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PRIVATE HEALTH INSURANCE (PRUDENTIAL SUPERVISION) ACT 2015

Table of Provisions

PART 1--INTRODUCTION

Division 1--Preliminary

  • 1 Short title  
  • 2 Commencement  
  • 3 Simplified outline of this Act  
  • 4 Interpretation  
  • 5 General administration of Act  
  • 5A Norfolk Island  

Division 2--Constitutional matters

  • 6 Act binds the Crown  
  • 7 Act not to apply to State insurance within that State  
  • 8 Compensation for acquisition of property  

PART 2--REGISTRATION--OF PRIVATE HEALTH INSURERS

Division 1--Introduction

  • 9 Simplified outline of this Part  

Division 2--Prohibition of carrying on health insurance business without registration

  • 10 Carrying on health insurance business without registration  
  • 11 Injunctions  

Division 3--Registration

  • 12 Applying for registration  
  • 13 Requiring further information  
  • 14 Criteria for registration  
  • 15 Deciding the application  
  • 16 Notifying the decision  
  • 17 APRA can be taken to refuse application  
  • 18 APRA to ensure that up - to - date record of information about private health insurers is publicly available  
  • 19 Changing registration status  
  • 20 Conversion to for profit status  
  • 21 Cancellation of registration  

PART 3--HEALTH--BENEFITS FUNDS

Division 1--Introduction

  • 22 Simplified outline of this Part  

Division 2--The requirement to have health benefits funds

  • 23 Private health insurers must have health benefits funds  
  • 24 Notifying APRA when health benefits funds are established  
  • 25 Inclusion of health - related businesses in health benefits funds  

Division 3--The operation of health benefits funds

  • 26 Assets of health benefits funds  
  • 27 Payments to health benefits funds  
  • 28 Expenditure and application of health benefits funds  
  • 29 Effect of non - compliance with section 28  
  • 30 Investment of health benefits funds  

Division 4--Restructure, merger and acquisition of health benefits funds

  • 31 Restriction on restructure, merger or acquisition of health benefits funds  
  • 32 Restructure of health benefits funds  
  • 33 Merger and acquisition of health benefits funds  
  • 34 Consent of policy holders not required  

Division 5--Termination of health benefits funds

Subdivision A--Approving the termination of health benefits funds
  • 35 Applying for termination  
  • 36 Requiring further information  
  • 37 Deciding the application  
  • 38 APRA can be taken to have refused to approve termination  
  • Subdivision B--Conducting the termination of health benefits funds
  • 39 The basis of the law relating to termination  
  • 40 Conduct of funds during termination process  
  • 41 Insurers etc. to give reports to APRA  
  • 42 Terminating managers displace management of funds  
  • Subdivision C--Ending the termination of health benefits funds
  • 43 Power to end termination  
  • Subdivision D--Completing the termination of health benefits funds
  • 44 Completion of the termination process  
  • 45 Distribution of remaining assets after completion of the termination process  
  • 46 Liability of officers of insurers for loss to terminated funds  
  • 47 Reporting by terminating manager  
  • 48 Applying for winding up  

Division 6--External management of health benefits funds

Subdivision A--Preliminary
  • 49 Purpose of Division  
  • 50 The basis of the law relating to external management  
  • Subdivision B--Appointment of external managers
  • 51 APRA may appoint external managers  
  • 52 Preconditions for appointment of external managers  
  • 53 External managers to displace management of funds  
  • Subdivision C--Duties and powers of external managers
  • 54 Duties of external managers  
  • 55 Additional powers of external managers  
  • 56 Protection of property during external management  
  • 57 Rights of chargee, owner or lessor of property of fund under external management  
  • Subdivision D--Procedure relating to voluntary deeds of arrangement
  • 58 Matters that may be included in APRA rules  
  • Subdivision E--External managers' reports to APRA
  • 59 External managers to give reports to APRA  
  • 60 Dealing with reports given to APRA  
  • 61 Federal Court orders in respect of schemes of arrangement  
  • Subdivision F--Miscellaneous
  • 62 When an external management begins and ends  
  • 63 Effect of things done during external management of health benefits funds  
  • 64 Disclaimer of onerous property  
  • 65 Application of provisions of Corporations Act  

Division 7--Ordering the termination of health benefits funds

  • 66 Applications by external managers to the Federal Court  
  • 67 Orders made on applications for appointments of terminating managers  
  • 68 Notice of appointments  
  • 69 Application of other provisions if Federal Court orders appointment of a terminating manager  

Division 8--External managers and terminating managers

Subdivision A--Powers of managers
  • 70 Powers of managers  
  • 71 Officers etc. not to perform functions etc. while fund is under management  
  • 72 Managers act as agents of private health insurers  
  • Subdivision B--Information concerning, and records and property of, health benefits funds
  • 73 Directors etc. to help managers  
  • 74 Managers' rights to certain records  
  • 75 Only manager can deal with property of fund under management  
  • 76 Order for compensation where officer involved in void transaction  
  • Subdivision C--Provisions incidental to appointment of managers
  • 77 Remuneration and allowances of managers  
  • 78 Directions to managers  
  • 79 Termination of appointments of managers  
  • 80 Acts of managers valid etc.  
  • 81 Indemnity  
  • 82 Qualified privilege  
  • Subdivision D--Miscellaneous
  • 83 Time for doing act does not run while act prevented by this Division or other provisions  
  • 84 Continued application of other provisions of Act  
  • 85 Modifications of this Act in relation to health benefits funds under management  
  • 86 Order of Federal Court to be binding on all persons  
  • 87 APRA rules dealing with various matters  

Division 9--Duties and liabilities of directors etc.

  • 88 Notices to remedy contraventions  
  • 89 Liability of directors in relation to non - compliance with notices  
  • 90 APRA may sue in the name of private health insurers  

PART 4--PRUDENTIAL--STANDARDS AND DIRECTIONS

Division 1--Introduction

  • 91 Simplified outline of this Part  

Division 2--Prudential standards

  • 92 Prudential standards  
  • 93 Additional matters in relation to standards that are not legislative instruments  
  • 94 Compliance with prudential standards  
  • 95 Notice of contravention of prudential standards or of other matters that materially affect financial position  

Division 3--Directions

  • 96 APRA's power to give directions  
  • 97 The kinds of direction that may be given  
  • 98 Power to comply with a direction  
  • 99 Varying or revoking a direction  
  • 100 When a direction ceases to have effect  
  • 101 Direction not grounds for denial of obligations  
  • 102 Supply of information about directions  
  • 103 Secrecy requirements  
  • 104 Non - compliance with a direction  

PART 5--OTHER--OBLIGATIONS OF PRIVATE HEALTH INSURERS

Division 1--Introduction

  • 105 Simplified outline of this Part  

Division 2--Appointed actuaries

  • 106 Appointment  
  • 107 Terminating an appointment as actuary  
  • 108 Notification of appointment etc.  
  • 109 Role of appointed actuary  
  • 110 Actuary's obligations to inform of matters etc.  
  • 111 Appointed actuary may give information or documents to APRA  
  • 112 Duty of appointed actuary to give information or documents when required  
  • 113 Qualified privilege of appointed actuary  
  • 114 Referring matters to professional associations for actuaries  
  • 115 APRA may direct removal of actuary  

Division 3--Disqualified persons

  • 116 Private health insurers not to allow disqualified persons to act as officers or appointed actuaries  
  • 117 Disqualified persons must not act for private health insurers  
  • 118 Effect of non - compliance  
  • 119 Who is a disqualified person ?  
  • 120 Court power of disqualification  
  • 121 Court power to revoke or vary a disqualification etc.  
  • 122 Privilege against exposure to penalty--disqualification under section 120  

Division 4--Miscellaneous

  • 123 Restrictions on payment of pecuniary penalties etc.  
  • 124 Giving APRA copies of reports made to policy holders  
  • 125 Notifying APRA of name and contact details of officers  

PART 6--MONITORING--AND INVESTIGATION

Division 1--Introduction

  • 126 Simplified outline of this Part  

Division 2--Monitoring

  • 127 Purposes for which powers may be exercised etc.  
  • 128 Power to require private health insurer to provide information and reports  
  • 129 Power to require production of documents  

Division 3--Investigation

  • 130 Investigation of private health insurers by inspectors  
  • 131 Identity cards for inspectors  
  • 132 Powers of inspectors  
  • 133 Person may be represented by lawyer when being examined  
  • 134 Access to premises  
  • 135 General provisions relating to obtaining consent to enter premises  
  • 136 Investigation warrants  
  • 137 Announcement before entry under investigation warrant  
  • 138 Inspector to be in possession of investigation warrant  
  • 139 Details of warrant etc. to be given to occupier  
  • 140 Right to observe execution of warrant  
  • 141 Responsibility to provide facilities and assistance  
  • 142 Concealing etc. documents  
  • 143 Reports of inspectors  
  • 144 Dissemination of reports  
  • 145 Liability for publishing reports etc.  
  • 146 Powers of magistrates  
  • 147 Delegation by inspectors  

Division 4--Other matters

  • 148 Refusing or failing to comply with requirements  
  • 149 Self - incrimination  
  • 150 Protection from liability  

PART 7--ENFORCEABLE--UNDERTAKINGS

  • 151 Simplified outline of this Part  
  • 152 Enforceable undertakings  

PART 8--REMEDIES--IN THE FEDERAL COURT

  • 153 Simplified outline of this Part  
  • 154 APRA may apply to the Federal Court  
  • 155 Declarations of contravention  
  • 156 Civil penalty order  
  • 157 Compensation order  
  • 158 Other order  
  • 159 Civil evidence and procedure rules for declarations and orders  
  • 160 Civil proceedings after criminal proceedings  
  • 161 Criminal proceedings during civil proceedings  
  • 162 Criminal proceedings after civil proceedings  
  • 163 Evidence given in proceedings for penalty not admissible in criminal proceedings  
  • 164 APRA may require person to assist  

PART 9--MISCELLANEOUS

  • 165 Simplified outline of this Part  
  • 166 Relief from liability  
  • 167 Annual publication of information relating to health benefits funds  
  • 168 Review of decisions  
  • 169 Statements to accompany notification of decisions  
  • 170 Approvals, determinations etc. by APRA  
  • 171 Powers of Federal Court  
  • 172 Approved forms, and giving documents not required to be in approved forms  
  • 173 Delegation by Minister  
  • 174 APRA rules  

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