Federal Register of Legislation - Australian Government

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Determinations/Health as made
Amends the Health Benefits Reinsurance (Trust Fund Principles) Determination 1998.
Administered by: Health
Registered 31 May 2005
Gazetted 03 May 2000
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Repealed by Other
Repealing Comments Enabling provision repealed by Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 (Act No. 32, 2007).

I, MICHAEL WOOLDRIDGE, Minister for Health and Aged Care, make this Determination under subsection 73BC (5B) of the National Health Act 1953.

Dated 18 April 2000

M. WOOLDRIDGE

Minister for Health and Aged Care


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1              Name of Determination

                This Determination is the Health Benefits Reinsurance (Trust Fund Principles) Amendment Determination 2000 (No. 1).

2              Commencement

                This Determination commences on gazettal.

3              Amendment of Health Benefits Reinsurance (Trust Fund Principles) Determination 1998

                Schedule 1 amends the Health Benefits Reinsurance (Trust Fund Principles) Determination 1998.

 


Schedule 1        Amendments

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(section 3)

[1]         Sections 1.3A, 1.3B and 1.3C

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[2]         Subsection 2.2 (1A)

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[3]         Subsection 2.2 (2)

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subsections (1) and (1A)

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subsection (1)

[4]         After section 2.7

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Part 3A               Adjusting calculations

3A.1        Calculation of appropriate payment may be adjusted

         (1)   If, after a calculation (the primary calculation) is made under section 2.6 or 3.3, the Council receives information (new information) on a matter mentioned in subsection 2.2 (1) that, if received earlier, would have affected the result of that calculation, the Council may make a further calculation taking account of the new information.

         (2)   Unless subsection (3) applies, a further calculation may be made only if the new information is received by the Council:

                (a)    during the financial year in which the particular quarter concerned occurs; or

               (b)    within the period provided under subsection 82L (2) of the Act for the giving of the report, described in that subsection, that relates to the particular quarter concerned.

         (3)   A further calculation may be made as a result of new information received later than is allowed under subsection (2) if the Council is satisfied that:

                (a)    the new information demonstrates that, in preparing its report in respect of information that the Council is required to acquire under subsection 82G (1) of the Act, the registered organisation made a significant error; and

               (b)    it is in the best interests of registered organisations generally, and good administration of the Fund, that a further calculation be made.

Example 1

Under subsection (2), new information could be considered for a calculation made for the September quarter of 1998 if the new information was received by the Council at any time until, and including, 30 September 1999.

This is because the registered organisation concerned had until the end of September 1999 to give the Council information to enable the Council to prepare its report to the Minister about the 1998-1999 financial year (see subsection 82L (2) and section 82PA of the Act).

Example 2

Under subsection (2), new information could not be considered for a calculation made for the June quarter of 1999 if the information was received by the Council after 30 September 1999.

This is because 30 September 1999 was the last day for the Council to receive information about registered organisation operations in the 1998-1999 financial year to enable it to prepare its report to the Minister (see subsection 82L (2) of the Act).

3A.2        Determination of adjustment payments

                If a further calculation made under section 3A.1 shows that a payment made under subsection 73BC (6) or (12) was not appropriate, the Council may determine:

                (a)    under subsection 73BC (6) — that an adjusting amount is an appropriate payment in relation to the registered organisation concerned; or

               (b)    under subsection 73BC (12) — that an adjusting amount is to be paid to the registered organisation concerned.

3A.3        Application of adjustment payments

         (1)   In general, a determination under section 3A.2 takes effect in the first reinsurance settlement period for the registered organisation concerned that follows the making of the determination:

                (a)    if subsection 73BC (6) applies — as an appropriate payment in relation to that organisation; or

               (b)    if subsection 73BC (12) applies — as an amount to be paid to that organisation.

         (2)   However, if the Council is satisfied that the financial stability of the registered organisation, or the Fund, would be unreasonably affected by the application of subsection (1), the determination takes effect as payments (proportional, or as otherwise decided by the Council) in:

                (a)    the reinsurance settlement period mentioned in that subsection; and

               (b)    as many subsequent reinsurance settlement periods as the Council determines to be reasonable.

         (3)   In this section:

reinsurance settlement period means the period following the end of each quarter, during which the Council determines whether payment should be made to, or received from, each registered organisation in respect of that quarter.

unreasonably affected means:

                (a)    in the case of an organisation having to pay an adjusting amount under subsection 73BC (6) of the Act — that the amount of the payment is so large that, in the opinion of the Council, the financial stability of the organisation would be at risk; or

               (b)    in the case of a payment having to be made under subsection 73BC (12) of the Act — that the amount of the payment would be greater than 1% of the amount, at the time the determination is made, of the State or Territory pool of the Fund from which the payment is to be drawn.