PRIVATE HEALTH INSURANCE (TRANSITIONAL PROVISIONS AND CONSEQUENTIAL AMENDMENTS) ACT 2007
PART 3
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TRANSITIONAL PROVISIONS RELATING TO COMPLYING HEALTH INSURANCE PRODUCTS
SECTION 10
STATUS OF EXISTING APPLICABLE BENEFITS ARRANGEMENTS AND TABLES OF ANCILLARY BENEFITS
Applicable benefits arrangements
(1)
If, immediately before the commencement time, contributors to a health benefits fund conducted by a registered organization were covered by an applicable benefits arrangement of the organization, then:
(a) at the commencement time, the arrangement is, to the extent to which it covered a particular contributor and his or her dependants (if any), taken to be a complying health insurance policy under which that contributor and those dependants (if any) are insured; and
(b) that part of the arrangement continues to be taken to be a complying health insurance policy until the earlier of:
Tables of ancillary benefits
(2)
If, immediately before the commencement time, contributors to a health benefits fund conducted by a registered organization were covered by a table of ancillary health benefits of the organization, then:
(a) at the commencement time, the table is, to the extent to which it covered a particular contributor and his or her dependants (if any), taken to be a complying health insurance policy under which that contributor and those dependants (if any) are insured; and
(b) that part of the table continues to be taken to be a complying health insurance policy until the earlier of:
Relevant change
(3)
If, more than 15 days after the commencement time, a private health insurer makes a change to its rules, or to anything else, in a way that affects:
(a) the amount of premiums payable under an arrangement or table that is taken to be a complying health insurance policy because of subsection (1) or (2); or
(b) the treatments covered by such a policy; or
(c) a benefit for treatment covered by such a policy;
Applicable benefits arrangements
(1)
If, immediately before the commencement time, contributors to a health benefits fund conducted by a registered organization were covered by an applicable benefits arrangement of the organization, then:
(a) at the commencement time, the arrangement is, to the extent to which it covered a particular contributor and his or her dependants (if any), taken to be a complying health insurance policy under which that contributor and those dependants (if any) are insured; and
(b) that part of the arrangement continues to be taken to be a complying health insurance policy until the earlier of:
(i) 1 July 2008; and
(ii) the day on which a relevant change (see subsection (3)) to that part of the arrangement takes effect.
Tables of ancillary benefits
(2)
If, immediately before the commencement time, contributors to a health benefits fund conducted by a registered organization were covered by a table of ancillary health benefits of the organization, then:
(a) at the commencement time, the table is, to the extent to which it covered a particular contributor and his or her dependants (if any), taken to be a complying health insurance policy under which that contributor and those dependants (if any) are insured; and
(b) that part of the table continues to be taken to be a complying health insurance policy until the earlier of:
(i) 1 July 2008; and
(ii) the day on which a relevant change (see subsection (3)) to that part of the table takes effect.
Relevant change
(3)
If, more than 15 days after the commencement time, a private health insurer makes a change to its rules, or to anything else, in a way that affects:
(a) the amount of premiums payable under an arrangement or table that is taken to be a complying health insurance policy because of subsection (1) or (2); or
(b) the treatments covered by such a policy; or
(c) a benefit for treatment covered by such a policy;
the change is a relevant change to each part of the arrangement or table.
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