93‑20 Keeping insured people up to date93‑20 Keeping insured people up to date

93‑20 Keeping insured people up to date (1) A private health insurer must ensure that an *adult insured under a *complying health insurance policy issued by the insurer is given the *private health information statement for the *product subgroup that the policy belongs to, at least once every 12 months. (2) A private health insurer must ensure that, if a proposed change to the insurer’s *rules: (a) is or might be detrimental to the interests of an insured person; and (b) will require an update to the *private health information statements for a *complying health insurance product of the insurer; an *adult insured under each *complying health insurance policy in the product: (c) is informed about the proposed change a reasonable time before the change takes effect; and (d) is given the updated private health information statement for the *product subgroup that the policy belongs to as soon as practicable after the statement is updated. (3) A private health insurer must ensure that, if an *adult who is insured under a *complying health insurance policy of the insurer asks an *officer, employee or agent of the insurer for information about what the policy covers or the benefits the policy provides, the adult is given the information as soon as practicable. (4) If a private health insurer changes the *health benefits fund to which a *complying health insurance policy of the insurer is *referable, the insurer must ensure that: (a) before the change takes effect, an *adult insured under the policy is given a statement identifying the health benefits fund to which the policy will be referable as a result of the change; or (b) within 2 weeks after the change takes effect, an adult insured under the policy is given a statement identifying the health benefits fund to which the policy is referable as a result of the change. Note: The health benefits fund to which a policy is referable may change in accordance with Division 4 of Part 3 of the Private Health Insurance (Prudential Supervision) Act 2015. (5) If more than one *adult is insured under a single *complying health insurance policy of a private health insurer, the insurer is taken to comply with subsection (1), (2) or (4) if the insurer complies with the subsection in relation to only one of those adults.