Private Health Insurance Act 2007

A private health insurer must apply to the Minister for approval of:

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

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).

The application must:

be in the *approved form; and

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

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

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.

The Minister must, by written notice to the insurer, either approve or refuse to approve the proposed premiums.

If the application is made within an *approved application period, the Minister must approve the proposed premiums, unless:

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 would be contrary to the public interest.

If the application is not made within an *approved application period, the Minister must:

approve the proposed premiums if, and only if, either:

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

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

otherwise, refuse to approve the proposed premiums.

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:

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

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.

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.

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.

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

A fee specified for the purposes of paragraph (2)(b):

must not amount to taxation; and

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

If the Minister delegates the Minister’s powers under this section to a delegate:

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

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

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

must refer the application to the Minister for the Minister’s consideration.

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