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Commonwealth legislation
This APRA reporting standard requires all Australian private health insurers to submit quarterly, electronic statistical data (by state/territory and risk‑equalisation jurisdiction) on policies, insured persons, hospital and general treatment claims, and age/gender splits. It applies to reporting periods ending on/after 31 March 2024, with reports due 28 days after each quarter and an annual auditor’s report by 30 September. APRA uses the data for prudential supervision, administering risk equalisation and calculating industry levies; insurers must maintain board‑approved quality controls.
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Direct links to the current provisions in Financial Sector (Collection of Data) (reporting standard) determination No. 1 of 2024.
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Financial Sector (Collection of Data) (reporting standard) determination No. 1 of 2024
Reporting Standard HRS 601.0 Statistical Data by State
Financial Sector (Collection of Data) Act 2001
I, Andrew Robertson, delegate of APRA, under paragraph 13(1)(a) of the Financial Sector (Collection of Data) Act 2001 (the Act) and subsection 33(3) of the Acts Interpretation Act 1901:
(a) revoke Financial Sector (Collection of Data) (reporting standard) determination No. 22 of 2016, including Reporting Standard HRS 601.0 Statistical Data by State made under that Determination; and
(b) determine Reporting Standard HRS 601.0 Statistical Data by State, in the form set out in the Schedule, which applies to the financial sector entities to the extent provided in paragraph 3 of the reporting standard.
Under section 15 of the Act, I declare that Reporting Standard HRS 601.0 Statistical Data by State shall begin to apply to those financial sector entities, and the revoked reporting standard shall cease to apply, at the start of the day after the instrument is registered on the Federal Register of Legislation.
This instrument commences at the start of the day after the instrument is registered on the Federal Register of Legislation.
Dated: 1 February 2024
Andrew Robertson
General Manager – Chief Data Officer
Technology and Data Division
Interpretation
In this Determination:
APRA means the Australian Prudential Regulation Authority.
Federal Register of Legislation means the register established under section 15A of the Legislation Act 2003.
financial sector entity has the meaning given by section 5 of the Act.
Schedule
Reporting Standard HRS 601.0 Statistical Data by State comprises the document commencing on the following page.
Reporting Standard HRS 601.0
Statistical Data by State
Objective of this Reporting Standard
This Reporting Standard sets out the requirements for the provision of information to APRA allowing for the calculation of the risk equalisation special account and calculation of levies in respect of private health insurers, administered by APRA.
It includes Form HRF 601.1 Statistical Data – Cover Page, Form HRF 601.1 Statistical Data - by State and associated specific instructions.
Authority
Purpose
Application
This Reporting Standard applies to all private health insurers.
This Reporting Standard applies for reporting periods ending on or after
31 March 2024.
Information required
A private health insurer must provide APRA with the information required by Form HRF 601.1 Statistical Data - by State in respect of each reporting period.
The information required by this Reporting Standard must be provided for:
(a) each health benefits fund of the private health insurer; and
(b) in relation to Form HRF 601.1 Statistical Data - by State, each risk equalisation jurisdiction of the health benefits fund[1].
Method of submission
(a) in electronic format using an electronic method available on APRA’s website; or
(b) by a method notified by APRA prior to submission.
Reporting periods and due dates
A private health insurer to which this Reporting Standard applies must provide the information required by this Reporting Standard for each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June).
The information required by this Reporting Standard must be provided to APRA within 28 calendar days after the end of the reporting period to which the information relates.[2]
APRA may, in writing, grant a private health insurer an extension of a due date, in which case the new due date for the provision of the information will be the date on the notice of extension.
Quality control
Annual audit requirements
12. By 30 September each year, a private health insurer must give to APRA an auditor’s report relating to:
(a) the information provided by the private health insurer under this Reporting Standard for each quarter in the year ending 30 June of that year; or
(b) if the private health insurer provides an amended quarterly return to replace a return referred to in paragraph (a) — the amended quarterly return.
13. The auditor providing the report to a private health insurer must not be an Officer of, or employed by, the private health insurer.
14. For the purposes of paragraph 12, the auditor’s report must be addressed to APRA and must set out the auditor’s opinion as to whether:
(a) the records for the health benefits fund contain the information required to be kept by this Reporting Standard and the Private Health Insurance Risk Equalisation (Administration) Rules 2015;
(b) the submitted information for the purposes of this Reporting Standard, accurately reflects the information contained in the records of the health benefits fund; and
(c) the records of the health benefits fund have been accurately compiled so as to permit the private health insurer to fairly state the information required by this Reporting Standard.
15. If a private health insurer received a qualified auditor’s report for a health benefits fund 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.
16. The auditor’s report must:
(a) state details of the program adopted to carry out the audit; and
(b) include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
Variations
Transitional
19. A private health insurer must report under the old reporting standard in respect of a transitional reporting period. For these purposes:
old reporting standard means the reporting standard revoked in the determination making this Reporting Standard; and
transitional reporting period means a reporting period under the old reporting standard:
(a) which ended before 31 March 2024; and
(b) in relation to which the private health insurer was required, under the old reporting standard, to report by a date on or after the date of revocation of the old reporting standard.
Note: For the avoidance of doubt, if a private health insurer was required to report under an old reporting standard, and the reporting documents were due before the date of revocation of the old reporting standard, the private health insurer is still required to provide any overdue reporting documents in accordance with the old reporting standard.
Interpretation
(a) unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard HPS 001 Definitions (HPS 001); and
(b) APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015;
Private Health Insurance (Health Insurance Business) Rules 2018 means the Private Health Insurance (Health Insurance Business) Rules 2018 dated 1 August 2022 as amended from time to time or any Private Health Insurance (Health Insurance Business) Rules subsequently made by the Minister under section 333-20 of the Private Health Insurance Act 2007;
Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2023 means the Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2023 dated 17 June 2023 as amended from time to time or any Private Health Insurance (Medical Devices and Human Tissue Products) Rules (subsequently made by the Minister under section 333-20 of the Private Health Insurance Act 2007;
private health insurer has the meaning in the Private Health Insurance (Prudential Supervision) Act 2015;
reporting period means a period mentioned in paragraph 8;
risk equalisation jurisdiction means the risk equalisation jurisdiction as defined in the Private Health Insurance (Prudential Supervision) Act 2015; and
risk equalisation special account means the risk equalisation special account as defined in the Private Health Insurance (Prudential Supervision) Act 2015.
<table cellspacing="0" cellpadding="0" style="width:1261.75pt; border-collapse:collapse"><tbody><tr style="height:20.25pt"><td colspan="3" style="width:347.05pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:middle"><p><span style="font-family:Arial, sans-serif; font-weight:bold">HRF_601_1: Statistical Data - by State</span></p></td><td colspan="5" style="width:124.05pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:bottom"><p><span style="font-family:Arial, sans-serif; font-weight:bold"></span></p></td><td colspan="6" style="width:167.6pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:bottom"><p style="text-align:center"><span style="font-family:Arial, sans-serif"></span></p></td><td colspan="8" style="width:339.2pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:bottom"><p style="text-align:center"><span style="font-family:Arial, sans-serif"></span></p></td><td colspan="2" style="width:1pt; 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border-bottom:1pt solid #000000; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:middle"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold">Australian Business Number</span></p></td><td style="width:76.95pt; border-bottom:1pt solid #000000; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:middle"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold">Institution Name</span></p></td><td colspan="19" style="width:641.6pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:bottom"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold"></span></p></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td></tr><tr style="height:15.75pt"><td style="width:246.1pt; border-right:0.75pt solid #000000; border-left:1pt solid #000000; border-bottom:1pt solid #000000; padding-top:0.75pt; padding-right:0.38pt; padding-left:0.25pt; vertical-align:bottom"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif"></span><span style="font-family:Arial, sans-serif"></span></p></td><td colspan="8" style="width:239.75pt; border:0.75pt solid #000000; padding-top:0.75pt; padding-right:0.38pt; padding-left:0.38pt; vertical-align:bottom"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif"></span><span style="font-family:Arial, sans-serif"></span></p></td><td colspan="12" style="width:478.8pt; border-left:0.75pt solid #000000; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.38pt; vertical-align:bottom"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif"></span></p></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td></tr><tr style="height:15.75pt"><td style="width:246.1pt; border-bottom:1pt solid #000000; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:middle"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold">Reporting Period</span></p></td><td style="width:76.95pt; border-bottom:1pt solid #000000; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:middle"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold">Scale Factor</span><span style="font-family:Arial, sans-serif; font-weight:bold"></span></p></td><td colspan="19" style="width:641.6pt; padding-top:0.75pt; padding-right:0.75pt; padding-left:0.75pt; vertical-align:bottom"><p style="text-align:center; font-size:9pt"><span style="font-family:Arial, sans-serif; font-weight:bold"></span></p></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td><td style="vertical-align:top"></td></tr><tr style="height:17.2pt"><td style="width:246.1pt; 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