Document ID: chunk:federal_register_of_legislation:F2024L00144:reg:65:p21
Version: federal_register_of_legislation:F2024L00144
Segment Type: reg
Provision Reference: reg 65 (pt 21/38)
Character Range: 98244–101592

under 18: or
                                (ii)          a dependent child under the rules of the insurer that insures the person; and
                             (b)       who is not aged 25 or over; and
                             (c)        who does not have a partner.
                          (Schedule 1, Private Health Insurance Act 2007)

holder                    Means a person who is insured under the policy and who is not a dependent child.

(of an insurance policy)  (Schedule 1, Private Health Insurance Act 2007)

Insured persons           All persons covered by health insurance policies.

insured persons

policy holder                     Means a holder of a policy that is referable to the fund.

Policies, policies                (Schedule 1, Private Health Insurance Act 2007)

(of a health benefits fund)

private health insurance policy   Means an insurance policy that covers hospital treatment or general treatment or both (whether or not it also covers any other treatment or provides a benefit for anything else).

                                  (Schedule 1, Private Health Insurance Act 2007)

Single equivalent unit/s (SEU/s)  Single equivalent units (SEUs) are used as a standard measure of the different categories of policies. The Single equivalent units for each category of policy are:

                                     (a)        Single―1
                                     (b)       Couple―2
                                     (c)        2+ persons no adults―1
                                     (d)       Single parent―1
                                     (e)        Family―2
                                     (f)         3+ adults―2
                                  (the Preliminary section, Private Health Insurance (Risk Equalisation Policy) Rules 2015)

                                  SEUs are calculated as:

Type of cover

All definitions are taken from the Preliminary section, Private Health Insurance (Risk Equalisation Policy) Rules 2015.

2 + persons, no adults  A policy under which 2 or more people are insured, none of whom is an adult.

3 + adults              A policy under which 3 or more people are insured, at least 3 of whom are adults.

couple                  A policy under which 2 adults are insured (and no-one else).

family                  A policy under which 3 or more people are insured, only 2 of whom are adults.

single                  A policy under which only one person is insured.

single parent           A policy under which 2 or more people are insured, only one of whom is an adult.

Types of Policies

Excess & Co-payments        Means an amount of money a policy holder agrees to pay before private health insurance benefits are payable. A co-payment could apply every time a person insured under the policy goes to hospital in a year, or an excess may be capped at a total amount for the year. The terms "Excess" and "Co-payments" are sometimes referred to as "Front-end Deductibles" and are similar in meaning.

                            For taxation purposes those taxpayers who would be subject to the Medicare Levy Surcharge are exempted if they have a hospital treatment policy with an excess no greater than $500 for a policy covering a single person or an excess no greater than $1,000 for a policy covering more than