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Notifying the public of the private health insurance statement data-matching program

Last updated 7 December 2022

To notify the public of our intention to collect 2014–15 to 2027–28 data, we have:

  • published a notice in the Federal Register of LegislationExternal Link gazette in the week starting 5 December 2022
  • published this data-matching program protocol on our website at ato.gov.au/dmprotocols
  • advised the data providers they  
    • can notify their clients of their participation in this program
    • update their privacy policies to note that personal information is disclosed to the ATO for data-matching purposes.
     

Gazette notice content

The following information about the data-matching program appears as a gazette notice in the Federal Register of Legislation.

Gazette notice: Commissioner of Taxation – Notice of a private health insurance statement data-matching program 8 December 2022

The Australian Taxation Office (ATO) will acquire private health insurance (PHI) statement data from private health insurance statement providers for 2014–15 through to 2027–28.

The data items include:

  • software provider's identification details – name of the organisation sending the data, addresses, email addresses, phone numbers, Australian Business number etc.
  • PHI provider's identification details – business and trading name, fund code, addresses, email addresses, phone numbers, Australian Business number etc.
  • insured individuals' identification details – policy membership number, unique personal identifier, names on the policy, dates of birth, addresses, email addresses, phone numbers etc.
  • PHI statement details – policy membership number, unique personal identifier, policy role, premium paid in the financial year, Australian Government rebate received, premium eligible for Australian Government rebate, benefit code, Medicare levy surcharge (MLS) record start and end date etc.

We estimate that records relating to approximately 14.6 million individuals will be obtained each financial year.

The ATO acquire and match the data for the administration and enforcement of tax and superannuation laws by:

  • making the data available in our pre-filling service to assist taxpayers to meet their obligations
  • undertaking compliance checks to determine:  
    • liability for MLS
    • eligibility for the private health insurance rebate (PHIR).
     

These obligations may include registration, lodgment, reporting and payment responsibilities.

The objectives of this program are to:

  • promote voluntary compliance and increase community confidence in the tax and superannuation systems
  • assist taxpayers with their reporting, by pre-filling tax returns with PHI statement data
  • speed up processing of income tax returns by making the PHI statement data available in our online services
  • identify taxpayers who are entitled to claim the private health insurance rebate (PHIR)
  • identify the taxpayers who have to pay the Medicare levy surcharge (MLS)
  • gain insights to help develop and implement strategies to help improve voluntary compliance; strategies may include educational or compliance activities
  • identify and educate individuals who can't meet their registration or lodgment obligations and assist them to comply
  • help ensure individuals are meeting their tax and superannuation obligations.

A document describing this program is available at ato.gov.au/dmprotocols.

This program follows the Office of the Australian Information Commissioner’s Guidelines on data matching in Australian Government administration (2014) (the guidelines). The guidelines include standards for the use of data matching as an administrative tool in a way that:

  • complies with the Australian Privacy Principles (APPs) and the Privacy Act 1988 (Privacy Act)
  • is consistent with good privacy practice.

A full copy of the ATO’s privacy policy can be accessed at ato.gov.au/privacy.

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