Health Insurance Levies Act 1982

The Act uses a tight set of defined concepts that determine liability, calculation, and exemptions. Key statutory definitions are in section 4. "Organisation" means a society, body or group of persons, corporate or unincorporate, which conducts a health benefits fund (s 4). "Health benefits fund" is defined as the fund out of which an organisation makes payments to contributors for hospital accommodation and maintenance and for medical or health treatment, services or procedures in hospitals (s 4). "Contributor" has a dual meaning: in relation to a health benefits fund, it is a person who is a contributor under the organisation's rules (including those temporarily in arrears); in relation to the State Ambulance Insurance Plan, it means a person who is a member under the Plan (s 4).

The levy regime depends on the "prescribed rate", a monetary amount that is adjusted over time under Schedule 2 (s 4, s 16). The monthly levy formula uses counts of single contributors (S) and contributing families (F), plus the prescribed rate C and the number of days D in the month, to calculate L the levy (s 10A(1)). The Act specifies exclusions for counting S and F , persons permanently resident outside NSW and certain classes (e.g. those contributing only for benefits other than "basic health benefits", certain Commonwealth concession card holders, and recipients of service pensions under the Veterans’ Entitlements Act 1986) are not to be counted in S and F for levy computation purposes (s 10A(3)). The Act also prescribes rounding rules: disregard cents if a levy comprises cents (s 10A(4)).

For the State Ambulance Insurance Plan, the Act defines membership classes (single and family), ties the family membership to the Health Insurance Act 1973 definition of dependent child where relevant, and treats spouse to include de facto partner (s 16B). The Plan sets contributions by reference to the same "prescribed rate" used for levies; single membership requires payment of the prescribed rate and family membership twice the prescribed rate (s 16E(1)). Authorised agents, appointed by the Minister for Health from a list of prescribed organisations or others prescribed by regulation, collect contributors’ payments and are entitled to a commission determined by the Minister (s 16C, s 16D). The remittance formula for authorised agents requires them to pay to the Chief Commissioner the total collected less the authorised agent’s commission (s 16F).

Schedule 2 operationalises "adjustment percentage" calculations. The principal calculation combines an annual percentage change in average weekly earnings for NSW employees, p(L), and an annual percentage change in consumer prices for Sydney, p(I), into a formula that yields the adjustment percentage for a year (Sch 2 cl 2(1)). The schedule sets thresholds and rounding conventions (no adjustment if percentage < 0.1 per cent, rounding rules for fractions, and optional Ministerial or Governor intervention to specify or replace the calculated percentage under constrained conditions) (Sch 2 cl 2(2)-(8), cl 3). The Chief Commissioner must publish the adjusted prescribed rate in the Gazette prior to the operative date (Sch 2 cl 5).

Administration and enforcement are to be carried out consistently with the Taxation Administration Act 1996 (s 3), which the Act says "is to be read together" with this Act and which "makes provision for the administration and enforcement of this Act and other taxation laws" (s 3). The Act also gives the Governor and the Minister regulatory and appointment powers (s 26, s 16C).

Primary statutory payers are organisations that "carry on the business in New South Wales of providing health benefits to contributors" (s 10). The Act contains a deeming provision that an organisation is deemed to carry on that business in NSW if it uses premises in NSW for enrolment/payment purposes, uses services of a servant or agent in NSW for such purposes, or has contributors permanently resident in NSW (s 4(2)). That deeming expands the scope of the levy to organisations that have nexus with NSW by operations, service use or contributor residency.

Contributors to health benefits funds and members of the State Ambulance Insurance Plan are affected in multiple ways. Contributors are the basic units counted for the levy calculation (single contributors S and contributing families F) (s 10A). The Act also affects contributors by granting an exemption from ambulance fees where the contributor was, at the time the ambulance service was provided, a contributor to a health benefits fund to which s 10 applies, or a contributor to the State Ambulance Insurance Plan (s 17(2)). That exemption is conditioned by a statutory declaration requirement (s 18).

Authorised agents are affected because the Minister for Health may appoint prescribed organisations as authorised agents to collect contributions and perform other functions under the State Ambulance Insurance Plan (s 16C). The authorised agents have obligations to lodge monthly returns and to remit amounts to the Chief Commissioner under the statutory remittance formula (s 16F). Authorised agents also have the right to a commission on contributions determined by the Minister (s 16D), and face an annual reconciliation obligation which may trigger refunds or additional payments (s 16G).

The Chief Commissioner plays a central administrative role: receiving levies under s 10, receiving authorised agent remittances under s 16F, and publishing adjustments to the prescribed rate under Schedule 2 cl 5. The Minister for Health decides on appointment and termination of authorised agents (s 16C) and, with the concurrence of the Minister (unspecified which but text indicates concurrence of "the Minister" for commission determination), sets authorised agent commissions (s 16D). The Governor and the regulation‑making power (s 26) also have influence over rates, application and exceptions.

Entities and persons explicitly excluded from counting for levy purposes under s 10A(3) include contributors who are permanently resident outside NSW, persons who contribute only for benefits other than "basic health benefits", holders of specified Commonwealth concession cards, and persons receiving certain veterans’ entitlements. The Act is also expressed to bind the Crown (s 5), so public bodies are not automatically excluded.

Regulators and decision makers are affected insofar as the Act must be administered under the Taxation Administration Act 1996 (s 3). The Act creates compliance obligations (returns, records), administrative discretions (Ministerial appointment/revocation, commission determinations, Governor or regulation‑based adjustments to percentages), and enforcement tools (penalties set in the Act and via regulations).

Duties on organisations conducting health benefits business:

• Pay the monthly levy to the Chief Commissioner on or before the 15th day of the month in which the organisation, on the first day of the month, carried on the business in NSW of providing health benefits to contributors; levy is calculated per s 10A (s 10, s 10A).
• Furnish, together with each monthly levy, a return in a form approved by the Chief Commissioner (s 11). Failure to furnish carries a maximum penalty of 50 penalty units and corporate breaches attract executive liability under the Taxation Administration Act 1996 (s 11, note).
• Keep records as prescribed containing prescribed particulars relating to the business (s 19). Failure to comply with record‑keeping attracts a maximum penalty of 50 penalty units (s 19).

Rights and duties where counting cannot be accurate:

• If an organisation cannot determine accurately the number of contributors for the levy, it must estimate and pay on that basis, then notify the Chief Commissioner when the precise number is known, assess differences and either pay additional amounts or apply for a refund if overpaid (s 11A). That creates a duty to later reconcile estimates with actuals and to make corrective payments or claim refunds.

State Ambulance Insurance Plan duties and rights:

• Persons not already covered by an organisation to which s 10 applies and not exempt from ambulance fees may become members (s 16B).
• Membership classes: single and family, with "dependants" incorporating the Health Insurance Act 1973 dependent child definition and spouse including de facto partners (s 16B).
• Contributions are payable at weekly rates set by reference to the prescribed rate (single = prescribed rate; family = twice prescribed rate) (s 16E(1)). The regulations may define when non‑payment terminates membership (s 16E(2)).
• Authorised agents appointed by the Minister collect contributions and are entitled to a commission determined by the Minister with the concurrence of the Minister and notified in writing (s 16C(2), s 16D(1)). Commissions may be varied according to specified factors (s 16D(2)).
• Authorised agents must lodge a monthly return with the Chief Commissioner and pay amounts calculated under the prescribed remittance formula (s 16F). They must reconcile annually under s 16G, and claim refunds or pay differences as required (s 16G).

Administrative and regulatory powers and duties:

• The Chief Commissioner receives payments and must publish notice of adjusted prescribed rates in the Gazette when Schedule 2 adjustments occur (Sch 2 cl 5).
• The Minister for Health may appoint and revoke authorised agents, and may terminate agreements where the agent fails to comply with the Act, the agreement, or written requirements from the Minister (s 16C(2)-(3)). The Minister may certify changes of name for prescribed organisations by Gazette notice (s 16C(4)).
• The Governor may make regulations under s 26, including penalties of up to 20 penalty units for regulation breaches (s 26(3)). Regulations may be broadly framed and may delegate matters to specified persons or bodies (s 26(2)(c)).

Exemption and declaration duty:

• Persons who are contributors to a health benefits fund to which s 10 applies or to the State Ambulance Insurance Plan are not required to pay a fee for ambulance services provided under the Health Services Act 1997, subject to the declaration requirement in s 18 (s 17(2), s 18). The exemption does not disturb specified statutory rights under workers compensation or motor third‑party insurance (s 17(3)).

Adjustment mechanism and constraints:

• The prescribed rate is subject to periodic adjustment under Schedule 2’s formula that combines changes in average weekly earnings (p(L)) and the Consumer Price Index for Sydney (p(I)) into an adjustment percentage; the Governor or regulations can specify or displace the calculated percentage under constrained circumstances (Sch 2 cl 2-3). The Chief Commissioner must publicise an adjusted prescribed rate (Sch 2 cl 5).

The Act specifies a limited range of express penalties and otherwise delegates enforcement procedures to the Taxation Administration Act 1996. Two express maximum penalties are in the Act: failing to furnish the monthly return required by s 11 carries a maximum penalty of 50 penalty units; failing to keep prescribed records under s 19 also attracts a maximum penalty of 50 penalty units (s 11, s 19). The note to s 11 expressly states that an offence by a corporation is an executive liability offence attracting executive liability for a director or other person involved in management under section 121 of the Taxation Administration Act 1996, thereby linking corporate enforcement to the mechanisms in that Act (s 11 note). The Act itself is to be read together with the Taxation Administration Act 1996, which "makes provision for the administration and enforcement of this Act and other taxation laws" (s 3). That cross‑reference indicates that assessment, collection, recovery, objection, review, and other taxation enforcement mechanisms are intended to apply, but the text of those mechanisms is not reproduced in this Act (s 3).

Regulation‑making power includes penal provisions: s 26(3) permits regulations to impose a penalty not exceeding 20 penalty units for an offence against a regulation. This creates subsidiary enforcement options beyond the primary penalties in ss 11 and 19.

Administrative enforcement and discretion:

• The Chief Commissioner is the recipient of levies and remittances (s 10, s 16F) and is required to publish adjustments to the prescribed rate (Sch 2 cl 5), implying a role in public notification and hence in the operational enforcement of new rates.
• The Minister for Health has power to appoint and revoke authorised agents and to terminate agreements where an authorised agent fails to comply with the Act, the agreement or the Minister’s written requirements (s 16C(2)-(3)). That confers administrative sanctioning power over collectors.
• The Minister determines authorised agent commissions with the concurrence of the Minister and must notify the agent in writing (s 16D(1)), giving the executive control over a key financial term.

Audit and reconciliation:

• Where authorised agents collect contributions, they must make monthly remittances and lodge returns (s 16F). They face annual reconciliation: if they remitted more than actually payable, they may apply for a refund; if they remitted less, they must pay the difference by the date of the first monthly return of the next year (s 16G). This reconciliation provides an ex post enforcement and correction mechanism.

Procedural compliance requirements that could trigger enforcement:

• Timely payment and return filing (s 10, s 11, s 16F).
• Accurate counting of contributors in the statutory formula (s 10A(1), (3)).
• Record retention as prescribed (s 19).
• Proper process for estimates and later notification to the Chief Commissioner (s 11A).

What the Act does not specify:

• The Act references the Taxation Administration Act 1996 for detailed administration and enforcement mechanisms (s 3) but does not itself lay out audit powers, interest or penalty rates on unpaid levies, objection and review processes, or criminal sanctions other than the specified monetary penalties and executive liability note in s 11.

The Act is explicitly linked to other Commonwealth and State statutes by definition, cross‑reference and savings clauses. Section 3 requires the Act to be read together with the Taxation Administration Act 1996, which "makes provision for the administration and enforcement of this Act and other taxation laws" (s 3). The Act therefore incorporates (by reference) the administrative and enforcement framework established by that Act for tax collection, assessments, objections, penalties, and executive liability, though the content of that framework is not reproduced here (s 3).

Definitions in s 4 incorporate external statutory concepts. "Basic health benefits" is defined by reference to an "applicable benefits arrangement (within the meaning of the Private Health Insurance Act 2007 of the Commonwealth)" (s 4). The definition of "dependent child" in s 16B(3) invokes section 10AA of the Health Insurance Act 1973 (Commonwealth) for the meaning of dependent child. The exclusion classes in s 10A(3) draw on Commonwealth concession cards and the Veterans’ Entitlements Act 1986 for persons in receipt of a service pension.

The exemption from ambulance fees in s 17 operates in the context of the Health Services Act 1997: s 17(2) provides that, notwithstanding anything to the contrary in Chapter 5A of that Act, no fee shall be payable where the person was a contributor to a relevant health benefits fund or the State Ambulance Insurance Plan. Section 17(3) then expressly preserves the operation of Division 3 of Part 3 of the Workers Compensation Act 1987 and Division 2 of Part 2 of the Motor Vehicles (Third Party Insurance) Act 1942, indicating that the ambulance fee exemption does not supplant entitlements or cost recovery mechanisms under those Acts (s 17(3)).

Schedule 2 creates procedural interaction with executive instruments and statutory notice requirements: the Governor may specify an operative date or adjust the adjustment percentage by order in the Gazette, and the Chief Commissioner must publicise adjusted prescribed rates in the Gazette (Sch 2 cl 1, cl 3(1), cl 5). The schedule also permits Ministerial direction where Australian Statistician publications are unavailable or have been restated, embedding reliance on Commonwealth statistical series in the adjustment mechanics (Sch 2 cl 2(1), (4)-(5), (7)-(8)).

The Act also permits the regulations to prescribe organisations (including bodies that do not conduct health benefits funds) as "prescribed organisations" eligible to be appointed as authorised agents (s 16C(1)(e), s 16H). The regulation power under s 26 is broad and may authorise matters to be determined by a specified person or body and may impose penalties of up to 20 penalty units (s 26(2)-(3)).

Transitional and consequential parts of the Act catalogue interactions with specific amending Acts and successor organisations in later amendments. For example, Part 6 (Provision consequent on the State Revenue Legislation Amendment Act 2010) treats appointments and agreements as taken to be appointments of successor organisations for specified named funds (Part 6 cl 7). Those transitional provisions modify how earlier instruments and appointments interact with successor corporate structures.

Finally, the Act binds the Crown "not only in right of New South Wales but also, so far as the legislative power of Parliament permits, the Crown in all its other capacities" (s 5), which interacts with questions of Crown immunity and application to government bodies.

The Act’s marginal notes and schedule footnotes record a substantial amendment history, with additions, substitutions and repeals over a sequence of statutes. The Act as presented bears the imprint of legislative change spanning from its 1982 origin to amendment and insertion of new parts and clauses.

Key chronological markers in the text include:

• Early 1983 amendments and the addition of the State Ambulance Insurance Plan: The notation "pt 3A: Ins 1983 No 162, Sch 2 (5)" and accompanying notes show that Part 3A (State Ambulance Insurance Plan), including sections 16A-16H, was inserted in 1983 (s 16A, s 16B, s 16C, etc state "Ins 1983 No 162, Sch 2 (5)").
• Insertions and substitutions in the 1990s: Section 10A (calculation of the monthly levy) is shown as being inserted in 1992 ("s 10A: Ins 1992 No 86, Sch 4 (2)"). Schedule 2 has undergone multiple amendments over years, with notes showing amendments in 1983, 1986, 2001 and later (Sch 2: Am 1983 No 18, Sch 1 (6); 1983 No 162, Sch 1 (10); 1986 No 218, Sch 19; 2001 No 22, Sch 2; 2012 No 76, Sch [2]-[10]).
• 1994 and 1999 amendments: Section 11A (assessment by organisations where the number of contributors is uncertain) was inserted in 1994 (s 11A Ins 1994 No 48, Sch 4 (4)) and later amended in 1996; Part 3A was amended by the 1999 Statute (s 16D substitution "Subst 1999 No 60, Sch 3 [3]" and s 16F "Subst 1999 No 60, Sch 3 [3]") affecting authorised agents’ remittance formula and commission arrangements.
• 2000s continuity: Subsequent amendments adjusted definitions and administrative details, including the definition of spouse to include de facto partner (s 16B; annotated "Am 2002 No 73, Sch 1.11; 2008 No 67, Sch 3; 2009 No 51, Sch 7.2 [2]; 2010 No 19, Sch 3.44 [2] [3]").
• 2010 and 2012 amendments: Part 6 transitional provisions (clause 7) were consequential on the State Revenue Legislation Amendment Act 2010 to recognise successor organisations for authorised agents. Part 7 (Provision consequent on enactment of State Revenue Legislation Further Amendment Act 2012) amended Schedule 2 application rules for 2013 operative dates and adjusted the calculation of p(L) and p(I) to include an additional reference period (Part 7 cl 8; Sch 2 amendments noted "2012 No 76" in Sch 2 metadata).

The Act also contains multiple repeals and repealed sections, with annotations indicating sections 6-9, 12-15, 20-24 and Schedule 1 have been repealed by subsequent statutes (e.g. "pt 2: Rep 1996 No 98, Sch 1.2 (6)" and "sch 1: Rep 1992 No 86, Sch 4 (6)"). Many provisions carry historical footnotes indicating the amending instrument (e.g. "s 3: Am 1983 No 162, Schs 1 (2), 2 (1). Subst 1996 No 98, Sch 1.2 (1).").

Transitional parts of the Act themselves spell out application of amendments: for example, Schedule 3 contains transitional provisions; Part 5 (1999 amendments) includes clause 6 specifying that amendments to Part 3A do not apply to contributions received by authorised agents before 1 February 2000 and that older provisions continue to apply to those earlier contributions (Schedule 3 Part 5 cl 6). Part 4 (1994 amendments) protects liabilities that arose before 1 July 1994, ensuring that pre‑amendment liabilities and return requirements remained enforceable (Schedule 3 Part 4 cl 5).

The Act’s marginal history therefore records a pattern of iterative change: establishment of the ambulance plan and authorised agent framework in 1983, introduction and refinement of the levy calculation in 1992-1994, adjustments to agent remittance and commissions in 1999, updates to corporate successors and appointment mechanics in 2010, and an overhaul of adjustment mechanics and reference periods in 2012. The Schedule 2 adjustment mechanism has been the object of repeated amendment and Gazette notice practice, as shown by the editorial note listing multiple Gazette notices for adjusted prescribed rates.

Readers should rely on the statute text and its amendment annotations for precise effective dates and transitional treatment; the Act itself contains several transitional clauses that preserve or carve out application of amendments to particular time windows (see Schedule 3 and Parts 1-7 of transitional provisions).

The text of the Act contains no reported cases, judicial interpretations, or express litigation history. There are no named decisions or judicial authorities referenced in the Act, and no case law citations appear in the provided text. The Act instead relies on administrative mechanisms (the Chief Commissioner, the Taxation Administration Act 1996) for enforcement and on Ministerial and Governor instruments for appointment, commission determination and rate adjustment.

Notwithstanding the absence of judicial entries in the statute text, the Act contains multiple provisions and discretionary points that are plausible loci for disputes and therefore potential litigation or administrative review. The Act identifies specific points of operational discretion and calculation that could generate disagreements amenable to legal challenge or review, including:

• Counting of contributors for levy calculation: The statutory formula in s 10A depends on accurate counts of single contributors (S) and contributing families (F). Section 10A(3) excludes certain classes from counting (persons permanently resident outside NSW, contributors for benefits other than basic health benefits, specified concession card holders, veterans on service pensions). Disputes could arise over whether a person falls into an excluded class; the Act provides no internal adjudicative mechanism in the text for such determinations (s 10A).
• Estimation and reconciliation procedures: Section 11A requires estimation where numbers are unknown, later notification to the Chief Commissioner, and adjustment (s 11A). Litigation could arise over whether an initial estimate complied with the duty to estimate "accurately" given available information or over the Chief Commissioner’s assessment of alleged under/overpayments arising from estimates.
• Authorised agent appointments and revocation: The Minister for Health may appoint and revoke authorised agents and terminate agreements for specified failures (s 16C(2)-(3)). Disputes could concern procedural fairness, compliance with agreement terms, or the Minister’s grounds for termination.
• Commission determinations: Section 16D allows commissions to be determined and to differ according to specified factors (s 16D(1)-(2)). Disputes might concern the validity of different commission rates, the Minister’s concurrence requirement, or alleged improper exercise of discretion.
• Remittance calculations and reconciliations for authorised agents: The remittance formula in s 16F and the annual adjustment provisions in s 16G create reconciliation obligations that could result in disagreements over the amount "actually payable" for a year and eligibility for refunds.
• Application of Schedule 2 adjustments: Schedule 2’s reliance on Australian Statistician publications and the Governor/Minister power to specify different percentages (Sch 2 cl 2-3) could generate disputes about the correct adjustment percentage and the validity of orders or regulations replacing the calculated percentage.

Any litigation would interact with the administrative and procedural framework in the Taxation Administration Act 1996, to which the Act is to be read together (s 3). That framework likely contains objection, review and recovery procedures that would shape dispute resolution, but those provisions are not reproduced in this Act. Because the statute text provides no case citations, practitioners must look to external sources (administrative determinations, tribunal or court decisions under the TAA framework) for precedential guidance; none are supplied in the Act as presented.

This Act contains several technical and procedural features that are potential compliance traps or sources of operational missteps if not closely followed. Key practical "gotchas" grounded in the statutory text are:

Counting rules and exclusions under s 10A:

• The levy formula depends on S and F counts at the beginning of the month (s 10A(1)). Section 10A(3) excludes contributors permanently resident outside NSW and several specified classes (e.g. those contributing only for non‑basic health benefits, holders of certain Commonwealth concession cards, and veterans receiving service pensions). Misclassifying contributors (for example treating some contributors as in‑scope when they meet an exclusion) will overstate the levy base. Organisations must maintain records sufficient to justify exclusion decisions (s 19) and be prepared to adjust under s 11A if an initial count was estimated.

Rounding rules:

• Where a monthly levy comprises cents, the Act requires the number of cents to be disregarded (s 10A(4)). Separately, Schedule 2 cl 4(2) contains rules about fractions of cents when adjusting the prescribed rate (fractions not greater than 0.5c disregarded, greater than 0.5c treated as one cent). Failure to apply these rounding conventions precisely will produce minor but systematic calculation errors and potential disputes over small amounts.

Timing and operative dates:

• Payments and returns are due on or before the 15th day of the month (s 10, s 16F). The prescribed rate adjustments take effect on the operative date in the following year under Schedule 2 cl 4(1), and the Chief Commissioner must publish adjusted rates before the operative date (Sch 2 cl 5). Organisations need to monitor Gazette notices and the Chief Commissioner’s publications to apply the correct prescribed rate on the correct operative date and to know when the change affects levy computations. Schedule 2 cl 6 explicitly states that adjustments do not alter liabilities for months before the adjustment takes effect, which affects retroactivity.

Declaration requirement to avoid liability:

• Section 18 makes clear that a person is liable for payment in respect of an ambulance service unless a declaration is made in the form approved by the Health Administration Corporation. Contributors who fail to produce the correct declaration at the point of service may remain liable for ambulance fees despite being contributors under the Act (s 18).

Estimate vs actual:

• Section 11A allows organisations to estimate contributor numbers if they cannot determine them accurately, but creates a duty to inform the Chief Commissioner when the precise numbers are known and to reconcile payments. Organisations that rely on estimates must have processes to reconcile and to claim refunds or pay additional amounts promptly (s 11A). Failure to follow the post‑event reconciliation protocol may leave them with unremedied liability or penalties under the broader Taxation Administration Act 1996.

Authorised agent commission variability:

• Section 16D permits commissions to differ according to specified factors. Agents and the Minister should ensure commissions are properly documented in writing and the variation factors are clear, else disputes over commission entitlements can arise (s 16D(1)-(2)). The Minister’s power to revoke appointments or terminate agreements if agents fail to comply with requirements (s 16C(3)) must be exercised with reference to the agreement terms to avoid procedural challenge.

Record‑keeping and form approvals:

• The Act requires returns "in a form approved by the Chief Commissioner" (s 11) and prescribed records (s 19). The regulations may prescribe further particulars. Organisations must adopt administrative systems that comply with forms and record formats approved or prescribed; failure to do so risks exposure to the 50 penalty unit maximums.

Interplay with external benefits definitions:

• The exclusions in s 10A(3) hinge on the concept of "basic health benefits" as defined by an applicable benefits arrangement under the Commonwealth’s Private Health Insurance Act 2007. Organisations must therefore align their internal classifications with that external definition and track changes to Commonwealth benefit arrangements to ensure correct levy base treatment (s 4, s 10A(3)).

Regulatory delegation and penalties:

• The regulation‑making power (s 26) authorises broad delegations and may impose penalties up to 20 penalty units for contraventions of regulations. Organisations and agents should review relevant regulations and delegated instruments to identify additional obligations or penalties not set out in the principal Act.

Successor organisations and appointments:

• Transitional clause Part 6 cl 7 treats existing appointments as appointments of successor organisations on commencement of certain amending Acts. Where corporate reorganisations occur, stakeholders should ensure the Minister records and publishes any successor arrangements to maintain the validity of authorised agent appointments.

Checklist and practical steps derived from the Act for organisations, authorised agents and contributors:

For organisations (health benefits fund operators):

1. Establish whether the organisation "carries on the business in New South Wales of providing health benefits to contributors" on the first day of a month. Apply the deeming rules in s 4(2): check for premises in NSW used for enrolment/payment, use of servants/agents in NSW for those purposes, or permanently resident contributors in NSW.
2. Maintain prescribed records containing prescribed particulars relating to the business (s 19). Identify the regulations or Chief Commissioner directions that specify record content and format.
3. Calculate the monthly levy L using the formula in s 10A(1). Maintain contemporaneous records showing how S (single contributors) and F (contributing families) were counted, and how exclusions under s 10A(3) were applied.
4. Apply the rounding rule in s 10A(4): disregard cents in levy calculations.
5. Pay the monthly levy to the Chief Commissioner on or before the 15th day of the month in which the levy falls due (s 10).
6. Lodge the monthly return in the form approved by the Chief Commissioner together with each monthly levy (s 11). Monitor the Chief Commissioner’s approved forms and any changes communicated in writing or published.
7. If accurate contributor counts cannot be determined by the due date, estimate and pay under s 11A(1), then inform the Chief Commissioner once precise numbers are known and reconcile any differences by paying additional amounts or applying for a refund under s 11A(3).
8. Monitor Schedule 2 adjustments: check the Chief Commissioner’s Gazette notices for changes to the prescribed rate (Sch 2 cl 5) and apply the correct rate from the operative date (Sch 2 cl 4(1)). Remember that adjustments do not affect liability for months before adjustments take effect (Sch 2 cl 6).

For authorised agents (State Ambulance Insurance Plan collectors):

1. Confirm appointment and any written agreement under s 16C: ensure the instrument of appointment is on file and complies with any written requirements from the Minister.
2. Apply the authorised agent remittance formula in s 16F when remitting to the Chief Commissioner on or before the 15th of each month. Keep precise monthly counts of S (single membership contributors) and F (family membership contributors), the prescribed rate C applicable during the month, days in month D, and the authorised agent’s commission E.
3. Ensure the agent’s commission is the amount notified in writing by the Minister and that any differing rates by factor are properly documented (s 16D).
4. Lodge the required return with the Chief Commissioner in the approved form for that month (s 16F(a)).
5. Perform the annual reconciliation in accordance with s 16G: calculate "actual amount payable for a year" (total contributions collected less total commission deducted) and either apply for a refund if overpaid or remit differences by the first monthly return date of the next year.
6. Maintain records supporting collection, commission calculations and reconciliations, and be ready to supply them to the Chief Commissioner on request.

For contributors and persons seeking ambulance fee exemption:

1. Establish contributor status: contributors to a health benefits fund to which s 10 applies or to the State Ambulance Insurance Plan are exempt from ambulance fees for services provided under Chapter 5A of the Health Services Act 1997, subject to the Act’s conditions (s 17(2)).
2. Ensure the prescribed declaration is completed and available: s 18 makes a person liable unless a declaration is made in the form approved by the Health Administration Corporation. Obtain and retain copies of that approved declaration form and any authorising guidance.
3. Note that s 17(4) states the exemption does not create an entitlement to ambulance service provision , it only operates to relieve the person of the fee if the conditions are met.

Administrative monitoring and governance:

• Maintain a compliance calendar keyed to the 15th‑day monthly payment and filing cycle, to Gazette notices for prescribed rate adjustments, and to any Ministerial notices or changes to authorised agent status.
• Design internal controls to segregate counting, payment, and reconciliation functions, and to record the basis for any exclusions claimed under s 10A(3). Maintain evidence to substantiate estimates made and later reconciliations under s 11A.
• Retain copies of all correspondence and written determinations from the Minister regarding commissions and appointments, including any notifications of commission rates and any factors specified under s 16D(2).

Interaction with external law and reporting:

• Align internal definitions of "basic health benefits" and "dependent child" with the relevant Commonwealth statutes cited in the Act (Private Health Insurance Act 2007; Health Insurance Act 1973) to ensure correct classification for levy purposes (s 4, s 16B).
• Be prepared to engage with the Taxation Administration Act 1996 procedures for assessments, objections, recovery and executive liability, as the Act is to be read with that Act for administration and enforcement (s 3).

Practical documentation:

• Adopt templates for monthly returns in the format expected by the Chief Commissioner and keep a master record cross‑referencing contributor lists, exclusions, and contributions received.
• If acting as an authorised agent, keep discrete ledgers for contributions collected, commissions deducted, remittances to the Chief Commissioner, and annual reconciliation computations under s 16G.

Dispute mitigation:

• Where counting or classification is uncertain, contemporaneously document the rationale for the position taken and engage the Chief Commissioner proactively under s 11A to mitigate later disputes.
• For agents, ensure agreements with the Minister include dispute resolution and procedural provisions addressing termination or revocation per s 16C(3).

Following these steps, with particular attention to s 10, s 10A, s 11, s 11A, s 16C-16G, s 17-18, s 19 and Schedule 2, will align operations with the Act’s principal duties and reduce the risk of penalties or administrative dispute.