6Restructure under section 146‑1 of the Act

6 Restructure under section 146‑1 of the Act

(1) A private health insurer may apply to the Council in the approved form for approval under section 146‑1 of the Act of a restructure of its health benefits fund or funds. (2) In the application, the insurer must set out the restructure proposal (the restructure proposal) by: (a) identifying the date on which, subject to the Council’s approval and compliance with the requirements of the Act, the Regulations and the Rules, the restructure proposal is to take effect (the restructure date); and (b) identifying which funds of the insurer are to be restructured under the restructure proposal (the restructuring funds); and (c) identifying the transferring fund (the transferring fund), being the fund whose policies are to become referable to another fund or other funds of the insurer (the receiving fund(s)) on the restructure date; and (d) identifying which policy group or groups of the transferring fund are to become referable to the receiving fund(s) on the restructure date; and (e) stating the risk equalisation jurisdiction or jurisdictions for each receiving fund and other funds of the insurer; and (f) stating for each receiving fund whether the fund is existing or proposed; and (g) if the restructure involves more than one receiving fund, specifying which policy group or groups are to become referable to which of the receiving funds on the restructure date; and (h) if the restructure would result in the insurer having more than one health benefits fund in respect of a particular risk equalisation jurisdiction, explaining how that result would be consistent with section 134‑1 of the Act; and (i) specifying which of the liabilities incurred for the purposes of the transferring fund, including policy liabilities, are to become treated as incurred for the purposes of a receiving fund on the restructure date; and

Note: The specification which is sufficient for this rule is stated in subrule (3).

(j) specifying which of the assets of the transferring fund are to become assets of a receiving fund on the restructure date; and

Note: The specification which is sufficient for this rule is stated in subrule (3).

(k) explaining why the assets and liabilities which are to be transferred under the restructure represent a reasonable estimate within the meaning of paragraph 146‑1(2)(a) of the Act of what would, immediately before the restructure, be the net asset position of the transferring fund; and
(l) if there is more than one receiving fund, explaining why the distribution of assets and liabilities between the restructuring funds is fairly distributed within the meaning of paragraph 146‑1(2)(aa) of the Act; and
(m) if it is proposed that some assets of the transferring fund will not become assets of a receiving fund, identifying the assets and stating why those assets are not to become assets of a receiving fund; and
(n) if it is proposed that some liabilities incurred for the purposes of the transferring fund are not to become treated as incurred for the purposes of a receiving fund, identifying the liabilities and stating why those liabilities are not to become treated as incurred for the purposes of a receiving fund; and
(o) explaining how the restructure will be consistent with
(i) the solvency standard; and
(ii) the capital adequacy standard.