{"id":"F2023L00631","name":"Financial Sector (Collection of Data) (reporting standard) determination No. 107 of 2023","slug":"financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":104333,"registerId":"commonwealth-F2023L00631-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"Objective of this Reporting Standard","sectionType":"part","heading":"Objective of this Reporting Standard","content":"## Objective of this Reporting Standard\n\nThis Reporting Standard sets out the requirements for the provision of information to APRA relating to a private health insurer’s Operational Risk Charge.\n\nIt includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 118 Capital Adequacy: Operational Risk Charge (HPS 118).","sortOrder":0},{"sectionNumber":"Authority","sectionType":"division","heading":"Authority","content":"### Authority\n\n1.  This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.","sortOrder":1},{"sectionNumber":"Purpose","sectionType":"division","heading":"Purpose","content":"### Purpose\n\n2. The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision including assessing compliance with capital standards.","sortOrder":2},{"sectionNumber":"Application and commencement","sectionType":"division","heading":"Application and commencement","content":"### Application and commencement\n\n3. This Reporting Standard applies to all private health insurers. This Reporting Standard applies for reporting periods ending on or after 1 July 2023.","sortOrder":3},{"sectionNumber":"Information required","sectionType":"division","heading":"Information required","content":"### Information required\n\n4. A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.","sortOrder":4},{"sectionNumber":"Method of submission","sectionType":"division","heading":"Method of submission","content":"### Method of submission\n\n5. The information required by this Reporting Standard must be given to APRA:\n\n    (a) in electronic format using an electronic method available on APRA’s website; or\n    (b) by a method notified by APRA prior to submission.","sortOrder":5},{"sectionNumber":"Reporting periods and due dates","sectionType":"division","heading":"Reporting periods and due dates","content":"### Reporting periods and due dates\n\n6. Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:\n\n    (a) in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and\n    (b) in respect of each year ending 30 June.\n\n7. If, having regard to the particular circumstances of a private health insurer, APRA considers it necessary or desirable to obtain information more or less frequently than as provided by subparagraph 6(a) or 6(b), APRA may, by notice in writing, change the reporting periods, or specify reporting periods, for the particular private health insurer.\n\n8. The information required by this Reporting Standard must be provided to APRA:\n\n(a) in the case of quarterly information, within 28 calendar days after the end of the reporting period to which the information relates;\n\n(b) in the case of annual information, by 30 September each year; or\n\n(c) in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.\n\n9. APRA may, in writing, grant a private health insurer an extension of a due date, in which case the new due date will be the date on the notice of extension.\n\nNote: For the avoidance of doubt, if the due date for a particular reporting period falls on a day other than a usual business day, a private health insurer is nonetheless required to submit the information required no later than the due date.","sortOrder":6},{"sectionNumber":"Quality control","sectionType":"division","heading":"Quality control","content":"### Quality control\n\n10. All information provided by a private health insurer under this Reporting Standard must be subject to systems, processes and controls developed by the private health insurer for the internal review and authorisation of that information. It is the responsibility of the Board and senior management of the private health insurer to ensure that an appropriate set of policies and procedures for the authorisation of information submitted to APRA is in place.","sortOrder":7},{"sectionNumber":"Annual audit requirements","sectionType":"division","heading":"Annual audit requirements","content":"### Annual audit requirements\n\n11. The information submitted for the purposes of paragraph 8(b) is to be subject to external audit to ensure consistency with the private health insurer’s statutory financial accounts and faithful application of the capital standards.\n\n12. Audit certification and opinion must be provided to APRA by 30 September each year.\n\n13. If a private health insurer received a qualified auditor’s report for a health benefits fund, the general fund or the private health insurer for the year previous to the year for which the report is provided, the report for the year for which the report is provided must state whether the auditor has examined the issues identified and is satisfied that the private health insurer has taken the appropriate steps to rectify the matters raised in the previous report.\n\n14. The auditor’s report must:\n\n    (a) state details of the program adopted to carry out the audit; and\n    (b) include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.","sortOrder":8},{"sectionNumber":"Authorisation","sectionType":"division","heading":"Authorisation","content":"### Authorisation\n\n15. A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.","sortOrder":9},{"sectionNumber":"Variations","sectionType":"division","heading":"Variations","content":"### Variations\n\n16. APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.","sortOrder":10},{"sectionNumber":"Interpretation","sectionType":"division","heading":"Interpretation","content":"### Interpretation\n\n17. In this Reporting Standard:\n\n(a) unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard HPS 001 Definitions (HPS 001); and\n\n(b) the following definitions are applicable:\n\n    APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;\n    capital standards means the prudential standards which relate to capital adequacy as defined in HPS 001;\n\nofficer has the same meaning as in the Act;\n\nprivate health insurer has the same meaning as in the Act;\n\nreporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and\n\nthe Act means the Private Health Insurance (Prudential Supervision) Act 2015.\n\n18. Unless the contrary intention appears, a reference to an Act, Prudential Standard, Reporting Standard, Australian Accounting or Auditing Standard is a reference to the instrument as in force from time to time.","sortOrder":11},{"sectionNumber":"Reporting tables","sectionType":"division","heading":"Reporting tables","content":"### Reporting tables\n\nTables described in this reporting form list each of the data fields required to be reported. The data fields are listed sequentially in the column order that they will appear in the reported data set. Constraints on the data that can be reported for each field have also been provided.\n\nAny specific combination of values in the table must not appear on more than one row in that table when reported.","sortOrder":12},{"sectionNumber":"Definitions","sectionType":"division","heading":"Definitions","content":"### Definitions\n\nTerms highlighted in bold italics indicate that the definition is provided in these instructions.\n\nG\n\n| General fund(Private health insurer fund type) | General fund has the same meaning as in HPS 001. |\n| ---------------------------------------------- | ------------------------------------------------ |\n\nH\n\n| Health benefits fund(Private health insurer fund type) | Health benefits fund has the same meaning as in the Act. |\n| ------------------------------------------------------ | -------------------------------------------------------- |","sortOrder":13},{"sectionNumber":"O","sectionType":"division","heading":"O","content":"### O\n\n| Operational Risk Charge (ORC)                                                                    | This is a derived item and is calculated using the formula in accordance with HPS 118.                                                                                                                                                                                       |\n| ------------------------------------------------------------------------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |\n| ORC - Central estimate of insurance liabilities                                                  | This is the value of the central estimate component of insurance liabilities, determined in accordance with Prudential Standard HPS 340 Insurance Liability Valuation.                                                                                                       |\n| ORC - Accrued premium for the 12 months ending on the date 12 months prior to the reporting date | This is the total accrued premium, for the period of 12 months ending on the date that is 12 months prior to the reporting date.Accrued premium is defined in HPS 001.Accrued premium is to be reported gross of any reinsurance for the purpose of this Reporting Standard. |\n| ORC - Accrued premium for the 12 months ending on the reporting date                             | This is the total accrued premium, for the period of 12 months ending on the reporting date.Accrued premium is defined in HPS 001.Accrued premium is to be reported gross of any reinsurance for the purpose of this Reporting Standard.                                     |","sortOrder":14},{"sectionNumber":"Specific instructions","sectionType":"part","heading":"Specific instructions","content":"## Specific instructions\n\n### Reporting basis\n\nReport items relating to Operational Risk Charge for each health benefits fund and the general fund.\n\nReport all items gross of any associated outwards reinsurance expense.\n\n### Units of measurement\n\nThis values in this table must be completed in whole Australian dollars.\n\n### Table 1: Operational Risk Charge\n\n| Column 1 | Report the value for each of the items listed below. |\n| -------- | ---------------------------------------------------- |\n\n1.  Operational Risk Charge (ORC)\n\n| Item 1   | The ORC is a derived item and is calculated using the formula in accordance with HPS 118.                    |\n| -------- | ------------------------------------------------------------------------------------------------------------ |\n| Item 1.1 | Report the ORC - Accrued premium for the 12 months ending on the reporting date.                             |\n| Item 1.2 | Report the ORC - Accrued premium for the 12 months ending on the date 12 months prior to the reporting date. |\n| Item 1.3 | Report the ORC - Central estimate of insurance liabilities.                                                  |","sortOrder":15},{"sectionNumber":"Reporting basis","sectionType":"division","heading":"Reporting basis","content":"### Reporting basis\n\nReport items relating to Operational Risk Charge for each health benefits fund and the general fund.\n\nReport all items gross of any associated outwards reinsurance expense.","sortOrder":16},{"sectionNumber":"Units of measurement","sectionType":"division","heading":"Units of measurement","content":"### Units of measurement\n\nThis values in this table must be completed in whole Australian dollars.","sortOrder":17},{"sectionNumber":"Table 1: Operational Risk Charge","sectionType":"division","heading":"Table 1: Operational Risk Charge","content":"### Table 1: Operational Risk Charge\n\n| Column 1 | Report the value for each of the items listed below. |\n| -------- | ---------------------------------------------------- |\n\n1.  Operational Risk Charge (ORC)\n\n| Item 1   | The ORC is a derived item and is calculated using the formula in accordance with HPS 118.                    |\n| -------- | ------------------------------------------------------------------------------------------------------------ |\n| Item 1.1 | Report the ORC - Accrued premium for the 12 months ending on the reporting date.                             |\n| Item 1.2 | Report the ORC - Accrued premium for the 12 months ending on the date 12 months prior to the reporting date. |\n| Item 1.3 | Report the ORC - Central estimate of insurance liabilities.                                                  |","sortOrder":18}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This Reporting Standard appears tightly scoped to its original purpose. It implements a specific data collection requirement under the Financial Sector (Collection of Data) Act 2001 for operational risk capital reporting. There is no evidence of scope creep — it does not expand into unrelated areas of prudential supervision or impose obligations beyond data provision for the ORC calculation."},"complexity_factors":["Heavy reliance on external documents: the Reporting Standard cannot be understood without cross-referencing Prudential Standard HPS 118 (for the ORC formula), HPS 001 (for definitions), and HPS 340 (for insurance liability valuation)","Circular and duplicated structure: sections like 'Reporting basis', 'Units of measurement', and 'Table 1' appear multiple times with identical content, suggesting formatting errors or copy-paste issues in the source document","Conditional reporting timelines: paragraph 7 allows APRA to override standard quarterly/annual cycles with custom periods, creating variability in obligations","Nested definitions: terms defined in HPS 001 are incorporated by reference, while local definitions in section 17 create a dual-layer interpretation framework","Audit trail requirements: paragraphs 11-14 impose specific external audit obligations with conditional logic for qualified auditor reports from previous years","Derived item complexity: the ORC itself is not reported directly but calculated via a formula contained in a separate prudential standard, requiring insurers to navigate multiple documents"],"plain_english_summary":"This rule requires private health insurers to report their Operational Risk Charge (the dollar buffer for losses from IT failures, fraud, etc.) to APRA, using APRA’s electronic system. Reports are quarterly and annual, submitted in whole AUD, signed and externally audited.  \n\nAPRA uses the data to monitor insurer resilience and intervene early if firms lack adequate operational-risk capital, protecting policyholders and system stability."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument sets reporting obligations for all private health insurers for periods ending on or after 1 July 2023 (para 3). The standard defines who must report, what to report and timing, but contains no text comparing or altering a prior scope; therefore no change of scope from an earlier instrument can be identified from this text alone."},"complexity_factors":["Dependency on other prudential instruments for definitions and the ORC formula (HPS 118 and HPS 001) increases implementation complexity and requires cross-referencing.","Multiple reporting cadences (quarterly and annual) with APRA discretion to change frequency for a particular insurer (paras 6–7,16).","Mandatory external audit and certification linking reported information to statutory financial accounts (paras 11–14).","Governance and quality‑control obligations placed on boards and senior management for internal review and authorisation (para 10).","Data specification requirements (tables, units in whole AUD, gross of reinsurance) and electronic submission method (Specific instructions; Units of measurement; para 5).","APRA’s administrative discretions (granting extensions, varying requirements, specifying alternative submission methods) create compliance uncertainty (paras 9,5,16).","Derived nature of key item (ORC) requires accurate calculation per HPS 118 and consistent actuarial/accounting inputs (Definitions; Table 1)."],"plain_english_summary":"This Standard requires all private health insurers to report to APRA the data APRA needs to calculate and supervise each insurer’s Operational Risk Charge (ORC). Reports are due quarterly and annually, must follow the ORC formula and definitions in HPS 118/HPS 001, be submitted electronically and are subject to annual external audit (paras 3,6,5,11). \n\nInsurers (and their boards) must maintain internal controls over submissions, supply authorised signatories, report amounts gross of reinsurance, and accept APRA’s power to vary frequency or other requirements (paras 10,15,Specific instructions,7,16)."}},"importantCases":[],"_links":{"self":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023","history":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023/history","analysis":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023/analysis","conflicts":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023/conflicts","importantCases":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023/important-cases","documents":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-107-of-2023/documents"}}