PRIVATE HEALTH INSURANCE INCENTIVES ACT 1998

CHAPTER 4 - PROVISIONS APPLYING BOTH TO INCENTIVE PAYMENTS SCHEME AND TO PREMIUMS REDUCTION SCHEME  

PART 8 - DICTIONARY OF DEFINED EXPRESSIONS  

Division 20 - Defined expressions  

SECTION 20-5  

20-5   DEFINITIONS  

In this Act, unless the contrary intention appears:

ancillary cover
a *private health insurance policy provides ancillary cover if people covered by the policy are covered (wholly or partly) for liability to pay fees and charges for ancillary health benefits within the meaning of section 67 of the National Health Act 1953 .

appropriate private health insurance policy
means a *private health insurance policy that satisfies the following conditions:

(a) it provides *hospital cover, *ancillary cover or *combined cover;

(b) the person, or each of the persons, covered by it is an eligible person within the meaning of section 3 of the Health Insurance Act 1973 , or is treated as such a person because of section 6 or 7 of that Act.

business day
means a day other than a Saturday, a Sunday or a public holiday in the place concerned.

combined cover
a *private health insurance policy provides combined cover if it provides both *hospital cover and *ancillary cover.

Commissioner
means the Commissioner of Taxation.

dependent child
, in relation to an *appropriate private health insurance policy, means a person:

(a) who is covered by the policy; and

(b) whom the *health fund that issued the policy accepts as a dependent child for the purposes of the policy;

but does not include:

(c) a person who is the *partner of another person; or

(d) a person (other than a full-time student) who is 18 years of age or older; or

(e) a full-time student who is 25 years of age or older.

employee of Medicare Australia
means an employee within the meaning of the Medicare Australia Act 1973 .

fringe benefit
means:

(a) a fringe benefit as defined by subsection 136(1) of the Fringe Benefits Tax Assessment Act 1986 ; and

(b) a benefit that would be a fringe benefit (as defined by subsection 136(1) of that Act) if paragraphs (d) and (e) of the definition of employer in that subsection of that Act were omitted.

health fund
means a registered organisation within the meaning of Part VI of the National Health Act 1953 .

HIC

hospital cover
a *private health insurance policy provides hospital cover if it is an applicable benefits arrangement, within the meaning of section 5A of the National Health Act 1953 , to which paragraph 5A(1)(a) of that Act applies.

hospital treatment
has the meaning given by section 3 of the Health Insurance Act 1973.

incentive amount
has the meaning given by section 20-10 .

incentive payments scheme
means the scheme provided for by Chapter 2 .

known gap policy
means a private health insurance policy that covers all but a specified amount or percentage of the full cost of hospital treatment and associated professional attention for the person or persons insured.

Managing Director

Medicare Australia CEO
means the Chief Executive Officer of Medicare Australia.

no gap policy
means a private health insurance policy that covers the full cost of hospital treatment and associated professional attention for the person or persons insured.

notification period
, in relation to a month, means the period starting on the first day of the month and finishing on the seventh day of the month.

parent
of a dependent child means:

(a) unless the dependent child is a full-time student who is 18 years of age or older - a person who has the right (whether alone or jointly with another person):

(i) to have the daily care and control of the child; and

(ii) to make decisions about the daily care and control of the child; or

(b) if the dependent child is a full-time student who is 18 years of age or older - a person who is primarily responsible (whether alone or jointly with another person) for the maintenance and support of the student.

participant in the premiums reduction scheme
has the meaning given by section 12-10 .

participating fund
means a *health fund referred to in subsection 14-5(1) or (3) other than such a fund whose status as a participating fund has been revoked under subsection 14A-1(1) .

partner
, in relation to another person, means:

(a) a person who is legally married to the other person and is not living separately and apart from the other person on a permanent basis; or

(b) a person who, although not legally married to the other person, lives with the other person on a bona fide domestic basis as the husband or wife of the other person.

pay
a premium includes make a payment in respect of a premium.

premiums reduction scheme
means the scheme provided for by Chapter 3 .

private health insurance policy
means a contract of insurance that was entered into by a *health fund in the course of carrying on a health insurance business within the meaning of section 67 of the National Health Act 1953 .

professional attention
has the meaning given by section 3 of the Health Insurance Act 1973.

tax file number
means a tax file number as defined in section 202A of the Income Tax Assessment Act 1936 .

type of cover
, in relation to a private health insurance policy, means:

(a) *hospital cover; or

(b) *ancillary cover; or

(c) *combined cover.

you
see subsection 1-15(5) .