Get a plain-English read of Reporting Form HRF 605.0

Turn the raw legal text into a practical explanation grounded in Financial Sector (Collection of Data) (reporting standard) determination No. 12 of 2021.

Reporting Form HRF 605.0

Private Health Insurance Reform Data Collection

Instruction Guide

This instruction guide is designed to assist in the completion of Reporting Form HRF 605.0 Private Health Insurance Reform Data Collection (HRF 605.0). This form collects information on a private health insurer’s (PHI’s) implementation of the Government’s private health insurance reforms announced in October 2017.

General directions and notes

Reporting entity

HRF 605.0 must be completed by all PHIs for each health benefits fund of the PHI.

Reporting period

This form is to be completed in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June).

Unit of measurement

This form must be completed in whole Australian dollars (no decimal place).

Definitions

Terms highlighted in bold italics indicate that the definition is provided in these instructions.

Age Based Discount Percentages	Means the age based discount percentage applicable.If an age based discount of 2% applies, report 2%.If an age based discount of 4% applies, report 4%.If an age based discount of 6% applies, report 6%.If an age based discount of 8% applies, report 8%.If an age based discount of 10% applies, report 10%.If an age based discount does not apply, report Not Applicable.
Basic (private hospital insurance product tier type)	Means a health insurance policy (policy) that:a) covers hospital treatment;b) covers at least the treatments in all of the clinical categories indicated for a basic policy in Schedule 4 of the Private Health Insurance (Complying Product) Rules 2015; andc) is not a Gold, Silver, or Bronze policy.
Bronze (private hospital insurance product tier type)	Means a policy that:a) covers hospital treatment;b) covers at least the treatments in all of the clinical categories indicated for a bronze policy in Schedule 4 of the Private Health Insurance (Complying Product) Rules 2015; andc) is not a Gold or Silver policy.
Couple (policy cover type)	Means a policy under which two adults are insured (and no-one else).
Day (length of treatment type)	Means the treatment is one day only.
Day (private hospital type)	Means a private hospital that is not licensed or otherwise permitted to provide treatment that includes part of an overnight stay at a hospital.

Benefits Paid Amount	The benefits paid amount under a psychiatric care waiting period exemption means the total eligible benefits paid by the PHI for an episode that occurred during the two months waived period for the quarter.
First Admission	To be considered a first admission with psychiatric care waiting period exemption, a first admission must have occurred within the first two months of the upgrade and the person must have decided to use the once-off exemption for the admission.
Not Applicable (Admission Type)	Means the admission type does not apply.
Psychiatric Care Indicators	Report Yes if psychiatric care has been provided, otherwise report No.
Psychiatric Care Waiting Period Exemption Types	A psychiatric care waiting period exemption has been used if:a person transfers to a policy which provides higher benefits for psychiatric treatment than the benefit for psychiatric treatment under the old policy;the person makes a claim under the new policy for psychiatric treatment within the first two months following the product upgrade; andthe person decides to utilise the once-off exemption and receive higher benefits for that admission.A psychiatric care waiting period exemption is not used if all of the above do not apply. If the waiting period exemption is not applicable, then report not applicable.
Subsequent Admission	Means subsequent admissions to a hospital for the same condition as the initial admission. To be considered a subsequent admission with waiting period exemption, a subsequent admission must have occurred within the waived period.

Reporting Form HRF 605.0Reporting Form HRF 605.0