Get a plain-English read of General instructions

Turn the raw legal text into a practical explanation grounded in Financial Sector (Collection of Data) (reporting standard) determination No. 97 of 2023.

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.

Accrued premium	This refers to accrued premium as defined in HPS 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.

Claims handling expenses amount	This has the same meaning as claims handling expenses as defined in HPS 001.
Claims incurred amount	This has the same meaning as claims incurred as defined in HPS 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.

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.

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. 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 HPS 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.

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.

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.

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.

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 RETF amount	The net RETF (Risk Equalisation Trust Fund) 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.

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 management 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 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 management 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 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 (OVC)(Health-related insurance business)	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.

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 management 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 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 management 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 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 (OVC)(Health-related insurance business)

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.

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.

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.

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.

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.