{"id":"F2025L01100","name":"Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025","slug":"private-health-insurance-health-benefits-fund-enforcement-rules-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":106838,"registerId":"commonwealth-F2025L01100-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"Private Health Insurance (Health Benefit","sectionType":"part","heading":"Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025","content":"# Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025\n\nI, Suzanne Smith, a delegate of the Australian Prudential Regulation Authority:\n\n1.  under subsection 174(1) of the Private Health Insurance (Prudential Supervision) Act 2015 (the Act) and subsection of the 33(3) of the Acts Interpretation Act 1901, REVOKE Private Health Insurance (Health Benefits Fund Enforcement) Rules 2015 made on 26 June 2015; and\n\n1.  under subsection 174(1) of the Act, MAKE these Rules.\n\nThis instrument commences on 30 September 2025.\n\nDated: 11 September 2025\n\nSuzanne Smith\n\nMember","sortOrder":0},{"sectionNumber":"1. Name of Rules","sectionType":"part","heading":"1. Name of Rules","content":"# 1. Name of Rules\n\nThese Rules are the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.","sortOrder":1},{"sectionNumber":"2. Commencement","sectionType":"part","heading":"2. Commencement","content":"# 2. Commencement\n\nThese Rules commence on 30 September 2025.","sortOrder":2},{"sectionNumber":"3. Definitions","sectionType":"part","heading":"3. Definitions","content":"# 3. Definitions\n\nNote: Terms used in these Rules have the same meaning as in the Act – see section 13 of the Legislation Act 2003. These terms include:\n\napplied Corporations Act provision  \nAPRA  \nexternal manager  \nhealth benefits fund  \nprivate health insurer  \nresponsible insurer  \nvoluntary deed of arrangement\n\nIn these Rules:\n\nAct means the Private Health Insurance (Prudential Supervision) Act 2015.\n\nCorporations Act means the Corporations Act 2001.","sortOrder":3},{"sectionNumber":"4. Interpretation","sectionType":"part","heading":"4. Interpretation","content":"# 4. Interpretation\n\nIn this Part, a reference to a creditor of a health benefits fund includes a policy holder of the fund.","sortOrder":4},{"sectionNumber":"5. Convening of meetings","sectionType":"part","heading":"5. Convening of meetings","content":"# 5. Convening of meetings\n\nThe external manager of a health benefits fund may convene a meeting of the creditors of the fund to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager.","sortOrder":5},{"sectionNumber":"6. Procedure for convening of the meetin","sectionType":"part","heading":"6. Procedure for convening of the meeting","content":"# 6. Procedure for convening of the meeting\n\n(1) If the external manager decides to convene a meeting to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager, the external manager must:\n\n1.  give notice to APRA at the same time that the manager gives notice to the creditors; and\n2.  give written notice of the meeting to as many of the creditors as reasonably practicable; and\n3.  cause notice of the meeting to be published:\n\n(i) in a national newspaper; or\n\n(ii) in each jurisdiction in which the business of the fund is carried on – in a daily newspaper that circulates generally in that jurisdiction;\n\nat least 14 business days before the meeting.\n\n(2) The notice given to creditors and APRA under subrule (1) must be accompanied by:\n\n1.  a report by the external manager about the business, property, affairs and financial circumstances of the fund; and\n2.  a statement setting out details of the proposed deed of arrangement; and\n3.  a statement setting out the external manager’s opinion as to why it would be in the interests of the creditors of the fund for the responsible insurer to execute such a deed of arrangement.\n\n(3) If:\n\n1.  telephone or electronic conference facilities are expected to be available at the place where the meeting is to be held; and\n2.  the external manager considers that, having regard to all the circumstances, it will be appropriate to use those facilities, the notice of the meeting must:\n\n(i) set out the relevant telephone number; and\n\n(ii) indicate that a person, or the proxy of a person, who wishes to participate in the meeting by telephone must give to the external manager, not later than the second-last working day before the day on which the meeting is to be held, a written statement setting out:\n\n(A) the name of the person and of the proxy (if any); and\n\n(B) an address to which notices to the person or proxy may be sent; and\n\n(C) a telephone number at which the person or proxy may be contacted; and\n\n(D) a facsimile transmission number (if any) to which notices to the person or proxy may be sent; and\n\n(E) that a person, or the proxy of a person, who participates in the meeting by telephone must pay any costs incurred by the person or proxy in participating and is not entitled to be reimbursed for those costs from the assets of the fund.","sortOrder":6},{"sectionNumber":"7. Conduct of the meeting","sectionType":"part","heading":"7. Conduct of the meeting","content":"# 7. Conduct of the meeting\n\n(1) The external manager is to preside at a meeting convened under this rule.\n\n(2) Such a meeting may be adjourned from time to time at the discretion of the external manager, but may not be adjourned to a day more than 30 days after the first day on which the meeting was held.\n\n(3) If a person, or a person’s proxy, who wishes to participate in a meeting by means of telephone conference facilities, has given the external manager a statement in accordance with subparagraph 6 (3) (b) (ii), the external manager must take all reasonable steps to ensure that the person, or the person’s proxy, is contacted before the start of the meeting on the telephone number provided by that person.\n\n(4) The external manager must also take all reasonable steps to ensure that the person or proxy can hear the proceedings, and can be heard, by means of those facilities.\n\n(5) A person who, or whose proxy, participates in the meeting by telephone under this rule is taken to be present in person at the meeting.\n\n(6) A quorum for the meeting consists of:\n\n1.  if the number of persons entitled to vote exceeds 2 – at least 2 of those persons; or\n2.  if only one person is, or 2 persons are, entitled to vote – that person or those persons,\n\npresent in person or by proxy.\n\n(7) A meeting may be held if all the persons who are entitled to attend, and to vote at, the meeting agree, even if it has not been convened in accordance with these Rules.\n\n(8) If, within 30 minutes after the time appointed for a meeting:\n\n1.  a quorum is not present; or\n2.  the meeting is not otherwise sufficiently constituted,\n\nthe meeting is adjourned:\n\n1.  to the same day in the next week, at the same time and place; or\n2.  to the day (not being less than 7 or more than 21 days after the day on which the meeting is adjourned) and at the time and place that the external manager thinks are most convenient for the majority of persons entitled to attend the meeting.\n\n(9) The external manager must, without delay, give written notice of the adjournment to the persons to whom notice of the meeting must be given under rule 6.\n\n(10) If within 30 minutes after the time appointed for the adjourned meeting:\n\n1.  a quorum is not present; or\n2.  the meeting is not otherwise sufficiently constituted,\n3.  the adjourned meeting lapses.\n\n(11) A resolution is carried if:\n\n1.  a majority of the creditors voting (whether in person or by proxy) vote in favour of the resolution; and\n2.  the value of the debts owed by the fund to those voting in favour of the resolution is more than half the total debts owed to all the creditors voting (whether in person or by proxy).","sortOrder":7},{"sectionNumber":"8. Matters that may be decided at the me","sectionType":"part","heading":"8. Matters that may be decided at the meeting","content":"# 8. Matters that may be decided at the meeting\n\nAt meetings convened in accordance with these Rules, the creditors must resolve:\n\n1.  that the responsible insurer execute:\n\n(i) the deed of arrangement proposed by the external manager; or\n\n(ii) a different deed of arrangement from that originally proposed by the administrator; or\n\n1.  to reject the deed.","sortOrder":8},{"sectionNumber":"9. External managers recommendations to ","sectionType":"part","heading":"9. External managers recommendations to APRA","content":"# 9. External managers recommendations to APRA\n\n(1) If the creditors have made a resolution referred to in paragraph 8 (a), the external manager must recommend in the report to APRA under section 59 of the Act, that APRA approve the execution of the deed, unless subrule (2) applies.\n\n(2) The external manager must not recommend that APRA approve the execution of the deed if:\n\n1.  the deed has been varied by the meeting and the external manager is not satisfied that the varied deed is, in the circumstances, still protective of the interests of the policy holders of the fund; or\n2.  the deed limits the rights of a creditor or creditors unless, in the opinion of the external manager, the fund is insolvent or likely to become insolvent at some future time.\n\n(3) For paragraph (2) (b), a deed will be taken to limit the rights of a creditor or creditors if it involves:\n\n1.  removing or limiting the right of a creditor to the payment of a debt or other liability, or removing or limiting a creditor’s entitlement to an asset; or\n2.  delaying the right of a creditor to make or enforce a claim for the payment of a debt or other liability, or delaying the right of a creditor to make or enforce the creditor’s entitlement to an asset.","sortOrder":9},{"sectionNumber":"10. Actions APRA may take","sectionType":"part","heading":"10. Actions APRA may take","content":"# 10. Actions APRA may take\n\n(1) If APRA is satisfied that the execution of the deed as recommended in the report of the external manager will, in the circumstances, be in the interests of policy holders of the fund, APRA must, by written notice:\n\n1.  inform the external manager that it approves the execution of the deed; and\n2.  request the preparation of the deed for execution.\n\n(2) If APRA is not satisfied that the execution of the deed as recommended in the report of the external manager will be, in the circumstances, in the interests of policy holders of the fund, APRA must, by written notice:\n\n1.  inform the external manager to that effect; and\n2.  request that the external manager:\n\n(i) seek another meeting of the creditors to consider a further voluntary deed of arrangement; or\n\n(ii) examine other possible courses of action,\n\nand, on the basis of that further meeting or examination, to make a further report to APRA under section 59 of the Act within a time specified by APRA.\n\n(3) If the external manager provides a further report to APRA in accordance with paragraph (2) (b), this rule, other than subparagraph (2) (b) (i), applies in respect of that report as if it were the original report of the external manager.\n\n  \nPart 3 – Modifications of terms in applied Corporations Act provisions","sortOrder":10},{"sectionNumber":"11. Modifications","sectionType":"part","heading":"11. Modifications","content":"# 11. Modifications\n\nFor subparagraph 50 (1) (b) (ii) and subsection 55 (2) of the Act, if an applied Corporations Act provision includes a term specified in rule 12 the provision applies as if a reference to the specified term were a reference to the term as modified by rule 12.","sortOrder":11},{"sectionNumber":"12. Specified terms","sectionType":"part","heading":"12. Specified terms","content":"# 12. Specified terms\n\n(1) The following terms are modified as set out in this rule:\n\n1.  board of the company, in relation to a responsible insurer, is modified to mean, as the case may be for a particular insurer:\n\n(i) the board of directors; or\n\n(ii) committee of management; or\n\n(iii) other governing body; and\n\n1.  company is modified to mean the responsible insurer; and\n2.  company secretary is modified to mean in relation to a responsible insurer that is not a company within the meaning of the Corporations Act, the secretary of the insurer or person who carries out the role similar to a company secretary; and\n3.  creditor, in relation to a fund, is modified to include a policy holder of the fund; and\n4.  director or director of a company or of a fund, for a responsible insurer that is not a company within the meaning of the Corporations Act, is modified to include a member of the committee of management, or other governing body, of the insurer; and\n5.  deed of company arrangement is modified to mean a voluntary deed of arrangement agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025; and\n6.  lodge is modified to include that the document to be lodged must be lodged at the same time with APRA; and\n7.  officer is modified to mean an 'officer' within the meaning of that word in the Private Health Insurance (Prudential Supervision) Act 2015; and\n8.  resolution, in relation to creditors and policy holders, is modified to mean a resolution agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.\n\n(2) References in an applied Corporations Act provision to Parts or Divisions of the Corporations Act are taken to also include a reference to the Private Health Insurance (Prudential Supervision) Act 2015 and the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.\n\n  \nPart 4 – Modifications of Part 5.3A and Division 7A of Part 5.6","sortOrder":12},{"sectionNumber":"13. Modifications for subparagraph 50 (1","sectionType":"part","heading":"13. Modifications for subparagraph 50 (1) (b) (ii) of the Act","content":"# 13. Modifications for subparagraph 50 (1) (b) (ii) of the Act\n\nFor subparagraph 50 (1) (b) (ii) of the Act, the applied Corporations Act provisions mentioned in this Part are modified as set out in this Part.","sortOrder":13},{"sectionNumber":"14. Subsection 440D (1)","sectionType":"part","heading":"14. Subsection 440D (1)","content":"# 14. Subsection 440D (1)\n\nDespite subsection 50 (4) of the Act, the reference in subsection 440D (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.\n\nNote: Subsection 56 (2) of the Act provides for the matters to which the external manager or the Court must have regard.","sortOrder":14},{"sectionNumber":"15. Subsections 440J (2) and (3)","sectionType":"part","heading":"15. Subsections 440J (2) and (3)","content":"# 15. Subsections 440J (2) and (3)\n\nomit the subsections","sortOrder":15},{"sectionNumber":"16. Subsection 441B (2)","sectionType":"part","heading":"16. Subsection 441B (2)","content":"# 16. Subsection 441B (2)\n\nomit\n\n198G, 440B, 440F or 440G\n\ninsert\n\n440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,","sortOrder":16},{"sectionNumber":"17. Subsection 441B (3)","sectionType":"part","heading":"17. Subsection 441B (3)","content":"# 17. Subsection 441B (3)\n\nomit\n\n437D\n\ninsert\n\n75 of the Private Health Insurance (Prudential Supervision) Act 2015,","sortOrder":17},{"sectionNumber":"18. Section 441C","sectionType":"part","heading":"18. Section 441C","content":"# 18. Section 441C\n\nomit the section","sortOrder":18},{"sectionNumber":"19. Section 441E","sectionType":"part","heading":"19. Section 441E","content":"# 19. Section 441E\n\nomit\n\n198G or 440B\n\ninsert\n\n440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,","sortOrder":19},{"sectionNumber":"20. Subsection 441F (2)","sectionType":"part","heading":"20. Subsection 441F (2)","content":"# 20. Subsection 441F (2)\n\nomit\n\n198G or 440B\n\ninsert\n\n440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,","sortOrder":20},{"sectionNumber":"21. Subsection 441F (3)","sectionType":"part","heading":"21. Subsection 441F (3)","content":"# 21. Subsection 441F (3)\n\nomit\n\n437D\n\ninsert\n\n75 of the Private Health Insurance (Prudential Supervision) Act 2015,","sortOrder":21},{"sectionNumber":"22. Subsection 441G (2)","sectionType":"part","heading":"22. Subsection 441G (2)","content":"# 22. Subsection 441G (2)\n\nomit the subsection","sortOrder":22},{"sectionNumber":"23. Subsection 442D (2)","sectionType":"part","heading":"23. Subsection 442D (2)","content":"# 23. Subsection 442D (2)\n\nomit the subsection","sortOrder":23},{"sectionNumber":"24. Subsection 442F (1)","sectionType":"part","heading":"24. Subsection 442F (1)","content":"# 24. Subsection 442F (1)\n\nomit\n\nthis Act\n\ninsert\n\nthe Private Health Insurance (Prudential Supervision) Act 2015 and any applied Corporations Act provision as modified.","sortOrder":24},{"sectionNumber":"25. Subsection 442F (2)","sectionType":"part","heading":"25. Subsection 442F (2)","content":"# 25. Subsection 442F (2)\n\nomit the subsection","sortOrder":25},{"sectionNumber":"26. Subsections 444A (1), (2) and (3)","sectionType":"part","heading":"26. Subsections 444A (1), (2) and (3)","content":"# 26. Subsections 444A (1), (2) and (3)\n\nomit the subsections\n\nsubstitute\n\n(1) This section applies where, at a meeting of creditors convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025, a fund’s creditors resolve that the responsible insurer execute a voluntary deed of arrangement.\n\n(2) The external manager of the fund is to be the administrator of the deed, unless the creditors, by resolution passed at the meeting, appoint someone else to be administrator of the deed, and APRA, by notice in writing, approves the resolution.\n\n(3) If APRA, by notice in writing, has approved the execution of the deed, the administrator of the deed must prepare an instrument setting out the terms of the deed.","sortOrder":26},{"sectionNumber":"27. Paragraph 444A (4) (b)","sectionType":"part","heading":"27. Paragraph 444A (4) (b)","content":"# 27. Paragraph 444A (4) (b)\n\nDespite subsection 50 (4) of the Act, the second occurring reference in paragraph 444A (4) (b) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":27},{"sectionNumber":"28. Paragraph 444A (4) (d)","sectionType":"part","heading":"28. Paragraph 444A (4) (d)","content":"# 28. Paragraph 444A (4) (d)\n\nomit the paragraph\n\nsubstitute\n\n(d) to what extent the company is to be released from its debts in so far as the debts are debts of the fund\n\nDespite subsection 50 (4) of the Act, the reference in paragraph 444A (4) (d) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":28},{"sectionNumber":"29. Paragraph 444A (4) (i)","sectionType":"part","heading":"29. Paragraph 444A (4) (i)","content":"# 29. Paragraph 444A (4) (i)\n\nomit\n\ndeed\n\ninsert\n\ndeed;\n\n(j) the number of policy holders of the fund, and the total amount owing to policy holders.","sortOrder":29},{"sectionNumber":"30. Subsection 444A (5)","sectionType":"part","heading":"30. Subsection 444A (5)","content":"# 30. Subsection 444A (5)\n\nomit the subsection","sortOrder":30},{"sectionNumber":"31. Section 444B","sectionType":"part","heading":"31. Section 444B","content":"# 31. Section 444B\n\nDespite subsection 50 (4) of the Act, the references in section 444B of the Corporations Act to 'the company' are not to be taken as references to 'the fund'","sortOrder":31},{"sectionNumber":"32. Subsection 444B (2)","sectionType":"part","heading":"32. Subsection 444B (2)","content":"# 32. Subsection 444B (2)\n\nomit\n\nThe company\n\ninsert\n\nIf APRA, by notice in writing, has approved the execution of the deed, the company","sortOrder":32},{"sectionNumber":"33. Subsection 444B (4)","sectionType":"part","heading":"33. Subsection 444B (4)","content":"# 33. Subsection 444B (4)\n\nomit\n\n198G\n\ninsert\n\n71 of the Private Health Insurance (Prudential Supervision) Act 2015","sortOrder":33},{"sectionNumber":"34. Subsection 444B (5)","sectionType":"part","heading":"34. Subsection 444B (5)","content":"# 34. Subsection 444B (5)\n\nDespite subsection 50 (4) of the Act, the reference in subsection 444B (5) of the Corporations Act to 'the proposed administrator' is not to be taken as a reference to 'the external manager'.","sortOrder":34},{"sectionNumber":"35. Subsection 444B (7)","sectionType":"part","heading":"35. Subsection 444B (7)","content":"# 35. Subsection 444B (7)\n\nomit the subsection","sortOrder":35},{"sectionNumber":"36. Subsection 444C (1)","sectionType":"part","heading":"36. Subsection 444C (1)","content":"# 36. Subsection 444C (1)\n\nomit\n\nsection 439A\n\ninsert\n\nthe Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025\n\nDespite subsection 50 (4) of the Act, the reference in subsection 444C (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":36},{"sectionNumber":"37. Paragraphs 444D (2) (a) and (3) (a)","sectionType":"part","heading":"37. Paragraphs 444D (2) (a) and (3) (a)","content":"# 37. Paragraphs 444D (2) (a) and (3) (a)\n\nDespite subsection 50 (4) of the Act, the references in paragraphs 444D (2) (a) and (3) (a) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.","sortOrder":37},{"sectionNumber":"38. Subsection 444E (4)","sectionType":"part","heading":"38. Subsection 444E (4)","content":"# 38. Subsection 444E (4)\n\nomit the words after the colon\n\nsubstitute\n\nproperty, in relation to the fund, includes property used for the purposes of the business of the fund.","sortOrder":38},{"sectionNumber":"39. Subsections 444F (1) and (2)","sectionType":"part","heading":"39. Subsections 444F (1) and (2)","content":"# 39. Subsections 444F (1) and (2)\n\nDespite subsection 50 (4) of the Act, the references in subsections 444F (1) and (2) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.","sortOrder":39},{"sectionNumber":"40. Subsection 444F (2)","sectionType":"part","heading":"40. Subsection 444F (2)","content":"# 40. Subsection 444F (2)\n\nomit\n\nSubject to subsection 441A (3), the\n\ninsert\n\nThe","sortOrder":40},{"sectionNumber":"41. Subsection 444F (4)","sectionType":"part","heading":"41. Subsection 444F (4)","content":"# 41. Subsection 444F (4)\n\nomit the subsection\n\nsubstitute\n\nThe Court may order the owner or lessor of property that is used for the purposes of the business of the fund not to take possession of the property or otherwise recover it.","sortOrder":41},{"sectionNumber":"42. Section 444G","sectionType":"part","heading":"42. Section 444G","content":"# 42. Section 444G\n\nDespite subsection 50 (4) of the Act, the reference in section 444G of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":42},{"sectionNumber":"43. Section 444H","sectionType":"part","heading":"43. Section 444H","content":"# 43. Section 444H\n\nAfter the word 'debt', insert\n\nthat is a debt of the fund.\n\nDespite subsection 50 (4) of the Act, the reference in section 444H of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":43},{"sectionNumber":"44. Paragraph 445D (2) (b)","sectionType":"part","heading":"44. Paragraph 445D (2) (b)","content":"# 44. Paragraph 445D (2) (b)\n\nomit the paragraph","sortOrder":44},{"sectionNumber":"45. Section 445E","sectionType":"part","heading":"45. Section 445E","content":"# 45. Section 445E\n\nomit the section","sortOrder":45},{"sectionNumber":"46. Subsection 445G (1)","sectionType":"part","heading":"46. Subsection 445G (1)","content":"# 46. Subsection 445G (1)\n\nomit\n\nASIC\n\ninsert\n\nAPRA","sortOrder":46},{"sectionNumber":"47. Subsection 447A (2)","sectionType":"part","heading":"47. Subsection 447A (2)","content":"# 47. Subsection 447A (2)\n\nomit the subsection","sortOrder":47},{"sectionNumber":"48. Paragraphs 447A (4) (a) and (d)","sectionType":"part","heading":"48. Paragraphs 447A (4) (a) and (d)","content":"# 48. Paragraphs 447A (4) (a) and (d)\n\nDespite subsection 50 (4) of the Act, the references in paragraphs 447A (4) (a) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.","sortOrder":48},{"sectionNumber":"49. Paragraph 447A (4) (e)","sectionType":"part","heading":"49. Paragraph 447A (4) (e)","content":"# 49. Paragraph 447A (4) (e)\n\nomit\n\nASIC\n\ninsert\n\nAPRA","sortOrder":49},{"sectionNumber":"50. Subsection 447B (1)","sectionType":"part","heading":"50. Subsection 447B (1)","content":"# 50. Subsection 447B (1)\n\nomit\n\nASIC\n\ninsert\n\nAPRA","sortOrder":50},{"sectionNumber":"51. Subsection 450A (1)","sectionType":"part","heading":"51. Subsection 450A (1)","content":"# 51. Subsection 450A (1)\n\nomit\n\n436A, 436B or 436C\n\ninsert\n\n51 of the Private Health Insurance (Prudential Supervision) Act 2015","sortOrder":51},{"sectionNumber":"52. Subsection 450A (2)","sectionType":"part","heading":"52. Subsection 450A (2)","content":"# 52. Subsection 450A (2)\n\nomit the subsection\n\nsubstitute\n\n(2) As soon as practicable, and in any event before the end of the next business day, after appointing an external manager under section 51 of the Private Health Insurance (Prudential Supervision) Act 2015, APRA must give written notice of the appointment to the responsible insurer.","sortOrder":52},{"sectionNumber":"53. Subsection 450A (3)","sectionType":"part","heading":"53. Subsection 450A (3)","content":"# 53. Subsection 450A (3)\n\nomit\n\n436A, 436B or 436C\n\ninsert\n\n51 of the Private Health Insurance (Prudential Supervision) Act 2015","sortOrder":53},{"sectionNumber":"54. Subsection 450A (4)","sectionType":"part","heading":"54. Subsection 450A (4)","content":"# 54. Subsection 450A (4)\n\nomit the subsection","sortOrder":54},{"sectionNumber":"55. Paragraph 450C (b)","sectionType":"part","heading":"55. Paragraph 450C (b)","content":"# 55. Paragraph 450C (b)\n\nomit\n\nof the company’s creditors\n\ninsert\n\npolicy holder\n\nDespite subsection 50 (4) of the Act, a reference in section 450C of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":55},{"sectionNumber":"56. Subsection 568 (1)","sectionType":"part","heading":"56. Subsection 568 (1)","content":"# 56. Subsection 568 (1)\n\nDespite subsection 50 (4) of the Act, the second reference in subsection 568 (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":56},{"sectionNumber":"57. Paragraph 568 (1) (h)","sectionType":"part","heading":"57. Paragraph 568 (1) (h)","content":"# 57. Paragraph 568 (1) (h)\n\nDespite subsection 50 (4) of the Act, the reference in paragraph 568 (1) (h) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.","sortOrder":57},{"sectionNumber":"58. Subsections 568 (1AA) and 568 (9)","sectionType":"part","heading":"58. Subsections 568 (1AA) and 568 (9)","content":"# 58. Subsections 568 (1AA) and 568 (9)\n\nDespite subsection 50 (4) of the Act, references in subsection 568 (1AA) and subsection 568 (9) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.","sortOrder":58},{"sectionNumber":"59. Subsection 568D (1)","sectionType":"part","heading":"59. Subsection 568D (1)","content":"# 59. Subsection 568D (1)\n\nDespite subsection 50 (4) of the Act, the reference in subsection 568D (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.\n\n  \nPart 5 – Modifications of sections 128 and 129","sortOrder":59},{"sectionNumber":"60. Modifications for subsection 55 (2) ","sectionType":"part","heading":"60. Modifications for subsection 55 (2) of the Act","content":"# 60. Modifications for subsection 55 (2) of the Act\n\nFor subsection 55 (2) of the Act, the applied Corporations Act provisions mentioned in this Part are modified as set out in this Part.","sortOrder":60},{"sectionNumber":"61. Sections 128 and 129","sectionType":"part","heading":"61. Sections 128 and 129","content":"# 61. Sections 128 and 129\n\nIn sections 128 and 129 of the Corporations Act:\n\ncompany means a private health insurer.\n\nofficer includes:\n\n1.  for a private health insurer that is a company within the meaning of the Corporations Act – a director of the company; and\n2.  for any other private health insurer – a member of the committee of management, or other governing authority, of the insurer; and\n3.  if a person has been appointed as a receiver of the property of a private health insurer and manages, or has, under the terms of the receiver’s appointment, power to manage, the affairs of the insurer – the receiver.","sortOrder":61},{"sectionNumber":"62. Subsection 129 (2)","sectionType":"part","heading":"62. Subsection 129 (2)","content":"# 62. Subsection 129 (2)\n\nomit\n\nfrom ASIC","sortOrder":62},{"sectionNumber":"63. After subsection 129 (5)","sectionType":"part","heading":"63. After subsection 129 (5)","content":"# 63. After subsection 129 (5)\n\ninsert\n\n(5A) For a private health insurer that is not a company within the meaning of the Corporations Act, a person may assume that a document has been duly executed by the insurer if the document appears to have been signed in accordance with subsection 129A (1).","sortOrder":63},{"sectionNumber":"64. After subsection 129 (6)","sectionType":"part","heading":"64. After subsection 129 (6)","content":"# 64. After subsection 129 (6)\n\ninsert\n\n(6A) For a private health insurer that is not a company within the meaning of the Corporations Act, a person may assume that a document has been duly executed by the insurer if:\n\n1.  the common seal of the insurer appears to have been fixed to the document in accordance with subsection 129A (2); and\n2.  the fixing of the common seal appears to have been witnessed in accordance with that subsection.","sortOrder":64},{"sectionNumber":"65. After section 129","sectionType":"part","heading":"65. After section 129","content":"# 65. After section 129\n\ninsert\n\n129A Execution of documents (including deeds) by a private health insurer that is not a company\n\n(1) A private health insurer that is not a company within the meaning of the Corporations Act may execute a document without using a common seal if the document is signed by 2 directors or by 2 members of the management committee, or other governing body, of the insurer.\n\n(2) A private health insurer that is not a company within the meaning of the Corporations Act and that has a common seal, has executed a document if the seal is fixed to the document and the fixing of the seal is witnessed by 2 directors or by 2 members of the management committee, or other governing body, of the insurer.","sortOrder":65}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"The legislation appears consistent with its original intent. It remains focused on the specific administrative procedures for managing troubled health benefits funds and adapting corporate insolvency law to the private health insurance sector. The 2025 version updates the 2015 rules but does not appear to expand beyond the original scope of fund enforcement and external administration."},"complexity_factors":["Extensive cross-referencing: The rules modify 40+ specific sections of the Corporations Act 2001, requiring readers to flip between this instrument and the primary legislation constantly","Nested conditional logic: Multiple layers of 'if/then' conditions — e.g., rule 9 requires recommendations unless subrule (2) applies, which itself has two alternative conditions (varied deed vs. limiting creditor rights)","Dual statutory framework: Operates across two primary Acts (Private Health Insurance (Prudential Supervision) Act 2015 and Corporations Act 2001) with term substitutions that vary by context","Entity-type variations: Terms like 'officer' and 'director' have different meanings depending on whether the insurer is a company under the Corporations Act or another structure (mutual, cooperative, etc.)","Modified voting mechanics: Rule 7(11) imposes a dual test for resolutions — majority of creditors voting AND majority of debt value — creating a complex counting mechanism","Telephone participation rules: Rule 6(3) contains five nested sub-requirements (A through E) for electronic participation with specific timing deadlines","Quorum adjournment cascade: Rules 7(8)-7(10) create a multi-stage process for failed quorums with specific time windows (30 minutes, 7-21 days, 30-day maximum)","Term substitution inconsistencies: Some 'company' references are modified to 'fund', others are explicitly preserved as 'company' despite subsection 50(4) of the Act — requiring careful tracking of which substitution applies where"],"plain_english_summary":"This law replaces the 2015 regime and creates a tailored rescue and wind‑up process for troubled private health insurers, treating policyholders as creditors and allowing an APRA‑appointed external manager to convene creditor meetings and propose deeds of arrangement.  \n\nIt adapts parts of the Corporations Act for mutuals and cooperatives, gives APRA final approval, and ensures an orderly process to protect policyholders’ interests when a fund faces insolvency."},"flash_summary":{"complexity_score":8,"scope_assessment":{"changed":true,"description":"The Rules expressly revoke the 2015 instrument and replace it with a more detailed regime that (a) gives APRA a clear gatekeeper role in approving and preparing voluntary deeds of arrangement, (b) adapts and applies many Corporations Act insolvency provisions to health benefits funds with numerous textual modifications, and (c) clarifies execution and governance rules for insurers that are not Corporations. Collectively these changes consolidate enforcement, extend APRA’s operational role, and tailor insolvency mechanics to funds."},"complexity_factors":["Extensive cross-references and modifications to multiple Corporations Act provisions (Parts 5.3A, 5.6, sections 128–129) creating interpretation burdens across statutes.","Large number of targeted omissions, insertions and substitutions (many sections omitted or rewritten) requiring line-by-line reconciliations with the Corporations Act.","Re-characterisation of parties and terms (e.g. treating policy holders as creditors; redefining 'company', 'officer', 'director' for insurers) alters statutory roles and thresholds.","Shift of administrative and enforcement roles from ASIC to APRA in multiple provisions, concentrating decision-making within APRA (see rules substituting APRA for ASIC).","Detailed procedural requirements for convening and conducting creditor meetings (notice, publication, electronic participation, quorum, voting value tests) create operational compliance obligations for external managers (rules 5–7).","Discretion points: external manager’s judgment on convening, recommending deeds, and APRA’s subjective assessment of policyholder interests introduce administrative discretion and review risk.","Special execution rules for insurers that are not Corporations (129A) add documentary formality differences depending on organisational form.","Interplay between fund and responsible insurer (references clarifying when 'company' does not mean 'fund') adds interpretive complexity for insolvency and property-related remedies (multiple rules in Part 4)."],"plain_english_summary":"This instrument revokes the 2015 Rules and replaces them with a new framework letting an external manager of a health benefits fund convene creditors (including policy holders) to consider a voluntary deed of arrangement for the responsible insurer. It sets detailed notice, quorum and voting rules, requires the external manager to report and recommend to APRA, and makes APRA the decision-maker on approving and preparing deeds. The Rules also adapt many Corporations Act insolvency provisions to apply to health benefits funds, substitute APRA for ASIC in several places, and clarify execution rules for non-company insurers."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025","history":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025/history","analysis":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025/analysis","conflicts":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025/conflicts","importantCases":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025/important-cases","documents":"/api/acts/private-health-insurance-health-benefits-fund-enforcement-rules-2025/documents"}}