Federal Register of Legislation - Australian Government

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Determinations/Health as made
Amendment to the Health Benefits Reinsurance (Records of Organisations) Determination 1998.
Administered by: Health
Registered 01 Jun 2005
Gazetted 06 Oct 1999
Date of repeal 01 Apr 2007
Repealed by Other
Repealing Comments Enabling provision repealed by Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 (Act No. 32, 2007).

Health Benefits Reinsurance (Records of Organisations) Amendment Determination 1999 (No. 1)

I, GAYLE GINNANE, Chief Executive Officer, Private Health Insurance Administration Council, make this Determination under subsection 73BB (1) of the National Health Act 1953.

Dated 21 September 1999.

 

G. GINNANE

Chief Executive Officer

 


Health Benefits Reinsurance (Records of Organisations) Amendment Determination 1999 (No. 1)

made under the

 

 

 

Contents

                                                                                                                 Page

                        1  Name of Determination                                                       2

                        2  Commencement                                                                 2

                        3  Amendment of Health Benefits Reinsurance (Records of Organisations) Determination 1998 2

Schedule 1       Amendment                                                                 3

 


Do not delete : Part placeholder

Do not delete : Division placeholder

1              Name of Determination

                This Determination is the Health Benefits Reinsurance (Records of Organisations) Amendment Determination 1999 (No. 1).

2              Commencement

                This Determination commences on gazettal.

3              Amendment of Health Benefits Reinsurance (Records of Organisations) Determination 1998

                Schedule 1 amends the Health Benefits Reinsurance (Records of Organisations) Determination 1998.

 


Schedule 1        Amendment

Do not delete : Schedule Part placeholder

(section 3)

[1]         Schedule, Part 2

substitute

Part 2                 Form PHIAC 1

PHIAC 1 Template

 

 

 

 Page 1

 

Quarter

 

 

 

 

Fund ID

 

DE

 

 

(For Council use only)

Err.

Exp.

 

 

 

 

 

 

Name of Your Organisation

 

 

 

 

State

 

Phone

 

 

Contact Name

 

Fax

 

 

 

 

 

 

 

 

Part 1  Membership and Coverage

 

Total Hospital Membership

 

 

 

 

 

Front-end

Non Front-end

 

 

 

deductible

deductibles

Total

 

Exclusionary Tables

0

0

0

 

Non–Exclusionary

0

0

0

 

Total Contributors

0

0

0

 

Total persons covered

0

0

0

 

 

Age 64 & <

Age 65+

Total

 

Total persons covered

0

0

0

 

Single Membership

 

 

 

 

 

Front-end

Non Front-end

Total

 

 

deductible

deductibles

 

 

Exclusionary Tables

0

0

0

 

Non–Exclusionary

0

0

0

 

Total Contributors

0

0

0

 

Total persons covered

0

0

0

 

 

Age 64 & <

Age 65+

Total

 

Single members

0

0

0

 

Family Membership

 

 

 

 

 

Front-end

Non Front-end

Total

 

 

deductible

deductibles

 

 

Exclusionary Tables

0

0

0

 

Non–Exclusionary

0

0

0

 

Total Contributors

0

0

0

 

Total persons covered

0

0

0

 

 

Age 64 & <

Age 65+

Total

 

Total persons covered

0

0

0

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 

 

 

Part 1 (Cont.)  Membership and Coverage

 

 

 

 

 

 

Page 2

Single Parent Membership

 

 

 

 

 

 

Front-end

  Non Front-end

 

 

 

deductible

deductibles

Total

 

 

Exclusionary Tables

0

0

0

 

 

Non–Exclusionary

0

0

0

 

 

Total Contributors

0

0

0

 

 

Total persons covered

0

0

0

 

 

 

 

 

 

 

 

 

Age 64 & <

Age 65+

Total

 

 

Total persons covered

0

0

0

 

 

 

 

 

 

 

Couples Membership

Front-end

Non Front-end

Total

 

 

 

deductible

deductibles

 

 

 

Exclusionary Tables

0

0

0

 

 

Non–Exclusionary

0

0

0

 

 

Total Contributors

0

0

0

 

 

Total persons covered

0

0

0

 

 

 

 

 

 

 

 

 

Age 64 & <

Age 65+

Total

 

 

Total persons covered

0

0

0

 

 

 

 

 

 

 

Hospital Membership Changes During the Quarter

 

 

 

Single Members

Family Members

Single Parents

Couples

 

Members Joining

0

0

0

0

 

Members Leaving

0

0

0

0

 

 

 

 

 

 

 

Medical Only Membership

 

 

 

 

 

Single Members

Family Members

Single Parents

Couples

 

Medical Only Contributors

0

0

0

0

 

Total persons covered

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 1 (Cont.)  Membership and Coverage

 

 

 

 

Page 3

 

Ancillary Insurance Tables

 

 

 

 

 

 

 

 

 

 

(a)        Ancillary Only Tables

 

 

 

 

 

Ambulance Only

Single Members

Family Members

Single Parents

Couples

 

Ambulance Only

0

0

0

0

 

Total persons covered

0

0

0

0

 

 

 

 

 

 

 

Other Ancillary Only

Single Members

Family Members

Single Parents

Couples

 

Other Ancillary Only Tables

0

0

0

0

 

Total persons covered

0

0

0

0

 

 

 

 

 

 

 

Total Ancillary Only Tables

Single Members

Family Members

Single Parents

Couples

 

Ancillary Only Tables

0

0

0

0

 

Total persons covered

0

0

0

0

 

 

 

 

 

 

 

(b)        All Ancillary Tables (includes hospital and ancillary, and total ancillary only)

 

 

Single Members

Family Members

Single Parents

Couples

 

Ancillary total

0

0

0

0

 

Total persons covered

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 


Part 2  Hospital Benefits Paid

 

 

 

 

 

Page 4

All Tables – Reinsurance Account Transactions For Persons Aged 65 and Over

 

 

 

 

 

 

 

 

Acute Patients

Episodes

Days

Benefits Paid

 

  Day Hospital Facilities

0

0

0

 

Recognised (Public) Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

Private Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

Total Acute Patients –

 

 

 

 

Reinsurance Aged 65 and Over

0

0

0

 

Nursing Home Type Patients

Episodes

Days

Benefits Paid

 

Recognised (Public) Hospitals

0

0

0

 

Private Hospitals

0

0

0

 

Total Nursing Home Type Patients

0

0

0

 

 Medical Benefits – Reinsurance Account (65+)

Number

Benefits Paid

 

 

Up to Schedule Fee

0

0

 

 

Up to 16% Above Schedule Fee

0

0

 

 

Above 16% Above Schedule Fee

0

0

 

 

 

Number

Benefits Paid

 

 

Prostheses Benefits

0

0

 

 

 

 

 

 

 

 

Total Reinsurance Benefits For Persons Aged 65 and Over

0

 

All Tables – All Reinsurance Account Transactions

 

 

 

Episodes

Days

Benefits Paid

 

 Day Hospital Facilities

0

0

0

 

Recognised (Public) Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

Private Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

Total Acute Patients –

 

 

 

 

All Reinsurance

0

0

0

 

 

 

 

 

 

Nursing Home Type Patients

Episodes

Days

Benefits Paid

 

Recognised (Public) Hospitals

0

0

0

 

Private Hospitals

0

0

0

 

Total Nursing Home Type Patients

0

0

0

 

 

 

 

 

 

 Medical Benefits – All Reinsurance

Number

Benefits Paid

 

 

Up to Schedule Fee

0

0

 

 

Up to 16% Above Schedule Fee

0

0

 

 

Above 16% Above Schedule Fee

0

0

 

 

 

Number

Benefits Paid

 

 

Prostheses Benefits

0

0

 

 

 

 

 

 

 

 

All Tables Total Reinsurance

0

 

The following Check Total must be Printed––>

0.00

 

 

 

 


Part 2 (Cont.)  Hospital Benefits Paid

 

 

 

 

  Page 5

 

 

 

 

 

 

 

 

 

 

All Tables – Total Benefits

 

 

 

 

 

All Claims (Ordinary and Reinsurance)

Acute Patients

Episodes

Days

  Benefits Paid

          Day Hospital Facilities

0

0

0

 

Recognised (Public) Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

Private Hospitals    Day Only

0

0

0

 

Overnight

0

0

0

 

 

 

 

 

 

 

Episodes

Days

  Benefits Paid

Total Acute Patients – All Claims

0

0

0

 

 

 

 

 

 

 

 

 

 

 

Nursing Home Type Patients

Episodes

Days

  Benefits Paid

Recognised (Public) Hospitals

0

0

0

 

Private Hospitals

0

0

0

 

Total Nursing Home Type Patients

0

0

0

 

 

 

 

 

 

 

 

 

 

 

Medical Benefits

 

Number

  Benefits Paid

 

 

Up to Schedule Fee

0

0

 

 

Up to 16% Above Schedule Fee

0

0

 

 

Above 16% Above Schedule Fee

0

0

 

 

 

 

 

 

 

 

Number

  Benefits Paid

 

Prostheses Benefits

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ineligible Benefits

0

 

 

 

 

 

 

 

 

 

 

 

 

 

Total  Benefits

 

 

 

Ordinary and Reinsurance Accounts Combined

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 3  Hospital Benefits by Age Category

All Tables – Benefits Paid by Age Category

 

 

  Page 6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Males

 

 

 

 

 

Age Group

Persons Covered

Episodes

Days

Benefits

 

0–4

0

0

0

0

 

5–9

0

0

0

0

 

10–14

0

0

0

0

 

15–19

0

0

0

0

 

20–24

0

0

0

0

 

25–29

0

0

0

0

 

30–34

0

0

0

0

 

35–39

0

0

0

0

 

40–44

0

0

0

0

 

45–49

0

0

0

0

 

50–54

0

0

0

0

 

55–59

0

0

0

0

 

60–64

0

0

0

0

 

65–69

0

0

0

0

 

70–74

0

0

0

0

 

75–79

0

0

0

0

 

80–84

0

0

0

0

 

85–89

0

0

0

0

 

90–94

0

0

0

0

 

95+

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 

Part 3 (Cont.)  Hospital Benefits by Age Category

All Tables – Benefits Paid by Age Category

 

 

  Page 7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Females

 

 

 

 

 

Age Group

Persons Covered

Episodes

Days

Benefits

 

0–4

0

0

0

0

 

5–9

0

0

0

0

 

10–14

0

0

0

0

 

15–19

0

0

0

0

 

20–24

0

0

0

0

 

25–29

0

0

0

0

 

30–34

0

0

0

0

 

35–39

0

0

0

0

 

40–44

0

0

0

0

 

45–49

0

0

0

0

 

50–54

0

0

0

0

 

55–59

0

0

0

0

 

60–64

0

0

0

0

 

65–69

0

0

0

0

 

70–74

0

0

0

0

 

75–79

0

0

0

0

 

80–84

0

0

0

0

 

85–89

0

0

0

0

 

90–94

0

0

0

0

 

95+

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00

 

 

 

Part 4  Benefits Paid From All Tables

BENEFITS PAID FROM INDIVIDUAL HOSPITAL TABLES

Page 8

(ORDINARY AND REINSURANCE COMBINED)

 

 

Table identification

        Total

 

 

(please specify)

   Contributors

Benefits Paid

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

 

 

 

Total

0

0

 

 

 

 

 

 

Part 5  Benefits Paid From Ancillary Tables

BENEFITS PAID FROM INDIVIDUAL ANCILLARY TABLES

 

Table identification

        Total

 

 

(please specify)

    Contributors

Benefits Paid

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

0

0

 

 

 

 

 

Total

0

0

 

CONTRACTUAL ARRANGEMENTS PAID OUT OF ANCILLARY TABLES

Type of Ancillary

 

Benefits Paid

 

 

 

0

 

 

 

0

 

 

 

0

 

 

Total Contractual Arrangements

0

 

 

 

 

 

 

Total Benefits Paid From Ancillary Tables

0

 

The following Check Total must be Printed ––––>

0.00

 

 

 

 

 

Part 5 (Cont.)  Benefits Paid From Ancillary Tables

 

 

 

 

   Page 9

 

 

 

 

 

Benefits paid from Ancillary Tables

 

 

 

TYPE OF ANCILLARY (NON CONTRACTUAL)

SERVICES

COST

BENEFITS

 

Accidental Death / Funeral Expenses

0

0

0

 

Acupuncture / Acupressure

0

0

0

 

Ambulance

0

0

0

 

Chiropractic

0

0

0

 

Community, Home, District Nursing

0

0

0

 

Dental

0

0

0

 

Dietetics

0

0

0

 

Domestic Assistance

0

0

0

 

Ex gratia Payments

0

0

0

 

Fitness and Lifestyle Courses / Equipment

0

0

0

 

Hearing Aids and Audiology

0

0

0

 

Hypnotherapy

0

0

0

 

Maternity Services

0

0

0

 

Natural Therapies

0

0

0

 

Occupational Therapy

0

0

0

 

Optical

0

0

0

 

Orthoptics (Eye Therapy)

0

0

0

 

Osteopathic Services

0

0

0

 

Overseas

0

0

0

 

Pharmacy

0

0

0

 

Physiotherapy

0

0

0

 

Podiatry (Chiropody)

0

0

0

 

Prostheses, Aids and Appliances

0

0

0

 

Psych / Group Therapy

0

0

0

 

School

0

0

0

 

Sickness and Accident

0

0

0

 

Speech Therapy

0

0

0

 

Theatre Fees

0

0

0

 

Travel and Accommodation

0

0

0

 

Other (please specify)

 

 

 

 

 

0

0

0

 

 

0

0

0

 

 

0

0

0

 

 

0

0

0

 

 

0

0

0

 

 

0

0

0

 

 

0

0

0

 

 

 

 

 

 

Total Non-Contractual Ancillaries

0

0

0

 

 

 

 

 

 

The following Check Total must be Printed ––––>

0.00