Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-3 - REQUIREMENTS FOR COMPLYING HEALTH INSURANCE PRODUCTS  

Division 66 - Community rating requirements  

SECTION 66-10   MINISTER ' S APPROVAL IF CERTAIN CHANGES ARE MADE TO PREMIUMS OR PRODUCTS  
Application for approval of changes

66-10(1)    
A private health insurer must apply to the Minister for approval of:

(a)    the premiums to be charged under one or more * product subgroups of a * complying health insurance product, if the insurer proposes to change the premiums to be charged under the product subgroups; or

(b)    the premiums to be charged under each product subgroup of a complying health insurance product, if the insurer proposes to make a * designated change to the * product (whether or not the insurer proposes to change the premiums when the designated change is made).

Requirements for application

66-10(2)    
The application must:

(a)    be in the * approved form; and

(b)    be accompanied by the fee (if any) specified in the Private Health Insurance (Product Premium) Rules.

Note:

The Private Health Insurance (Product Premium) Rules are made by the Minister under section 333-20 .

66-10(3)    
The application may propose different premiums for policies in a * product, but the proposed premiums must be the same for each policy in the product that belongs to the same * product subgroup.

Minister must make decision on application

66-10(4)    
The Minister must, by written notice to the insurer, either approve or refuse to approve the proposed premiums.

Minister ' s decision - applications made within approved application period

66-10(5)    
If the application is made within an * approved application period, the Minister must approve the proposed premiums, unless:

(a)    the insurer proposes to increase the premiums to be charged under one or more * product subgroups, or proposes to make a * designated change to the * product, or both; and

(b)    the Minister is satisfied that approving the proposed premiums would be contrary to the public interest.

Minister ' s decision - applications made outside approved application period

66-10(6)    
If the application is not made within an * approved application period, the Minister must:

(a)    approve the proposed premiums if, and only if, either:

(i) the insurer does not propose to increase the premiums to be charged under any * product subgroups, and does not propose to make a * designated change to the * product; or

(ii) the insurer proposes to increase the premiums to be charged under one or more product subgroups, or proposes to make a * designated change to the * product, or both, and the Minister is satisfied that approving the proposed premiums is in the public interest; or

(b)    otherwise, refuse to approve the proposed premiums.

Matters relating to the approval of proposed premiums

66-10(7)    
If the Minister approves the proposed premiums, the approval has effect, in relation to a * product subgroup to which the application relates, from the day specified in the approval until the earlier of the following:

(a)    the day when another approval for the product subgroup under this section takes effect;

(b)    if the insurer makes a * designated change to the * product without an approval under this section being in effect in relation to the change - the time when the insurer makes the designated change.

66-10(8)    
The day specified in the approval as the day from which the approval has effect must be a day that is after the day on which the Minister approves the proposed premiums.

Tabling of reasons for refusal to approve premiums

66-10(9)    
If the Minister refuses to approve the proposed premiums, the Minister must table the Minister ' s reasons for refusal in each House of the Parliament no later than 15 sitting days of that House after the refusal.

Other matters

66-10(10)    
A notice under subsection (4) is not a legislative instrument.

66-10(11)    
A fee specified for the purposes of paragraph (2)(b) :

(a)    must not amount to taxation; and

(b)    must not exceed the amount the Minister estimates to be the reasonable costs of processing an application made under subsection (1) .

Delegation

66-10(12)    
If the Minister delegates the Minister ' s powers under this section to a delegate:

(a)    the delegate may approve the proposed premiums in accordance with this section; or

(b)    if the delegate considers that the proposed premiums should not be approved, the delegate:

(i) must not make a final decision refusing to approve the proposed premiums; and

(ii) must refer the application to the Minister for the Minister ' s consideration.

Note:

For delegation by the Minister, see subsection 333-1(1) .