Get a plain-English read of Table 1: Insurance Risk Charge - Health-
Turn the raw legal text into a practical explanation grounded in Financial Sector (Collection of Data) (reporting standard) determination No. 21 of 2025.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, its name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Health-Related Insurance Business Accrued Premium Amount
Whole dollars
Report the health-related insurance business accrued premium amount.
Table 2: Insurance Risk Charge - Health Insurance Business Membership
Reporting basis
This table applies to health benefits funds only.
Units of measurement
Report counts as whole numbers.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the health benefits fund. This is in the event an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, its name should be the same as the insurer.
2
Health Insurance Business Membership Reporting Period
As at the current reporting dateOne year prior to the reporting dateTwo years prior to the reporting dateThree years prior to the reporting date
Report the health insurance business membership reporting period.
3
Single Equivalent Units (Fund) Count
Whole number
Report the Single Equivalent Units (fund) count.
4
Single Equivalent Units (Transferor Funds) Count
Whole number
Report the Single Equivalent Units (transferor funds) count.Single Equivalent Units (transferor funds) count is to be left blank where the health insurance business membership reporting period is ‘As at the current reporting date’.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Private Health Insurer Business Type
Health insurance businessHealth-related insurance business
Report the private health insurer business type.Health insurance business does not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
Claims Component - OCL Amount
Whole dollars
Report the claims component - OCL amount.
5
Claims Handling Expenses - OCL Amount
Whole dollars
Report the claims handling expenses - OCL amount.
6
Risk Equalisation Component - OCL Amount
Whole dollars
Report the risk equalisation component - OCL amount.Report risk equalisation amounts payable as a positive value.Report risk equalisation amounts receivable as a negative value.
7
Settled But Not Paid Claims - OCL Amount
Whole dollars
Report the settled but not paid claims - OCL amount.
8
Reinsurance Recoverables - OCL Amount
Whole dollars
Report the reinsurance recoverables - OCL amount.
9
Non-Reinsurance Recoveries - OCL Amount
Whole dollars
Report the non-reinsurance recoveries - OCL amount.
10
Discount on Outstanding Claims Liability Amount
Whole dollars
Report the discount on OCL amount.Report any discount on OCL as a positive value.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Private Health Insurer Business Type
Health insurance businessHealth-related insurance business
Report the private health insurer business type.Health insurance business does not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
Claims Component - PL Amount
Whole dollars
Report the claims component - PL amount.
5
Claims Handling Expenses - PL Amount
Whole dollars
Report the claims handling expenses - PL amount.
6
Policy Administration Expenses - PL Amount
Whole dollars
Report the policy administration expenses - PL amount.
7
Risk Equalisation Component - PL Amount
Whole dollars
Report the risk equalisation component - PL amount.Report risk equalisation amounts payable as a positive value.Report risk equalisation amounts receivable as a negative value.
8
Expected Reinsurance Recoveries - PL Amount
Whole dollars
Report the expected reinsurance recoveries - PL amount.
9
Non-reinsurance Recoveries - PL Amount
Whole dollars
Report the non-reinsurance recoveries - PL amount.
10
Discount on Premiums Liabilities Amount
Whole dollars
Report the discount on PL amount.Report any discount on PL as a positive value.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Unbilled Calculated Deficit Amount
Whole dollars
Report the unbilled calculated deficit amount.
4
Unbilled Gross Deficit Amount
Whole dollars
Report the unbilled gross deficit amount.
5
Billed Risk Equalisation Special Account Liability Amount
Whole dollars
Report the billed Risk Equalisation Special Account liability amount.
6
Risk Margin At 75th POA – Risk Equalisation Transfers Amount
Whole dollars
Report the risk margin at 75th POA – risk equalisation transfers amount.
Table 6: Insurance Liability Risk Charge - Other Insurance Liabilities
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Private Health Insurer Business Type
Health insurance businessHealth-related insurance business
Report the private health insurer business type.Health insurance business does not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
Individual Other Insurance Liability Description
Free text
Report the individual other insurance liability description.
5
Individual Other Insurance Liability At 75th POA Amount
Whole dollars
Report the individual other insurance liability at 75th POA amount.
6
Individual Other Insurance Liability At 99.5th POA Amount
Whole dollars
Report the individual other insurance liability at 99.5th POA amount.
Table 7: Future Exposure Risk Charge - Central Estimate
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report monetary values in whole Australian dollars.
Report counts as whole numbers.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Class Of Business
Hospital treatmentGeneral treatmentHealth-related insurance business
Report the class of business.Hospital treatment and general treatment do not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
Report monetary values in whole Australian dollars.
Report counts as whole numbers.
Name
Valid values
Description
1
Private Health Insurer Fund Name
Free text
Report the name of the health benefits fund. This is in the event an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.
Report the Single Equivalent Units (AES) count.Report this item only where the class of business is hospital treatment.
5
Accrued Premium (AES) Amount
Whole dollars
Report the accrued premium (AES) amount.Report this item net of any reinsurance.
6
Claims Incurred (AES) Amount
Whole dollars
Report the claims incurred (AES) amount.Report this item net of any reinsurance.
7
Gross Deficit (AES) Amount
Whole dollars
Report the gross deficit (AES) amount.Report this item only where the class of business is hospital treatment.
8
State Levies (AES) Amount
Whole dollars
Report the state levies (AES) amount.Report this item only where the class of business is hospital treatment.
9
Other Business Expenses (AES) Amount
Whole dollars
Report the other business expenses (AES) amount.
Table 9: Future Exposure Risk Charge - Adverse Event Stress and Prescribed Benefit Stress including Management Actions
Reporting basis
This table applies to health benefits funds and the general fund.
Units of measurement
Report monetary values in whole Australian dollars.
Report counts as whole numbers.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Class Of Business
Hospital treatmentGeneral treatmentHealth-related insurance business
Report the class of business.Hospital treatment and general treatment do not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
Future Exposure Risk Charge Period
Month 10Month 11Month 12
Report the Future Exposure Risk Charge period where management action is possible. That is, only months 10, 11 and 12.
5
Single Equivalent Units (MA) Count
Whole number
Report the Single Equivalent Units (MA) count.Report this item only where the class of business is hospital treatment.
6
Accrued Premium (MA) Amount
Whole dollars
Report the accrued premium (MA) amount.Report this item net of any reinsurance.
7
Claims Incurred (MA) Amount
Whole dollars
Report the claims incurred (MA) amount.Report this item net of any reinsurance.
8
Gross Deficit (MA) Amount
Whole dollars
Report the gross deficit (MA) amount.Report this item only where the class of business is hospital treatment.
9
State Levies (MA) Amount
Whole dollars
Report the state levies (MA) amount.Report this item only where the class of business is hospital treatment.
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Private Health Insurer Business Type
Health insurance businessHealth-related insurance business
Report the private health insurer business type.Health insurance business does not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
Insurance Profits Forecast After Management Actions Amount
Whole dollars
Report the insurance profits forecast after management actions amount.Insurance profits forecast after management actions amount is to be reported as a positive value, to reflect an addition to the Future Exposure Risk Charge.
5
Discount on Future Exposure Risk Charge Amount
Whole dollars
Report the discount on Future Exposure Risk Charge amount.Discounts on insurance losses are to be reported as a negative value, to reflect a deduction to the Future Exposure Risk Charge.
Table 11: Deferred Claims Liability Risk Charge
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 an insurer has multiple health benefits funds.In the event an insurer has only one health benefits fund, the name should be the same as the insurer.For the general fund, report the same name as the insurer.
3
Private Health Insurer Business Type
Health insurance businessHealth-related insurance business
Report the private health insurer business type.Health insurance business does not apply where the private health insurer fund type is general fund.Report health-related insurance business where the private health insurer fund type is general fund.
4
DCL at 75th POA Amount
Whole dollars
Report the DCL at 75th POA amount.
5
DCL at 99.5th POA Amount
Whole dollars
Report the DCL at 99.5th POA amount.
6
DCL Aggregation Benefit
Whole dollars
Report the DCL aggregation benefit.Report a DCL aggregation benefit that would result in decrease in the DCL Risk Charge as a positive value.