Private Health Insurance Act 2007

Pt 6-4 heading substituted by No 105 of 2013, s 3 and Sch 2 item 9, effective 1 July 2013. The heading formerly read:

PART 6-4 - ADMINISTRATION OF PREMIUMS REDUCTION AND INCENTIVE PAYMENTS SCHEMES

Div 279 heading substituted by No 105 of 2013, s 3 and Sch 2 item 12, effective 1 July 2013. The heading formerly read:

Division 279 - Provisions applying only to premiums reduction scheme

S 279-25 repealed by No 54 of 2025, s 3 and Sch 2 item 13, effective 1 April 2026. For application, transitional and validation provisions, see note under s 279-1 . S 279-25 formerly read:

SECTION 279-25 ADDITIONAL PAYMENT IF INSURER CLAIMS LESS THAN ENTITLEMENT  
279-25(1)
This section applies to a private health insurer in respect of a month if:
(a) the private health insurer is a ^[ast_1]

To find definitions of asterisked terms, see the Dictionary in Schedule 1.

participating insurer in respect of the month; and
(b) the private health insurer made a claim in respect of the month under section 279-1; and
(c) the amount claimed by the private health insurer was less than the sum of the amounts by which premiums in respect of the month under the ^[ast_1]

To find definitions of asterisked terms, see the Dictionary in Schedule 1.

complying health insurance policies issued by the private health insurer were reduced because of the operation of this Division.

279-25(2)
The private health insurer may apply to the Chief Executive Medicare for payment of an amount (the additional amount ) not exceeding the difference between:
(a) the sum of the amounts by which premiums in respect of the month under the ^[ast_1]

To find definitions of asterisked terms, see the Dictionary in Schedule 1.

complying health insurance policies issued by the private health insurer were reduced because of the operation of this Division; and
(b) the amount already paid to the private health insurer under section 279-1 in respect of the month.

279-25(3)
An application under subsection (2) may relate to more than one month.

S 279-25 amended by No 32 of 2011, s 3 and Sch 4 item 515, by substituting " Chief Executive Medicare " for " Medicare Australia CEO " (wherever occurring), effective 1 July 2011.