Financial Sector (Collection of Data) (reporting standard) determination No. 20 of 2025
In ForceCTH
Jurisdiction
Commonwealth
Collection
legislative instrument
Plain English Summary
7/10 complexity
**What this instrument does (mechanically)
Establishes a mandatory data‑reporting standard (HRS 101.0) that requires private health insurers to supply supplementary information for their regulatory income statement to APRA (the Australian Prudential Regulation Authority). The standard must be read together with Prudential Standards HPS 115 and HPS 340 (objective and cross‑references at the head of the instrument).
Who must report and when: applies to all private health insurers for reporting periods ending on or after 31 March 2026 (para 3). Insurers must report quarterly (periods ending 30 Sep, 31 Dec, 31 Mar, 30 Jun) and annually (year ending 30 Jun), unless APRA directs a different schedule for a particular insurer (paras 6–8).
How to submit: electronic submission using APRA’s method (or another method APRA notifies) (para 5). Quarterly returns are due within 28 calendar days after the quarter; annual information is due by 30 September (para 8). APRA can grant extensions in writing (para 9).
Internal controls and external audit: reported information must be subject to insurer systems, processes and internal authorisation overseen by the board and senior management (para 10). Annual submissions must be externally audited to ensure consistency with statutory financial accounts and capital standards; audit certification/opinion must be provided by 30 September (paras 11–12). The audit must include program details and be signed by the responsible auditor; where the prior year’s auditor report was qualified the current audit must address remediation (paras 12–14).
Regulatory Income Statement – Supplementary Information
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission
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
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
The information required by this Reporting Standard must be provided to APRA:
in the case of quarterly information under subparagraph 6(a), within 28 calendar days after the end of the reporting period to which the information relates;
in the case of annual information under subparagraph 6(b), by 30 September each year; or
in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.
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.
Note: 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.
Quality control
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
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.
Audit certification and opinion must be provided to by 30 September each year.
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 previous year (previous report), the current year’s auditor’s report 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.
The auditor’s report must:
state details of the program adopted to carry out the audit; and
include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transition
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:
which ended before 31 March 2026; and
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
In this Reporting Standard:
unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard CPS 001 Defined terms (CPS 001); and
the following definitions are applicable:
AASB references relate to the Australian Accounting Standards made by the Australian Accounting Standards Board;
APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the same meaning as in the Act;
private health insurer has the same meaning as in the Act;
reporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and
the Act means the Private Health Insurance (Prudential Supervision) Act 2015.
19. 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.
Regulatory Income Statement — Supplement
Regulatory Income Statement — Supplementary Information
Regulatory Income Statement – Supplementary Information
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission
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
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
The information required by this Reporting Standard must be provided to APRA:
in the case of quarterly information under subparagraph 6(a), within 28 calendar days after the end of the reporting period to which the information relates;
in the case of annual information under subparagraph 6(b), by 30 September each year; or
in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.
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.
Note: 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.
Quality control
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
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.
Audit certification and opinion must be provided to by 30 September each year.
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 previous year (previous report), the current year’s auditor’s report 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.
The auditor’s report must:
state details of the program adopted to carry out the audit; and
include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transition
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:
which ended before 31 March 2026; and
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
In this Reporting Standard:
unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard CPS 001 Defined terms (CPS 001); and
the following definitions are applicable:
AASB references relate to the Australian Accounting Standards made by the Australian Accounting Standards Board;
APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the same meaning as in the Act;
private health insurer has the same meaning as in the Act;
reporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and
the Act means the Private Health Insurance (Prudential Supervision) Act 2015.
19. 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.
Objective of this Reporting Standard
Objective of this Reporting Standard
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority
Authority
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
Purpose
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement
Application and commencement
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required
Information required
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission
Method of submission
Method of submission
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
Reporting periods and due dates
Reporting periods and due dates
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
The information required by this Reporting Standard must be provided to APRA:
in the case of quarterly information under subparagraph 6(a), within 28 calendar days after the end of the reporting period to which the information relates;
in the case of annual information under subparagraph 6(b), by 30 September each year; or
in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.
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.
Note: 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.
Quality control
Quality control
Quality control
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
Annual audit requirements
Annual audit requirements
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.
Audit certification and opinion must be provided to by 30 September each year.
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 previous year (previous report), the current year’s auditor’s report 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.
The auditor’s report must:
state details of the program adopted to carry out the audit; and
include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
Authorisation
Authorisation
A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
Variations
Variations
APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transition
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:
which ended before 31 March 2026; and
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
Interpretation
Interpretation
In this Reporting Standard:
unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard CPS 001 Defined terms (CPS 001); and
the following definitions are applicable:
AASB references relate to the Australian Accounting Standards made by the Australian Accounting Standards Board;
APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the same meaning as in the Act;
private health insurer has the same meaning as in the Act;
reporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and
the Act means the Private Health Insurance (Prudential Supervision) Act 2015.
19. 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.
General instructions
General instructions
Reporting Standard HRS 101.0
Regulatory Income Statement – Supplementary Information
General instructions
Purpose
This reporting standard contains details related to revenue and expenses for each health benefits fund or the general fund. The data collected by APRA supplements information provided in Reporting Standard HRS 310.0 Statement of Profit or Loss and Other Comprehensive Income, and is not intended to be aggregated to produce a financial performance result.
Reporting tables
Tables described in this reporting standard 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.
Any specific combination of values in a table must not appear on more than one row in that table when reported.
Definitions
Terms highlighted in bold italics indicate that the definition is provided in these instructions.
A
Accrued premium
This refers to accrued premium as defined in CPS 001.
Accrued premium discounts amount
The value of the effects on the HIB accrued premium (as recognised in Table 1: Insurance Revenue – HIB Accrued Premium by state) by discounts which are intended to be offered on an ongoing basis and/or to persons who have already purchased a policy. An example would be offering a discount for all policy holders paying electronically.
Accrued premium promotions amount
The value of the effects on the HIB accrued premium (as recognised in Table 1: Insurance Revenue – HIB Accrued Premium by state) by promotions which are offered to a person at the time the person first purchases a policy. An example would be offering a free period of cover to a new member.
Adjustments to retained earnings due to change in accounting policies / standards(Retained earnings item type)
This is the value of aggregate adjustments to retained earnings due to changes in accounting policies or accounting treatment.
Agency business(Health-related business non-insurance activities)
This is revenues of the private health insurer fund type related to agency business, as defined under Private Health Insurance (Health Benefits Fund Policy) Rules 2015.
Asset class type
The asset class types are:interest rate investments (direct);equities (direct);property (direct);loans (direct);indirect investments; andother investments.
C
Claims handling expenses amount
This has the same meaning as claims handling expenses as defined in CPS 001.
Claims incurred amount
This has the same meaning as claims incurred as defined in CPS 001.
Class of business
Relates to insurance business only. This can be:hospital treatment; orgeneral treatment.
Commissions & fees(Other business expenses type)
This is the value of fees and/or commissions paid to agents, brokers or aggregators.
Costs of goods/services: Dental business(Other business expenses type)
These are all expenses directly or indirectly attributed to the provision of dental business goods and/or services to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Hospitals & Medical Centres(Other business expenses type)
These are the costs of all hospital and medical centre business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Optical business(Other business expenses type)
These are the costs of all optical business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Other(Other business expenses type)
These are the costs of all other health related business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
D
Dividends declared or paid
Report dividends which are declared or paid by the private health insurer. A dividend is the amount paid out of a company's profits to its shareholders (interim and final dividend). The annual dividend equals the final dividend plus the interim dividend if declared.
E
Employee costs(Other business expenses type)
This is the value of items such as recruitment, wages and salaries, superannuation expenses, share-based payment expense, other long-term benefits expense, termination benefits expense, social security costs, contractor and on costs, and training.
Equities (direct)(Asset class type)
Equities (direct) are comprised of equity securities and of subordinated debt securities. Equity securities are, as defined by the Australian Accounting Standards, contracts that evidence a residual interest in the assets of an entity after deducting all its liabilities. This includes equity securities lent or sold by the entity under repurchase agreements, where the transaction does not result in the transfer of the rights of ownership of the securities away from the entity to another party. Subordinated debt is a debt security where the claim to repayment ranks lower in priority to other claims.
External sources(Health-related business non-insurance revenue type)
This means all HRB non-insurance revenue that is earned from:revenue from non-policy holders of the private health insurer;revenue to cover services provided by the private health insurer; andrevenue from policy holders of the private health insurer for services not covered by the insurance premium.
G
Gains/losses on investments amount
This is the total of all movements in assets values during the reporting period, from both revaluation and market movements (includes both realised and unrealised gains/losses). This amount must be recorded net of associated investment expenses and fees.
General fund(Private health insurer fund type)
General fund has the same meaning as in CPS 001.
General treatment(Class of business)
General treatment has the same meaning as in the Private Health Insurance Act 2007 (PHI Act).
Gross accrued premium
This is the value of accrued premium, gross of ceded revenue, for health-related insurance business.
Gross claims incurred amount
This is the value of health-related insurance business claims incurred, gross of reinsurance recoveries.
H
Health benefits fund(Private health insurer fund type)
Health benefits fund has the same meaning as in the Act.
Health-related business non-insurance activities
Health-related business non-insurance activities are:optical business;dental business;hospitals and medical centres;agency business; andother non-insurance health-related business.
Health-related business non-insurance revenue amount
This is the gross revenue for the health-related business non-insurance revenue type.
Health-related business non-insurance revenue type
The health-related business non-insurance revenue types are:External sourcesInsurer policy holder benefits
Health-related insurance business type
The health-related insurance business types are:overseas visitor coveroverseas student health cover
Hospital category
The hospital category must be one of the following, which have the same meaning as in the Private Health Insurance (Complying Product) Rules 2015:Gold;Silver +;Silver;Bronze +;Bronze;Basic +; orBasic.
Hospital treatment(Class of business)
Hospital treatment has the same meaning as in the PHI Act.
I
Indirect investments(Asset class type)
Indirect investments are unit trusts or managed investment schemes invested in by the private health insurer fund type, or mandates individually managed on behalf of the private health insurer fund type.
Insurer policy holder benefits(Health-related business non-insurance revenue type)
This is the value of health-related business non-insurance services provided to policy holders of the private health insurer, where that service is covered by their insurance premiums.
Interest rate investments (direct)(Asset class type)
Interest rate investments (direct) are debt securities held by the private health insurer fund type as at the relevant date. A debt security is a transferable instrument evidencing a relationship of indebtedness. It is characterised by having a definable return that is not based on the economic performance of the issuing entity.
Investment income amount
This is the total income, including interest and dividends, collected from investments over the reporting period. Income must be recorded net of associated expenses and fees.
L
Loans (direct)(Asset class type)
This is the value of loans (direct). Loans (direct) includes financial leases and mortgages, and are typically non-negotiable on the secondary market.
M
Major other source(Net other operational revenue type)
This is the largest other operational source, ranked by gross revenue.
Marketing and publicity(Other business expenses type)
This is the value of items such as publications, advertising, sponsorship, publicity, and health maintenance promotion programmes.
N
Net other operational revenue amount
This means all operational revenue other than HIB and HRB, net of expenses, attributable to the private health insurer fund type.
Net other operational revenue type
The net other operational revenue types are:major other source; andsecondary other source.
Net RESA amount
The net RESA (Risk Equalisation Special Account) amount is the value of risk equalisation payments/receipts, movements of provisions in the risk equalisation component of outstanding claims liability and movements of provisions for risk equalisation transfers, where provisions are determined in accordance with HPS 340.
O
Operations & administration(Other business expenses type)
This is the value of items such as self-occupied property expenses, IT and computing, postage, telephones, accounting audit and other professional feed and membership subscriptions.
Other business expenses amount
This means the other business expenses types attributable to the private health insurer fund type.
Other business expenses type
The other business expenses types are:commissions & fees;marketing and publicity;employee costs;operations & administration;share of corporate overheads;other expenses;costs of goods/services: Optical business;costs of goods/services: Dental business;costs of goods/services: Hospitals & Medical Centres; andcosts of goods/services: Other.
Other expenses(Other business expenses type)
This is the value of any expenses related to conducting the private health insurer business type, other than those separately reported as other business expenses type.
Other investments(Asset class type)
Other investments are those that have not been reported elsewhere in:interest rate investments (direct);equities (direct);property (direct);loans (direct); orindirect investments.
Other non-insurance health-related business(Health-related business non-insurance activities)
This means non-insurance revenues of the private health insurer fund type related to health-related business, as defined in the Act, other than those related to dental services, optical services, health services provided in hospital and medical centres or agency business.
Other retained earnings movements
This consists of all movements in retained earnings movements not specifically categorised as the following retained earnings item types:profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to / from parent entity;dividends declared or paid; andtransfers to / from other funds.
Overseas student health cover (OSHC)(Health-related insurance business)
Overseas student health cover refers to overseas student health insurance contracts and has the meaning in the Private Health Insurance (Health Insurance Business) Rules 2018.
Overseas visitor cover is the total of certain overseas visitors and specified temporary visa holder health insurance contracts.Certain overseas visitors and specified temporary visa holder health insurance contracts have the meaning in the Private Health Insurance (Health Insurance Business) Rules 2018.
P
Private health insurer business type
The private health insurer business types are:health insurance business;health-related insurance business; orhealth-related business – non-insurance.
Private health insurer fund type
This is either health benefits fund or general fund.
Profit / loss after income tax attributable to members of the company(Retained earnings item type)
Report this item in accordance with AASB 101.81B (a) (ii) for the private health insurer fund type.
Property (direct)(Asset class type)
Property (direct) is property held by the health benefits fund or general fund, in accordance with the classification and measurement basis under the relevant Australian Accounting Standards.
R
Reduction in retained earnings on share buy back
This is the value of the reduction in the private health insurer's retained earnings due to the buy back, or repurchase, of shares on issue during the relevant period. This represents the portion of the consideration used for share buy backs that is allocated to retained earnings.
Reinsurance premiums ceded amount
This is the value of health-related insurance business accrued premium ceded to a reinsurer.
Reinsurance recoveries amount
This is the value reinsurance recoveries in respect of claims incurred for health-related insurance business.
Retained earnings amount
This means the retained earnings amount for the private health insurer fund type.
Retained earnings at the beginning of the reporting period(Retained earnings item type)
This is the value, as at the relevant date, of retained earnings at the beginning of the current reporting period.
Retained earnings at the end of the reporting period
Retained earnings at the end of the reporting period is a derived value and is calculated as the sum of:retained earnings at the beginning of the reporting period;profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to / from parent entity;dividends declared or paid;transfers to / from other funds; andother retained earnings movements.
Retained earnings item type
The retained earnings item types are:retained earnings at the beginning of the reporting period;profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to/ from parent entity;dividends declared or paid;transfers to / from other funds; andother retained earnings movements.
S
Secondary other source(Net other operational revenue type)
This is the second largest other operational source, ranked by gross revenue.
Share of corporate overheads(Other business expenses type)
This is the value of overhead expenses of another entity borne by the private health insurer fund type.
State ambulance levies
State levies are all state ambulance levies payable by the health benefits fund.
T
Transfers to / from other funds(Retained earnings item type)
Report the value of funds transferred to or received from a health benefits fund or general fund of the private health insurer during the reporting period.
Transfers to / from parent entity(Retained earnings item type)
Report the value of dividends or funds transferred to or received from the parent entity during the reporting period.Transfers from parent entity only includes funds that are capital contributions from the parent entity and are not required to be repaid.
Transfers to / from reserves(Retained earnings item type)
Report the value of funds that have been transferred to (from) retained earnings from (to) reserves during the reporting period.
Reporting tables
Reporting tables
Reporting tables
Tables described in this reporting standard 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.
Any specific combination of values in a table must not appear on more than one row in that table when reported.
Definitions
Definitions
Definitions
Terms highlighted in bold italics indicate that the definition is provided in these instructions.
A
Accrued premium
This refers to accrued premium as defined in CPS 001.
Accrued premium discounts amount
The value of the effects on the HIB accrued premium (as recognised in Table 1: Insurance Revenue – HIB Accrued Premium by state) by discounts which are intended to be offered on an ongoing basis and/or to persons who have already purchased a policy. An example would be offering a discount for all policy holders paying electronically.
Accrued premium promotions amount
The value of the effects on the HIB accrued premium (as recognised in Table 1: Insurance Revenue – HIB Accrued Premium by state) by promotions which are offered to a person at the time the person first purchases a policy. An example would be offering a free period of cover to a new member.
Adjustments to retained earnings due to change in accounting policies / standards(Retained earnings item type)
This is the value of aggregate adjustments to retained earnings due to changes in accounting policies or accounting treatment.
Agency business(Health-related business non-insurance activities)
This is revenues of the private health insurer fund type related to agency business, as defined under Private Health Insurance (Health Benefits Fund Policy) Rules 2015.
Asset class type
The asset class types are:interest rate investments (direct);equities (direct);property (direct);loans (direct);indirect investments; andother investments.
C
Claims handling expenses amount
This has the same meaning as claims handling expenses as defined in CPS 001.
Claims incurred amount
This has the same meaning as claims incurred as defined in CPS 001.
Class of business
Relates to insurance business only. This can be:hospital treatment; orgeneral treatment.
Commissions & fees(Other business expenses type)
This is the value of fees and/or commissions paid to agents, brokers or aggregators.
Costs of goods/services: Dental business(Other business expenses type)
These are all expenses directly or indirectly attributed to the provision of dental business goods and/or services to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Hospitals & Medical Centres(Other business expenses type)
These are the costs of all hospital and medical centre business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Optical business(Other business expenses type)
These are the costs of all optical business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
Costs of goods/services: Other(Other business expenses type)
These are the costs of all other health related business goods and/or services provided to both policy holders and non-policy holders of the private health insurer.
D
D
D
Dividends declared or paid
Report dividends which are declared or paid by the private health insurer. A dividend is the amount paid out of a company's profits to its shareholders (interim and final dividend). The annual dividend equals the final dividend plus the interim dividend if declared.
E
Employee costs(Other business expenses type)
This is the value of items such as recruitment, wages and salaries, superannuation expenses, share-based payment expense, other long-term benefits expense, termination benefits expense, social security costs, contractor and on costs, and training.
Equities (direct)(Asset class type)
Equities (direct) are comprised of equity securities and of subordinated debt securities. Equity securities are, as defined by the Australian Accounting Standards, contracts that evidence a residual interest in the assets of an entity after deducting all its liabilities. This includes equity securities lent or sold by the entity under repurchase agreements, where the transaction does not result in the transfer of the rights of ownership of the securities away from the entity to another party. Subordinated debt is a debt security where the claim to repayment ranks lower in priority to other claims.
External sources(Health-related business non-insurance revenue type)
This means all HRB non-insurance revenue that is earned from:revenue from non-policy holders of the private health insurer;revenue to cover services provided by the private health insurer; andrevenue from policy holders of the private health insurer for services not covered by the insurance premium.
G
Gains/losses on investments amount
This is the total of all movements in assets values during the reporting period, from both revaluation and market movements (includes both realised and unrealised gains/losses). This amount must be recorded net of associated investment expenses and fees.
General fund(Private health insurer fund type)
General fund has the same meaning as in CPS 001.
General treatment(Class of business)
General treatment has the same meaning as in the Private Health Insurance Act 2007 (PHI Act).
Gross accrued premium
This is the value of accrued premium, gross of ceded revenue, for health-related insurance business.
Gross claims incurred amount
This is the value of health-related insurance business claims incurred, gross of reinsurance recoveries.
H
Health benefits fund(Private health insurer fund type)
Health benefits fund has the same meaning as in the Act.
Health-related business non-insurance activities
Health-related business non-insurance activities are:optical business;dental business;hospitals and medical centres;agency business; andother non-insurance health-related business.
Health-related business non-insurance revenue amount
This is the gross revenue for the health-related business non-insurance revenue type.
Health-related business non-insurance revenue type
The health-related business non-insurance revenue types are:External sourcesInsurer policy holder benefits
Health-related insurance business type
The health-related insurance business types are:overseas visitor coveroverseas student health cover
Hospital category
The hospital category must be one of the following, which have the same meaning as in the Private Health Insurance (Complying Product) Rules 2015:Gold;Silver +;Silver;Bronze +;Bronze;Basic +; orBasic.
Hospital treatment(Class of business)
Hospital treatment has the same meaning as in the PHI Act.
I
Indirect investments(Asset class type)
Indirect investments are unit trusts or managed investment schemes invested in by the private health insurer fund type, or mandates individually managed on behalf of the private health insurer fund type.
Insurer policy holder benefits(Health-related business non-insurance revenue type)
This is the value of health-related business non-insurance services provided to policy holders of the private health insurer, where that service is covered by their insurance premiums.
Interest rate investments (direct)(Asset class type)
Interest rate investments (direct) are debt securities held by the private health insurer fund type as at the relevant date. A debt security is a transferable instrument evidencing a relationship of indebtedness. It is characterised by having a definable return that is not based on the economic performance of the issuing entity.
Investment income amount
This is the total income, including interest and dividends, collected from investments over the reporting period. Income must be recorded net of associated expenses and fees.
L
Loans (direct)(Asset class type)
This is the value of loans (direct). Loans (direct) includes financial leases and mortgages, and are typically non-negotiable on the secondary market.
M
Major other source(Net other operational revenue type)
This is the largest other operational source, ranked by gross revenue.
Marketing and publicity(Other business expenses type)
This is the value of items such as publications, advertising, sponsorship, publicity, and health maintenance promotion programmes.
N
Net other operational revenue amount
This means all operational revenue other than HIB and HRB, net of expenses, attributable to the private health insurer fund type.
Net other operational revenue type
The net other operational revenue types are:major other source; andsecondary other source.
Net RESA amount
The net RESA (Risk Equalisation Special Account) amount is the value of risk equalisation payments/receipts, movements of provisions in the risk equalisation component of outstanding claims liability and movements of provisions for risk equalisation transfers, where provisions are determined in accordance with HPS 340.
O
Operations & administration(Other business expenses type)
This is the value of items such as self-occupied property expenses, IT and computing, postage, telephones, accounting audit and other professional feed and membership subscriptions.
Other business expenses amount
This means the other business expenses types attributable to the private health insurer fund type.
Other business expenses type
The other business expenses types are:commissions & fees;marketing and publicity;employee costs;operations & administration;share of corporate overheads;other expenses;costs of goods/services: Optical business;costs of goods/services: Dental business;costs of goods/services: Hospitals & Medical Centres; andcosts of goods/services: Other.
Other expenses(Other business expenses type)
This is the value of any expenses related to conducting the private health insurer business type, other than those separately reported as other business expenses type.
Other investments(Asset class type)
Other investments are those that have not been reported elsewhere in:interest rate investments (direct);equities (direct);property (direct);loans (direct); orindirect investments.
Other non-insurance health-related business(Health-related business non-insurance activities)
This means non-insurance revenues of the private health insurer fund type related to health-related business, as defined in the Act, other than those related to dental services, optical services, health services provided in hospital and medical centres or agency business.
Other retained earnings movements
This consists of all movements in retained earnings movements not specifically categorised as the following retained earnings item types:profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to / from parent entity;dividends declared or paid; andtransfers to / from other funds.
Overseas student health cover (OSHC)(Health-related insurance business)
Overseas student health cover refers to overseas student health insurance contracts and has the meaning in the Private Health Insurance (Health Insurance Business) Rules 2018.
Overseas visitor cover is the total of certain overseas visitors and specified temporary visa holder health insurance contracts.Certain overseas visitors and specified temporary visa holder health insurance contracts have the meaning in the Private Health Insurance (Health Insurance Business) Rules 2018.
P
Private health insurer business type
The private health insurer business types are:health insurance business;health-related insurance business; orhealth-related business – non-insurance.
Private health insurer fund type
This is either health benefits fund or general fund.
Profit / loss after income tax attributable to members of the company(Retained earnings item type)
Report this item in accordance with AASB 101.81B (a) (ii) for the private health insurer fund type.
Property (direct)(Asset class type)
Property (direct) is property held by the health benefits fund or general fund, in accordance with the classification and measurement basis under the relevant Australian Accounting Standards.
R
Reduction in retained earnings on share buy back
This is the value of the reduction in the private health insurer's retained earnings due to the buy back, or repurchase, of shares on issue during the relevant period. This represents the portion of the consideration used for share buy backs that is allocated to retained earnings.
Reinsurance premiums ceded amount
This is the value of health-related insurance business accrued premium ceded to a reinsurer.
Reinsurance recoveries amount
This is the value reinsurance recoveries in respect of claims incurred for health-related insurance business.
Retained earnings amount
This means the retained earnings amount for the private health insurer fund type.
Retained earnings at the beginning of the reporting period(Retained earnings item type)
This is the value, as at the relevant date, of retained earnings at the beginning of the current reporting period.
Retained earnings at the end of the reporting period
Retained earnings at the end of the reporting period is a derived value and is calculated as the sum of:retained earnings at the beginning of the reporting period;profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to / from parent entity;dividends declared or paid;transfers to / from other funds; andother retained earnings movements.
Retained earnings item type
The retained earnings item types are:retained earnings at the beginning of the reporting period;profit / loss after income tax attributable to members of the company;adjustments to retained earnings due to change in accounting policies / standards;reduction in retained earnings on share buy back;transfers to / from reserves;transfers to/ from parent entity;dividends declared or paid;transfers to / from other funds; andother retained earnings movements.
S
Secondary other source(Net other operational revenue type)
This is the second largest other operational source, ranked by gross revenue.
Share of corporate overheads(Other business expenses type)
This is the value of overhead expenses of another entity borne by the private health insurer fund type.
State ambulance levies
State levies are all state ambulance levies payable by the health benefits fund.
T
Transfers to / from other funds(Retained earnings item type)
Report the value of funds transferred to or received from a health benefits fund or general fund of the private health insurer during the reporting period.
Transfers to / from parent entity(Retained earnings item type)
Report the value of dividends or funds transferred to or received from the parent entity during the reporting period.Transfers from parent entity only includes funds that are capital contributions from the parent entity and are not required to be repaid.
Transfers to / from reserves(Retained earnings item type)
Report the value of funds that have been transferred to (from) retained earnings from (to) reserves during the reporting period.
Specific instructions
Specific instructions
Specific instructions
Table 1: Insurance Revenue – HIB Accrued Premium by state
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Class Of Business
Hospital treatmentGeneral treatment
Report the class of business.
3
State And Territory Of Australia
NSWVICQLDSAWATASACTNT
Report by state and territory of Australia.
4
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Report this item net of any reinsurance.
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Hospital Category
GoldSilver +SilverBronze +BronzeBasic +Basic
Report the hospital category.
3
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Private health insurers may use approximate methods and take into account overall materiality in apportioning this item by hospital category.Report this item net of any reinsurance.
Table 3: Insurance Revenue – HIB Discounts and Promotions
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Accrued Premium Discounts Amount
Whole dollars
Report the accrued premium discounts amount.
3
Accrued Premium Promotions Amount
Whole dollars
Report the accrued premium promotions amount.
Table 1: Insurance Revenue — HIB Accrued
Table 1: Insurance Revenue — HIB Accrued Premium by state
Specific instructions
Table 1: Insurance Revenue – HIB Accrued Premium by state
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Class Of Business
Hospital treatmentGeneral treatment
Report the class of business.
3
State And Territory Of Australia
NSWVICQLDSAWATASACTNT
Report by state and territory of Australia.
4
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Report this item net of any reinsurance.
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Hospital Category
GoldSilver +SilverBronze +BronzeBasic +Basic
Report the hospital category.
3
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Private health insurers may use approximate methods and take into account overall materiality in apportioning this item by hospital category.Report this item net of any reinsurance.
Table 3: Insurance Revenue – HIB Discounts and Promotions
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Accrued Premium Discounts Amount
Whole dollars
Report the accrued premium discounts amount.
3
Accrued Premium Promotions Amount
Whole dollars
Report the accrued premium promotions amount.
Reporting basis
Reporting basis
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Units of measurement
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Class Of Business
Hospital treatmentGeneral treatment
Report the class of business.
3
State And Territory Of Australia
NSWVICQLDSAWATASACTNT
Report by state and territory of Australia.
4
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Report this item net of any reinsurance.
Table 1: Insurance Revenue – HIB Accrued Premium by state
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Class Of Business
Hospital treatmentGeneral treatment
Report the class of business.
3
State And Territory Of Australia
NSWVICQLDSAWATASACTNT
Report by state and territory of Australia.
4
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Report this item net of any reinsurance.
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Hospital Category
GoldSilver +SilverBronze +BronzeBasic +Basic
Report the hospital category.
3
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Private health insurers may use approximate methods and take into account overall materiality in apportioning this item by hospital category.Report this item net of any reinsurance.
Table 3: Insurance Revenue – HIB Discounts and Promotions
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Accrued Premium Discounts Amount
Whole dollars
Report the accrued premium discounts amount.
3
Accrued Premium Promotions Amount
Whole dollars
Report the accrued premium promotions amount.
Table 3: Insurance Revenue — HIB Discoun
Table 3: Insurance Revenue — HIB Discounts and Promotions
Specific instructions
Table 1: Insurance Revenue – HIB Accrued Premium by state
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Class Of Business
Hospital treatmentGeneral treatment
Report the class of business.
3
State And Territory Of Australia
NSWVICQLDSAWATASACTNT
Report by state and territory of Australia.
4
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Report this item net of any reinsurance.
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Hospital Category
GoldSilver +SilverBronze +BronzeBasic +Basic
Report the hospital category.
3
Accrued Premium Amount
Whole dollars
Report the accrued premium amount.Private health insurers may use approximate methods and take into account overall materiality in apportioning this item by hospital category.Report this item net of any reinsurance.
Table 3: Insurance Revenue – HIB Discounts and Promotions
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.
2
Accrued Premium Discounts Amount
Whole dollars
Report the accrued premium discounts amount.
3
Accrued Premium Promotions Amount
Whole dollars
Report the accrued premium promotions amount.
Table 4: Insurance Revenue — HRIB Accrue
Table 4: Insurance Revenue — HRIB Accrued Premium
Table 4: Insurance Revenue – HRIB Accrued Premium
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Type
Health benefits fundGeneral fund
Report the private health insurer fund type.
2
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.For the general fund, report the same name as the private health insurer.
3
Health-Related Insurance Business Type
Overseas visitor coverOverseas student health cover
Report the health-related insurance business type.
4
Gross Accrued Premium Amount
Whole dollars
Report the gross accrued premium amount.
5
Reinsurance Premiums Ceded Amount
Whole dollars
Report the reinsurance premiums ceded amount.Report the reinsurance premiums ceded amount as a positive value.
Table 5: Health-Related Business Revenue - Non-Insurance Activities
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Type
Health benefits fundGeneral fund
Report the private health insurer fund type.
2
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.For the general fund, report the same name as the private health insurer.
3
Health-Related Business Non-Insurance Activities Type
Optical businessDental businessHospitals and medical centresAgency businessOther non-insurance health-related business
Report the health-related business non-insurance activities type.
4
Health-Related Business Non-Insurance Revenue Type
External sourcesInsurer policy holder benefits
Report the health-related business non-insurance revenue type.
5
Health-Related Business Non-Insurance Revenue Amount
Whole dollars
Report the health-related business non-insurance revenue amount.
Table 5: Health-Related Business Revenue
Table 5: Health-Related Business Revenue - Non-Insurance Activities
Table 4: Insurance Revenue – HRIB Accrued Premium
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Type
Health benefits fundGeneral fund
Report the private health insurer fund type.
2
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.For the general fund, report the same name as the private health insurer.
3
Health-Related Insurance Business Type
Overseas visitor coverOverseas student health cover
Report the health-related insurance business type.
4
Gross Accrued Premium Amount
Whole dollars
Report the gross accrued premium amount.
5
Reinsurance Premiums Ceded Amount
Whole dollars
Report the reinsurance premiums ceded amount.Report the reinsurance premiums ceded amount as a positive value.
Table 5: Health-Related Business Revenue - Non-Insurance Activities
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Type
Health benefits fundGeneral fund
Report the private health insurer fund type.
2
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.For the general fund, report the same name as the private health insurer.
3
Health-Related Business Non-Insurance Activities Type
Optical businessDental businessHospitals and medical centresAgency businessOther non-insurance health-related business
Report the health-related business non-insurance activities type.
4
Health-Related Business Non-Insurance Revenue Type
External sourcesInsurer policy holder benefits
Report the health-related business non-insurance revenue type.
5
Health-Related Business Non-Insurance Revenue Amount
Whole dollars
Report the health-related business non-insurance revenue amount.
Table 6: Net Other Operational Revenue -
Table 6: Net Other Operational Revenue - Non-HRB
Table 6: Net Other Operational Revenue - Non-HRB
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report values in whole Australian dollars.
Name
Valid values
Description
1
Private Health Insurer Fund Type
Health benefits fundGeneral fund
Report the private health insurer fund type.
2
Private Health Insurer Fund Name
Free text
Report the name of the private health insurer fund type. This is in the event a private health insurer has multiple health benefits funds.In the event a private health insurer has only one health benefits fund, its name should be the same as the private health insurer.For the general fund, report the same name as the private health insurer.
3
Net Other Operational Revenue Type
Major other sourceSecondary other source
Report the net other operational revenue type.
4
Net Other Operational Revenue Description
Free text
Report the source of the net other operational revenue amount.
5
Net Other Operational Revenue Amount
Whole dollars
Report the net other operational revenue amount.
More sections below
Source text: opening excerpt
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Reporting Standard HRS 101.0 Reporting Standard HRS 101.0
Reporting Standard HRS 101.0
Regulatory Income Statement – Supplementary Information
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission
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
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
Financial Sector (Collection of Data) (reporting standard) determination No. 20 of 2025 | Zoe
Authorisation, variation and transition: persons submitting data must be authorised by an officer of the insurer (para 15). APRA may vary reporting requirements in writing for an insurer (para 16). Transitional rules require some periods to be reported under the old (revoked) standard where those periods ended before 31 March 2026 but were due after revocation (para 17).
Substance of the data collected: the standard sets out detailed definitions and reporting tables (many fields and tables) capturing accrued premiums, discounts and promotions, claims (by state and hospital category), health‑related non‑insurance revenue, net other operational revenue, net investment income (by asset class), other business expenses (by type), claims handling expenses and movements in retained earnings, among other items. Definitions cross‑reference CPS 001 and Australian Accounting/Auditing Standards; numeric values must be reported in whole Australian dollars and certain apportionment/measurement rules are provided in the table instructions (see the “Specific instructions” and the table headers).
Why it matters (claimed purpose and practical implications)
APRA’s stated purpose for collecting the information is prudential supervision (para 2). That is, APRA uses this granular supplementary income statement data to assess insurers’ financial condition and compliance with capital and liability valuation requirements.
Costs and compliance burden: the instrument imposes recurring operational tasks on insurers — data extraction, mapping to APRA’s table formats, internal review and board sign‑off, and an annual external audit attestation. Those activities create direct costs (staff time, systems, audit fees) and may require upgrades to accounting and reporting systems, particularly to produce the disaggregated tables (see the many table instructions).
Who pays and who decides: private health insurers pay the compliance costs. APRA decides the exact content, timing and any insurer‑specific variations (paras 5, 7, 16). APRA also enforces deadlines and can require different reporting cadences in writing (para 7).
Behavioural incentives and trade‑offs: the standard increases transparency and granularity of insurer reporting, which may: (a) support earlier supervisory action by APRA; (b) incentivise insurers to tighten internal controls and accounting practices (para 10); and (c) create higher fixed compliance costs that favour insurers with more advanced reporting infrastructure. The instrument leaves room for APRA discretion (para 7, 16), which can concentrate oversight benefits with APRA while imposing diffuse costs on insurers.
Interaction with other rules: data definitions and valuation/measurement references point insurers to CPS 001, HPS 115 and HPS 340, and Australian Accounting/Auditing Standards (paras 18–19 and opening note). That means insurers must ensure consistency with accounting standards and specific prudential valuation standards when preparing inputs like RESA provisions or insurance liabilities.
Implementation and risks
Implementation risk centres on data quality and reconciliation: the standard requires internal quality controls and an external audit tying reported items to statutory accounts (paras 10–12). Mistakes or inconsistent apportionments (several tables permit ‘‘approximate methods where materiality is considered'') may trigger follow‑up from APRA.
Competitive/market effect: the detailed and frequent reporting increases ongoing compliance costs. Absent offsetting changes, those costs are borne by insurers and could be passed through to prices or influence product/service choices. Larger insurers with more mature systems will find it easier to absorb these requirements.
Key provisions (quick citations)
Application date: para 3
Reporting frequency and APRA discretion: paras 6–8
Submission method: para 5
Quality control and board responsibility: para 10
Annual audit requirements and auditor statements: paras 11–14
APRA variation power: para 16
Transitional rules: para 17
Definitions and cross‑references to other prudential/accounting standards: paras 18–19 and the detailed table instructions
Bottom line: the standard imposes a comprehensive, prescriptive reporting regime for private health insurers’ supplementary regulatory income statement information. It centralises the data format and timelines, requires internal control and annual external audit, and gives APRA scope to vary requirements for individual insurers. The regulator gains richer supervisory data; insurers incur one‑off and ongoing compliance costs to produce and attest to that data (see paras 2, 5–12, 16–17).
The information required by this Reporting Standard must be provided to APRA:
in the case of quarterly information under subparagraph 6(a), within 28 calendar days after the end of the reporting period to which the information relates;
in the case of annual information under subparagraph 6(b), by 30 September each year; or
in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.
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.
Note: 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.
Quality control
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
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.
Audit certification and opinion must be provided to by 30 September each year.
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 previous year (previous report), the current year’s auditor’s report 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.
The auditor’s report must:
state details of the program adopted to carry out the audit; and
include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transition
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:
which ended before 31 March 2026; and
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
In this Reporting Standard:
unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard CPS 001 Defined terms (CPS 001); and
the following definitions are applicable:
AASB references relate to the Australian Accounting Standards made by the Australian Accounting Standards Board;
APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the same meaning as in the Act;
private health insurer has the same meaning as in the Act;
reporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and
the Act means the Private Health Insurance (Prudential Supervision) Act 2015.
19. 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.
Regulatory Income Statement — Supplement Regulatory Income Statement — Supplementary Information
Reporting Standard HRS 101.0
Regulatory Income Statement – Supplementary Information
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission
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
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
The information required by this Reporting Standard must be provided to APRA:
in the case of quarterly information under subparagraph 6(a), within 28 calendar days after the end of the reporting period to which the information relates;
in the case of annual information under subparagraph 6(b), by 30 September each year; or
in the case of information provided in accordance with paragraph 7, within the time specified by notice in writing.
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.
Note: 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.
Quality control
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
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.
Audit certification and opinion must be provided to by 30 September each year.
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 previous year (previous report), the current year’s auditor’s report 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.
The auditor’s report must:
state details of the program adopted to carry out the audit; and
include the name of, and be signed by, the auditor who takes responsibility for the accuracy of the report.
Authorisation
A person who submits the information required under this Reporting Standard must be suitably authorised by an officer of the private health insurer.
Variations
APRA may, in writing, vary the reporting requirements of this Reporting Standard in relation to a private health insurer.
Transition
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:
which ended before 31 March 2026; and
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
In this Reporting Standard:
unless the contrary intention appears, words and expressions have the meanings given to them in Prudential Standard CPS 001 Defined terms (CPS 001); and
the following definitions are applicable:
AASB references relate to the Australian Accounting Standards made by the Australian Accounting Standards Board;
APRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998;
officer has the same meaning as in the Act;
private health insurer has the same meaning as in the Act;
reporting period means a period mentioned in paragraph 6 or, if applicable, paragraph 7; and
the Act means the Private Health Insurance (Prudential Supervision) Act 2015.
19. 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.
Objective of this Reporting Standard Objective of this Reporting Standard
Objective of this Reporting Standard
This Reporting Standard sets out requirements for the provision of information to APRA relating to a private health insurer’s supplementary information for its regulatory income statement.
It includes associated specific instructions and must be read in conjunction with Prudential Standard HPS 115 Capital Adequacy: Insurance Risk Charge (HPS 115), and Prudential Standard HPS 340 Insurance Liability Valuation (HPS 340).
Authority Authority
Authority
This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.
Purpose Purpose
Purpose
The information reported to APRA under this Reporting Standard is used by APRA for the purpose of prudential supervision.
Application and commencement Application and commencement
Application and commencement
This Reporting Standard applies to all private health insurers for reporting periods ending on or after 31 March 2026.
Information required Information required
Information required
A private health insurer must provide APRA with the information required by this Reporting Standard for each reporting period.
Method of submission Method of submission
Method of submission
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 Reporting periods and due dates
Reporting periods and due dates
Subject to paragraph 7, a private health insurer must provide the information required by this Reporting Standard:
in respect of each calendar quarter (i.e. the periods ending 30 September, 31 December, 31 March and 30 June); and
in respect of each year ending 30 June.
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.
The information required by this Reporting Standard must be provided to APRA:
in the cas
This is an opening excerpt, not the complete document.