31March 2024.

31 March 2024.

Information required

5. 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.

6. 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

7. The information required by this Reporting Standard must be given to APRA:

(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

8. 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).

9. 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]

10. 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

11. 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.

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.