121‑15 Extension to employee health bene121‑15 Extension to employee health benefits schemes

121‑15 Extension to employee health benefits schemes (1) An arrangement is an employee health benefits scheme if: (a) the arrangement provides for a person (an employer) to arrange payment in respect of the whole or part of the fees and charges that an employee of, or a person providing services to, the employer incurred in relation to *hospital treatment or *general treatment; and (b) one or more of the following applies: (i) the employer is a *constitutional corporation; (ii) the employer is a body corporate incorporated in a Territory; (iii) the employer carries on business in a Territory. (2) It does not matter for the purposes of this section whether the arrangement: (a) constitutes a business of undertaking liability by way of insurance; or (b) is a minor or incidental part of the employer’s business; or (c) does not require the employee, or person providing services, to pay any contributions; or (d) does not require the employee, or person providing services, to pay contributions that reflect the value of the benefits that the employer is providing under the arrangement; or (e) provides for the employer to make payments in relation to *hospital treatment, or *general treatment, provided to a person other than the employee or person providing services; or (f) confers on the employer or another person a discretion whether to make payments. (3) However, an arrangement: (a) is not an *employee health benefits scheme merely because, under the arrangement, the employer will pay, or will reimburse employees, or persons providing services, for payment of, one or both of the following: (i) the premiums payable by them for *complying health insurance policies; (ii) the difference between benefits payable to them under policies, and amounts that they are liable to pay, for health services provided to them or members of their families; and (b) is not an employee health benefits scheme if the Private Health Insurance (Health Insurance Business) Rules provide that: (i) it is not an employee health benefits scheme; or (ii) arrangements of a class in which it is included are not employee health benefits schemes; and (c) is not an employee health benefits scheme to the extent (if any) that the arrangement constitutes State insurance within the meaning of paragraph 51(xiv) of the Constitution.