to the new policy is to take effect.
Note: See also section 55‑10.
 (6) The Private Health Insurance (Complying Product) Rules may modify the requirements in this section in relation to all or particular kinds of private health insurers, benefits or insured persons. To the extent the Rules do so, the portability requirements in this Division are taken to be met if the conditions in the Rules are met.
Note: If a private health insurer provides an insured person with, or arranges for an insured person to be provided with, treatment, it is treated as a benefit for the purposes of this Division (see subsection 69‑5(3)).

Division 81—Quality assurance requirements

81‑1  Quality assurance requirements
  An insurance policy meets the quality assurance requirements in this Division if the policy prohibits the payment of benefits for a treatment that does not meet the standards in the Private Health Insurance (Accreditation) Rules.
Note: The Private Health Insurance (Accreditation) Rules are made by the Minister under section 333‑20.

Division 84—Enforcement of this Part

84‑1  Offence: advertising, offering or insuring under non‑complying policies
 (1) A person commits an offence if:
 (a) the person:
 (i) advertises a *product; or
 (ii) offers a person insurance under a policy; or
 (iii) insures a person under a policy; or
 (iv) arranges for another person to do a thing mentioned in subparagraph