17Working out the policy group for a policy that has 2 or more policy holders whose addresses are not in the same risk equalisation jurisdiction

17 Working out the policy group for a policy that has 2 or more policy holders whose addresses are not in the same risk equalisation jurisdiction

(1) Within 20 days of a private health insurer first being notified that a policy holder of a policy has an address which is not in the same risk equalisation jurisdiction as is the address of one or more other policy holders of the same policy, the insurer may by a written and dated determination allocate the policy to a risk equalisation jurisdiction in which one or more of the policy holders has their address. (2) If the insurer makes a determination in accordance with subrule (1), then the policy is allocated to the risk equalisation jurisdiction in accordance with the determination and is taken to have been so allocated from the date that the insurer was notified of the difference in addresses. (3) If the insurer relies on an allocation under subrule (1), the insurer must on written request from the Council to do so, provide access to the record of determination referred to in subrule (1). (4) If the insurer fails: (a) to allocate the policy to a risk equalisation jurisdiction, in accordance with subrule (1); or (b) to provide the access referred to in subrule (3) in response to a written request from the Council, then the policy is allocated to the risk equalisation jurisdiction which corresponds to the address of the first person named in the policy records of the insurer and is taken to have been so allocated from the date that the insurer was notified of the difference in addresses.