Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
In ForceCTH
Jurisdiction
Commonwealth
Collection
legislative instrument
Plain English Summary
8/10 complexity
This instrument revokes the 2015 Rules and replaces them with a new framework letting an external manager of a health benefits fund convene creditors (including policy holders) to consider a voluntary deed of arrangement for the responsible insurer. It sets detailed notice, quorum and voting rules, requires the external manager to report and recommend to APRA, and makes APRA the decision-maker on approving and preparing deeds. The Rules also adapt many Corporations Act insolvency provisions to apply to health benefits funds, substitute APRA for ASIC in several places, and clarify execution rules for non-company insurers.
These Rules (the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025) revoke the 2015 Rules and remake the enforcement framework governing health benefits funds and their responsible insurers under the Private Health Insurance (Prudential Supervision) Act 2015 (the Act). The instrument is made by an APRA delegate under s 174(1) of the Act and commences 30 September 2025 (preamble; Rules 1-2). It re-establishes a process by which an external manager of a health benefits fund may convene creditor meetings to consider execution of a voluntary deed of arrangement for the fund (rule 5). The Rules convert a number of applied provisions of the Corporations Act 2001 so they operate in the fund context by modifying defined terms (rules 11-12), and by tailored omissions, substitutions and replacements of specific Corporations Act sections and subsections (Parts 3-5, e.g. rules 13-59, 61-65). They also replace references to ASIC with APRA in a number of insolvency and administration contexts (see rules that omit “ASIC” and insert “APRA”, e.g. rules 46, 49, 50).
Mechanically, the Rules:
Treat creditors of a health benefits fund as including policyholders (rule 4; rule 12(1)(3)).
Allow the external manager to call creditor meetings to consider a proposed voluntary deed of arrangement and set specific notice and publication requirements and timelines (rule 6). The external manager must give APRA notice at the same time as creditors (rule 6(1)(a)) and provide an accompanying report, the deed details, and the external manager’s opinion that execution would be in creditors’ interests (rule 6(2)).
Prescribe meeting conduct, quorum, adjournment, teleconference participation rules including a requirement that telephone participants bear their own costs (rule 7). Voting is dual-tested: a majority of creditors voting and creditors representing more than half the total debt value of those voting are required for a resolution to carry (rule 7(11)).
Current sections
Direct links to the current provisions in Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
66
Private Health Insurance (Health Benefit
Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
I, Suzanne Smith, a delegate of the Australian Prudential Regulation Authority:
under subsection 174(1) of the Private Health Insurance (Prudential Supervision) Act 2015 (the Act) and subsection of the 33(3) of the Acts Interpretation Act 1901, REVOKE Private Health Insurance (Health Benefits Fund Enforcement) Rules 2015 made on 26 June 2015; and
under subsection 174(1) of the Act, MAKE these Rules.
This instrument commences on 30 September 2025.
Dated: 11 September 2025
Suzanne Smith
Member
1. Name of Rules
1. Name of Rules
1. Name of Rules
These Rules are the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
2. Commencement
2. Commencement
2. Commencement
These Rules commence on 30 September 2025.
3. Definitions
3. Definitions
3. Definitions
Note: Terms used in these Rules have the same meaning as in the Act – see section 13 of the Legislation Act 2003. These terms include:
applied Corporations Act provision
APRA
external manager
health benefits fund
private health insurer
responsible insurer
voluntary deed of arrangement
In these Rules:
Act means the Private Health Insurance (Prudential Supervision) Act 2015.
Corporations Act means the Corporations Act 2001.
4. Interpretation
4. Interpretation
4. Interpretation
In this Part, a reference to a creditor of a health benefits fund includes a policy holder of the fund.
5. Convening of meetings
5. Convening of meetings
5. Convening of meetings
The external manager of a health benefits fund may convene a meeting of the creditors of the fund to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager.
6. Procedure for convening of the meetin
6. Procedure for convening of the meeting
6. Procedure for convening of the meeting
(1) If the external manager decides to convene a meeting to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager, the external manager must:
give notice to APRA at the same time that the manager gives notice to the creditors; and
give written notice of the meeting to as many of the creditors as reasonably practicable; and
cause notice of the meeting to be published:
(i) in a national newspaper; or
(ii) in each jurisdiction in which the business of the fund is carried on – in a daily newspaper that circulates generally in that jurisdiction;
at least 14 business days before the meeting.
(2) The notice given to creditors and APRA under subrule (1) must be accompanied by:
a report by the external manager about the business, property, affairs and financial circumstances of the fund; and
a statement setting out details of the proposed deed of arrangement; and
a statement setting out the external manager’s opinion as to why it would be in the interests of the creditors of the fund for the responsible insurer to execute such a deed of arrangement.
(3) If:
telephone or electronic conference facilities are expected to be available at the place where the meeting is to be held; and
the external manager considers that, having regard to all the circumstances, it will be appropriate to use those facilities, the notice of the meeting must:
(i) set out the relevant telephone number; and
(ii) indicate that a person, or the proxy of a person, who wishes to participate in the meeting by telephone must give to the external manager, not later than the second-last working day before the day on which the meeting is to be held, a written statement setting out:
(A) the name of the person and of the proxy (if any); and
(B) an address to which notices to the person or proxy may be sent; and
(C) a telephone number at which the person or proxy may be contacted; and
(D) a facsimile transmission number (if any) to which notices to the person or proxy may be sent; and
(E) that a person, or the proxy of a person, who participates in the meeting by telephone must pay any costs incurred by the person or proxy in participating and is not entitled to be reimbursed for those costs from the assets of the fund.
7. Conduct of the meeting
7. Conduct of the meeting
7. Conduct of the meeting
(1) The external manager is to preside at a meeting convened under this rule.
(2) Such a meeting may be adjourned from time to time at the discretion of the external manager, but may not be adjourned to a day more than 30 days after the first day on which the meeting was held.
(3) If a person, or a person’s proxy, who wishes to participate in a meeting by means of telephone conference facilities, has given the external manager a statement in accordance with subparagraph 6 (3) (b) (ii), the external manager must take all reasonable steps to ensure that the person, or the person’s proxy, is contacted before the start of the meeting on the telephone number provided by that person.
(4) The external manager must also take all reasonable steps to ensure that the person or proxy can hear the proceedings, and can be heard, by means of those facilities.
(5) A person who, or whose proxy, participates in the meeting by telephone under this rule is taken to be present in person at the meeting.
(6) A quorum for the meeting consists of:
if the number of persons entitled to vote exceeds 2 – at least 2 of those persons; or
if only one person is, or 2 persons are, entitled to vote – that person or those persons,
present in person or by proxy.
(7) A meeting may be held if all the persons who are entitled to attend, and to vote at, the meeting agree, even if it has not been convened in accordance with these Rules.
(8) If, within 30 minutes after the time appointed for a meeting:
a quorum is not present; or
the meeting is not otherwise sufficiently constituted,
the meeting is adjourned:
to the same day in the next week, at the same time and place; or
to the day (not being less than 7 or more than 21 days after the day on which the meeting is adjourned) and at the time and place that the external manager thinks are most convenient for the majority of persons entitled to attend the meeting.
(9) The external manager must, without delay, give written notice of the adjournment to the persons to whom notice of the meeting must be given under rule 6.
(10) If within 30 minutes after the time appointed for the adjourned meeting:
a quorum is not present; or
the meeting is not otherwise sufficiently constituted,
the adjourned meeting lapses.
(11) A resolution is carried if:
a majority of the creditors voting (whether in person or by proxy) vote in favour of the resolution; and
the value of the debts owed by the fund to those voting in favour of the resolution is more than half the total debts owed to all the creditors voting (whether in person or by proxy).
8. Matters that may be decided at the me
8. Matters that may be decided at the meeting
8. Matters that may be decided at the meeting
At meetings convened in accordance with these Rules, the creditors must resolve:
that the responsible insurer execute:
(i) the deed of arrangement proposed by the external manager; or
(ii) a different deed of arrangement from that originally proposed by the administrator; or
to reject the deed.
9. External managers recommendations to
9. External managers recommendations to APRA
9. External managers recommendations to APRA
(1) If the creditors have made a resolution referred to in paragraph 8 (a), the external manager must recommend in the report to APRA under section 59 of the Act, that APRA approve the execution of the deed, unless subrule (2) applies.
(2) The external manager must not recommend that APRA approve the execution of the deed if:
the deed has been varied by the meeting and the external manager is not satisfied that the varied deed is, in the circumstances, still protective of the interests of the policy holders of the fund; or
the deed limits the rights of a creditor or creditors unless, in the opinion of the external manager, the fund is insolvent or likely to become insolvent at some future time.
(3) For paragraph (2) (b), a deed will be taken to limit the rights of a creditor or creditors if it involves:
removing or limiting the right of a creditor to the payment of a debt or other liability, or removing or limiting a creditor’s entitlement to an asset; or
delaying the right of a creditor to make or enforce a claim for the payment of a debt or other liability, or delaying the right of a creditor to make or enforce the creditor’s entitlement to an asset.
10. Actions APRA may take
10. Actions APRA may take
10. Actions APRA may take
(1) If APRA is satisfied that the execution of the deed as recommended in the report of the external manager will, in the circumstances, be in the interests of policy holders of the fund, APRA must, by written notice:
inform the external manager that it approves the execution of the deed; and
request the preparation of the deed for execution.
(2) If APRA is not satisfied that the execution of the deed as recommended in the report of the external manager will be, in the circumstances, in the interests of policy holders of the fund, APRA must, by written notice:
inform the external manager to that effect; and
request that the external manager:
(i) seek another meeting of the creditors to consider a further voluntary deed of arrangement; or
(ii) examine other possible courses of action,
and, on the basis of that further meeting or examination, to make a further report to APRA under section 59 of the Act within a time specified by APRA.
(3) If the external manager provides a further report to APRA in accordance with paragraph (2) (b), this rule, other than subparagraph (2) (b) (i), applies in respect of that report as if it were the original report of the external manager.
Part 3 – Modifications of terms in applied Corporations Act provisions
11. Modifications
11. Modifications
11. Modifications
For subparagraph 50 (1) (b) (ii) and subsection 55 (2) of the Act, if an applied Corporations Act provision includes a term specified in rule 12 the provision applies as if a reference to the specified term were a reference to the term as modified by rule 12.
12. Specified terms
12. Specified terms
12. Specified terms
(1) The following terms are modified as set out in this rule:
board of the company, in relation to a responsible insurer, is modified to mean, as the case may be for a particular insurer:
(i) the board of directors; or
(ii) committee of management; or
(iii) other governing body; and
company is modified to mean the responsible insurer; and
company secretary is modified to mean in relation to a responsible insurer that is not a company within the meaning of the Corporations Act, the secretary of the insurer or person who carries out the role similar to a company secretary; and
creditor, in relation to a fund, is modified to include a policy holder of the fund; and
director or director of a company or of a fund, for a responsible insurer that is not a company within the meaning of the Corporations Act, is modified to include a member of the committee of management, or other governing body, of the insurer; and
deed of company arrangement is modified to mean a voluntary deed of arrangement agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025; and
lodge is modified to include that the document to be lodged must be lodged at the same time with APRA; and
officer is modified to mean an 'officer' within the meaning of that word in the Private Health Insurance (Prudential Supervision) Act 2015; and
resolution, in relation to creditors and policy holders, is modified to mean a resolution agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
(2) References in an applied Corporations Act provision to Parts or Divisions of the Corporations Act are taken to also include a reference to the Private Health Insurance (Prudential Supervision) Act 2015 and the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
Part 4 – Modifications of Part 5.3A and Division 7A of Part 5.6
13. Modifications for subparagraph 50 (1
13. Modifications for subparagraph 50 (1) (b) (ii) of the Act
13. Modifications for subparagraph 50 (1) (b) (ii) of the Act
For subparagraph 50 (1) (b) (ii) of the Act, the applied Corporations Act provisions mentioned in this Part are modified as set out in this Part.
14. Subsection 440D (1)
14. Subsection 440D (1)
14. Subsection 440D (1)
Despite subsection 50 (4) of the Act, the reference in subsection 440D (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
Note: Subsection 56 (2) of the Act provides for the matters to which the external manager or the Court must have regard.
15. Subsections 440J (2) and (3)
15. Subsections 440J (2) and (3)
15. Subsections 440J (2) and (3)
omit the subsections
16. Subsection 441B (2)
16. Subsection 441B (2)
16. Subsection 441B (2)
omit
198G, 440B, 440F or 440G
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
17. Subsection 441B (3)
17. Subsection 441B (3)
17. Subsection 441B (3)
omit
437D
insert
75 of the Private Health Insurance (Prudential Supervision) Act 2015,
18. Section 441C
18. Section 441C
18. Section 441C
omit the section
19. Section 441E
19. Section 441E
19. Section 441E
omit
198G or 440B
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
20. Subsection 441F (2)
20. Subsection 441F (2)
20. Subsection 441F (2)
omit
198G or 440B
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
21. Subsection 441F (3)
21. Subsection 441F (3)
21. Subsection 441F (3)
omit
437D
insert
75 of the Private Health Insurance (Prudential Supervision) Act 2015,
22. Subsection 441G (2)
22. Subsection 441G (2)
22. Subsection 441G (2)
omit the subsection
23. Subsection 442D (2)
23. Subsection 442D (2)
23. Subsection 442D (2)
omit the subsection
24. Subsection 442F (1)
24. Subsection 442F (1)
24. Subsection 442F (1)
omit
this Act
insert
the Private Health Insurance (Prudential Supervision) Act 2015 and any applied Corporations Act provision as modified.
25. Subsection 442F (2)
25. Subsection 442F (2)
25. Subsection 442F (2)
omit the subsection
26. Subsections 444A (1), (2) and (3)
26. Subsections 444A (1), (2) and (3)
26. Subsections 444A (1), (2) and (3)
omit the subsections
substitute
(1) This section applies where, at a meeting of creditors convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025, a fund’s creditors resolve that the responsible insurer execute a voluntary deed of arrangement.
(2) The external manager of the fund is to be the administrator of the deed, unless the creditors, by resolution passed at the meeting, appoint someone else to be administrator of the deed, and APRA, by notice in writing, approves the resolution.
(3) If APRA, by notice in writing, has approved the execution of the deed, the administrator of the deed must prepare an instrument setting out the terms of the deed.
27. Paragraph 444A (4) (b)
27. Paragraph 444A (4) (b)
27. Paragraph 444A (4) (b)
Despite subsection 50 (4) of the Act, the second occurring reference in paragraph 444A (4) (b) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
28. Paragraph 444A (4) (d)
28. Paragraph 444A (4) (d)
28. Paragraph 444A (4) (d)
omit the paragraph
substitute
(d) to what extent the company is to be released from its debts in so far as the debts are debts of the fund
Despite subsection 50 (4) of the Act, the reference in paragraph 444A (4) (d) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
29. Paragraph 444A (4) (i)
29. Paragraph 444A (4) (i)
29. Paragraph 444A (4) (i)
omit
deed
insert
deed;
(j) the number of policy holders of the fund, and the total amount owing to policy holders.
30. Subsection 444A (5)
30. Subsection 444A (5)
30. Subsection 444A (5)
omit the subsection
31. Section 444B
31. Section 444B
31. Section 444B
Despite subsection 50 (4) of the Act, the references in section 444B of the Corporations Act to 'the company' are not to be taken as references to 'the fund'
32. Subsection 444B (2)
32. Subsection 444B (2)
32. Subsection 444B (2)
omit
The company
insert
If APRA, by notice in writing, has approved the execution of the deed, the company
33. Subsection 444B (4)
33. Subsection 444B (4)
33. Subsection 444B (4)
omit
198G
insert
71 of the Private Health Insurance (Prudential Supervision) Act 2015
34. Subsection 444B (5)
34. Subsection 444B (5)
34. Subsection 444B (5)
Despite subsection 50 (4) of the Act, the reference in subsection 444B (5) of the Corporations Act to 'the proposed administrator' is not to be taken as a reference to 'the external manager'.
35. Subsection 444B (7)
35. Subsection 444B (7)
35. Subsection 444B (7)
omit the subsection
36. Subsection 444C (1)
36. Subsection 444C (1)
36. Subsection 444C (1)
omit
section 439A
insert
the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
Despite subsection 50 (4) of the Act, the reference in subsection 444C (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
37. Paragraphs 444D (2) (a) and (3) (a)
37. Paragraphs 444D (2) (a) and (3) (a)
37. Paragraphs 444D (2) (a) and (3) (a)
Despite subsection 50 (4) of the Act, the references in paragraphs 444D (2) (a) and (3) (a) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.
38. Subsection 444E (4)
38. Subsection 444E (4)
38. Subsection 444E (4)
omit the words after the colon
substitute
property, in relation to the fund, includes property used for the purposes of the business of the fund.
39. Subsections 444F (1) and (2)
39. Subsections 444F (1) and (2)
39. Subsections 444F (1) and (2)
Despite subsection 50 (4) of the Act, the references in subsections 444F (1) and (2) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.
40. Subsection 444F (2)
40. Subsection 444F (2)
40. Subsection 444F (2)
omit
Subject to subsection 441A (3), the
insert
The
41. Subsection 444F (4)
41. Subsection 444F (4)
41. Subsection 444F (4)
omit the subsection
substitute
The Court may order the owner or lessor of property that is used for the purposes of the business of the fund not to take possession of the property or otherwise recover it.
42. Section 444G
42. Section 444G
42. Section 444G
Despite subsection 50 (4) of the Act, the reference in section 444G of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
43. Section 444H
43. Section 444H
43. Section 444H
After the word 'debt', insert
that is a debt of the fund.
Despite subsection 50 (4) of the Act, the reference in section 444H of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
44. Paragraph 445D (2) (b)
44. Paragraph 445D (2) (b)
44. Paragraph 445D (2) (b)
omit the paragraph
45. Section 445E
45. Section 445E
45. Section 445E
omit the section
46. Subsection 445G (1)
46. Subsection 445G (1)
46. Subsection 445G (1)
omit
ASIC
insert
APRA
47. Subsection 447A (2)
47. Subsection 447A (2)
47. Subsection 447A (2)
omit the subsection
48. Paragraphs 447A (4) (a) and (d)
48. Paragraphs 447A (4) (a) and (d)
48. Paragraphs 447A (4) (a) and (d)
Despite subsection 50 (4) of the Act, the references in paragraphs 447A (4) (a) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.
49. Paragraph 447A (4) (e)
49. Paragraph 447A (4) (e)
49. Paragraph 447A (4) (e)
omit
ASIC
insert
APRA
50. Subsection 447B (1)
50. Subsection 447B (1)
50. Subsection 447B (1)
omit
ASIC
insert
APRA
51. Subsection 450A (1)
51. Subsection 450A (1)
51. Subsection 450A (1)
omit
436A, 436B or 436C
insert
51 of the Private Health Insurance (Prudential Supervision) Act 2015
52. Subsection 450A (2)
52. Subsection 450A (2)
52. Subsection 450A (2)
omit the subsection
substitute
(2) As soon as practicable, and in any event before the end of the next business day, after appointing an external manager under section 51 of the Private Health Insurance (Prudential Supervision) Act 2015, APRA must give written notice of the appointment to the responsible insurer.
53. Subsection 450A (3)
53. Subsection 450A (3)
53. Subsection 450A (3)
omit
436A, 436B or 436C
insert
51 of the Private Health Insurance (Prudential Supervision) Act 2015
54. Subsection 450A (4)
54. Subsection 450A (4)
54. Subsection 450A (4)
omit the subsection
55. Paragraph 450C (b)
55. Paragraph 450C (b)
55. Paragraph 450C (b)
omit
of the company’s creditors
insert
policy holder
Despite subsection 50 (4) of the Act, a reference in section 450C of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
56. Subsection 568 (1)
56. Subsection 568 (1)
56. Subsection 568 (1)
Despite subsection 50 (4) of the Act, the second reference in subsection 568 (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
57. Paragraph 568 (1) (h)
57. Paragraph 568 (1) (h)
57. Paragraph 568 (1) (h)
Despite subsection 50 (4) of the Act, the reference in paragraph 568 (1) (h) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
58. Subsections 568 (1AA) and 568 (9)
58. Subsections 568 (1AA) and 568 (9)
58. Subsections 568 (1AA) and 568 (9)
Despite subsection 50 (4) of the Act, references in subsection 568 (1AA) and subsection 568 (9) of the Corporations Act to 'the company' are not to be taken as references to 'the fund'.
59. Subsection 568D (1)
59. Subsection 568D (1)
59. Subsection 568D (1)
Despite subsection 50 (4) of the Act, the reference in subsection 568D (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
Part 5 – Modifications of sections 128 and 129
60. Modifications for subsection 55 (2)
60. Modifications for subsection 55 (2) of the Act
60. Modifications for subsection 55 (2) of the Act
For subsection 55 (2) of the Act, the applied Corporations Act provisions mentioned in this Part are modified as set out in this Part.
61. Sections 128 and 129
61. Sections 128 and 129
61. Sections 128 and 129
In sections 128 and 129 of the Corporations Act:
company means a private health insurer.
officer includes:
for a private health insurer that is a company within the meaning of the Corporations Act – a director of the company; and
for any other private health insurer – a member of the committee of management, or other governing authority, of the insurer; and
if a person has been appointed as a receiver of the property of a private health insurer and manages, or has, under the terms of the receiver’s appointment, power to manage, the affairs of the insurer – the receiver.
62. Subsection 129 (2)
62. Subsection 129 (2)
62. Subsection 129 (2)
omit
from ASIC
63. After subsection 129 (5)
63. After subsection 129 (5)
63. After subsection 129 (5)
insert
(5A) For a private health insurer that is not a company within the meaning of the Corporations Act, a person may assume that a document has been duly executed by the insurer if the document appears to have been signed in accordance with subsection 129A (1).
64. After subsection 129 (6)
64. After subsection 129 (6)
64. After subsection 129 (6)
insert
(6A) For a private health insurer that is not a company within the meaning of the Corporations Act, a person may assume that a document has been duly executed by the insurer if:
the common seal of the insurer appears to have been fixed to the document in accordance with subsection 129A (2); and
the fixing of the common seal appears to have been witnessed in accordance with that subsection.
65. After section 129
65. After section 129
65. After section 129
insert
129A Execution of documents (including deeds) by a private health insurer that is not a company
(1) A private health insurer that is not a company within the meaning of the Corporations Act may execute a document without using a common seal if the document is signed by 2 directors or by 2 members of the management committee, or other governing body, of the insurer.
(2) A private health insurer that is not a company within the meaning of the Corporations Act and that has a common seal, has executed a document if the seal is fixed to the document and the fixing of the seal is witnessed by 2 directors or by 2 members of the management committee, or other governing body, of the insurer.
Source text: opening excerpt
Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.
Private Health Insurance (Health Benefit Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025
I, Suzanne Smith, a delegate of the Australian Prudential Regulation Authority:
under subsection 174(1) of the Private Health Insurance (Prudential Supervision) Act 2015 (the Act) and subsection of the 33(3) of the Acts Interpretation Act 1901, REVOKE Private Health Insurance (Health Benefits Fund Enforcement) Rules 2015 made on 26 June 2015; and
under subsection 174(1) of the Act, MAKE these Rules.
This instrument commences on 30 September 2025.
Dated: 11 September 2025
Suzanne Smith
Member
1. Name of Rules 1. Name of Rules
1. Name of Rules
These Rules are the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
2. Commencement 2. Commencement
2. Commencement
These Rules commence on 30 September 2025.
3. Definitions 3. Definitions
3. Definitions
Note: Terms used in these Rules have the same meaning as in the Act – see section 13 of the Legislation Act 2003. These terms include:
applied Corporations Act provision
APRA
external manager
health benefits fund
private health insurer
responsible insurer
voluntary deed of arrangement
In these Rules:
Act means the Private Health Insurance (Prudential Supervision) Act 2015.
Corporations Act means the Corporations Act 2001.
4. Interpretation 4. Interpretation
4. Interpretation
In this Part, a reference to a creditor of a health benefits fund includes a policy holder of the fund.
5. Convening of meetings 5. Convening of meetings
5. Convening of meetings
The external manager of a health benefits fund may convene a meeting of the creditors of the fund to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager.
6. Procedure for convening of the meetin 6. Procedure for convening of the meeting
6. Procedure for convening of the meeting
(1) If the external manager decides to convene a meeting to consider the possibility of the responsible insurer executing a deed of arrangement proposed by the external manager, the external manager must:
Require the external manager, where creditors resolve that the responsible insurer execute a deed, to recommend approval to APRA in the external manager’s section 59 report unless specified exceptions apply (rule 9). Those exceptions include variation of the deed that the external manager believes is not protective of policyholders, and deeds that limit creditor rights unless the fund is or will likely become insolvent (rule 9(2)-(3)).
Require APRA, on a satisfactory recommendation, to give written approval and request the deed be prepared (rule 10(1)), or if not satisfied, to request another meeting or further examination and a further report from the external manager (rule 10(2)).
Modify multiple Corporations Act insolvency and administration provisions so they operate for funds as if the applied provisions’ company-centric terms are replaced or adjusted (many rules across Parts 3-5). Notable changes include changes to who appoints and acts as an administrator of a deed of arrangement (rule 26), who is notified (rule 52), how property and debts of the fund are treated by court orders (rules 38, 41), and how execution of documents by insurers that are not companies is evidenced (rules 61-65).
The Rules therefore create a bespoke insolvency/arrangement pathway for health benefits funds, anchored to the external manager/APRA oversight model in the Act and borrowing adapted Corporations Act machinery where useful. The instrument creates procedural obligations (notice, reporting, meeting conduct), defines voting mechanics for creditors that include policyholders, assigns reporting and recommendation duties to external managers, and allocates final approval authority to APRA before a voluntary deed of arrangement can be executed (rules 5-10; 11-12; 26; 31-36; 52).
Main concepts
This instrument relies on a short set of core constructs and functional conversions of existing insolvency law:
Health benefits fund and responsible insurer. The Rules apply to a health benefits fund and to its responsible insurer as defined in the Act (Definitions; rule 3). Where the insurer is not a “company” under the Corporations Act the Rules systematically translate company terms to the insurer’s governance structures (rule 12(1)(1)-(4), (7)). The Rules therefore create a transposition principle to apply corporate insolvency concepts to funds and insurers regardless of corporate form.
Creditor as including policyholder. Rule 4 expressly states that a reference to a creditor of a health benefits fund includes a policyholder. Rule 12(1)(3) repeats that construction for applied Corporations Act provisions. That redefinition is central: it brings policyholders formally into creditor meetings and voting processes under these Rules.
External manager role. The external manager may convene creditor meetings to consider a voluntary deed of arrangement (rule 5). The external manager presides at the meeting and has duties: give simultaneous notice to APRA, provide a report about the fund’s affairs and the proposed deed, and present an opinion on why the deed would serve creditors’ interests (rule 6(1)-(2); rule 7(1)). The external manager is also required to recommend whether APRA should approve execution of the deed in the section 59 report unless disqualifying factors apply (rule 9(1)-(2)).
Voluntary deed of arrangement (VDA). The Rules repurpose the phrase “deed of company arrangement” from the Corporations Act and define it to mean a voluntary deed of arrangement agreed at a meeting convened under these Rules (rule 12(1)(5)). Creditors at the meeting can resolve to have the responsible insurer execute the proposed deed, a different deed, or to reject any deed (rule 8).
APRA approval and direction. APRA has a gatekeeping role. If APRA is satisfied that execution of the deed is in the interests of policyholders, APRA must approve and request preparation for execution (rule 10(1)). If APRA is not satisfied, it must refuse and require another meeting or further examination and reporting (rule 10(2)). The external manager must lodge reports with APRA and documents must be lodged “at the same time with APRA” where “lodge” is modified to include simultaneous lodging with APRA (rule 12(1)(6)).
Applied Corporations Act provisions and tailored modifications. The instrument identifies many specified applied Corporations Act provisions and modifies their terms to substitute fund and insurer concepts and to substitute APRA in roles where the Corporations Act assigns ASIC (rules 11-12 and Parts 3-5 generally). Several Corporations Act subsections are omitted outright, and others are replaced or modified so that court powers, administrator roles, property definitions and creditor protections operate in the fund context (e.g. rules 14-36, 38-44, 46-59, 61-65).
Document execution for non-company insurers. Where a private health insurer is not a company, the Rules provide a clear execution mechanism: documents may be signed by two directors or two members of the management committee or governing body; a common seal, if used, must be witnessed by two such persons (rule 65, inserting new ss 129A(1)-(2)).
These components form a regulatory architecture that adapts corporate insolvency and deed-of-arrangement processes to the private health insurance sector, with the external manager and APRA performing central decision and supervisory functions. The Rules therefore create a structured path for voluntary arrangements for funds, while preserving APRA oversight and attaching procedural burdens to ensure APRA and creditors (including policyholders) receive specified information.
Who it affects
The Rules assign procedural rights and obligations across a set of clearly defined actors. The primary affected parties and the changes that bear on them are:
External managers of health benefits funds. The external manager gains an explicit power to convene creditor meetings to consider a proposed voluntary deed of arrangement (rule 5). They must notify APRA simultaneously when giving notice to creditors, publish notice in a national or jurisdictional newspaper, circulate written notice to as many creditors as reasonably practicable, prepare and supply an accompanying report on the fund’s affairs and provide the external manager’s opinion on the deed’s desirability for creditors (rule 6(1)-(2)). The external manager presides at meetings, controls adjournment timelines (rule 7(1)-(2)), must ensure teleconference participants can hear and be heard (rule 7(3)-(5)), and must recommend APRA approval in the section 59 report unless specified disqualifying conditions are present (rule 9).
Responsible insurers (and their governing bodies). Where an insurer is asked to execute a voluntary deed of arrangement the responsible insurer is placed in the position of the “company” for many applied Corporations Act provisions (rule 12(1)(2) and multiple modifications across Parts 3-5). The insurer’s board, committee of management or other governing body are treated as the board for these purposes (rule 12(1)(1)). Insurers that are not Corporations Act “companies” are given prescribed document-execution processes (rule 65). Insurers may be required to act if creditors resolve the insurer execute a deed and APRA approves (rules 8, 10, 26, 31-36).
Policyholders. The definition of creditor includes a policyholder of the fund (rule 4 and rule 12(1)(3)), bringing policyholders into meetings, possibly to vote. Mechanically, policyholders will be part of creditor numerosity, and may vote by proxy and in person under the meeting rules. However, voting outcomes require both a majority of creditors voting and that creditors voting in favour represent more than half the total debt value of creditors voting (rule 7(11)), which establishes a value-weighted mechanism that may distinguish influence between holders of larger and smaller claims.
Other creditors. All creditors of the fund are within scope for notices, voting and being included in the external manager’s required report (rule 6). The Rules treat debts and assets of the fund as the currency of voting outcomes and insolvency considerations (see rule 7(11) and multiple modifications referring to debts and property).
APRA. The Australian Prudential Regulation Authority is centralised as the decision-maker for approving deeds (rule 10). The Rules require APRA be given notice simultaneously with creditors and to be supplied with the external manager’s report under section 59 of the Act (rule 6(1)(a); rule 9(1)). Several applied Corporations Act provisions are modified to replace ASIC with APRA in investigatory and administrative roles (e.g. rules 46, 49, 50, 51).
Courts. The Rules adapt Corporations Act provisions that give courts power to make orders in the administration context. For example, substituted wording allows the court to order owners/lessors of property used for the business of the fund not to take possession (rule 41), and other references to the court remain in the modified applied provisions (various rules in Parts 3-4). The Rules thus maintain an avenue to seek judicial orders in the fund administration context under modified Corporations Act machinery.
Administrators and appointed deed administrators. Where creditors resolve to execute a voluntary deed of arrangement, the external manager is to be the administrator of the deed by default (unless creditors appoint another person and APRA approves that appointment) (rule 26(2)). The administrator must prepare an instrument setting out the deed if APRA has approved execution (rule 26(3)).
Owners/lessors of property and third-party counterparties. Certain substituted provisions affect rights regarding property and possession (rule 41). The modification to definitions of property in section 444E(4) expands property to include property used for fund business (rule 38).
These Rules therefore change the distribution of notification, decision and reporting responsibilities primarily towards external managers and APRA, while formally including policyholders within creditor processes and adapting numerous Corporations Act insolvency mechanisms to the fund context.
Key duties and rights
The Rules create discrete duties for external managers, creditors, insurers and APRA, and create rights for creditors and policyholders to participate. Key duties and rights, with the operative Rules cited, are:
Duties of the external manager
Power/duty to convene creditor meetings to consider a voluntary deed of arrangement (rule 5). This is permissive in that the external manager may convene; it is prescriptive in the required procedure if the manager decides to convene (rule 6).
Simultaneous notification to APRA when issuing meeting notices to creditors (rule 6(1)(a)).
Provide written notice to as many creditors as reasonably practicable and publish notice in a national or jurisdictional daily newspaper at least 14 business days before the meeting (rule 6(1)(b)-(c)).
Accompany notices with: a report on the business, property, affairs and financial circumstances of the fund; details of the proposed deed; and the external manager’s opinion why execution is in creditors’ interests (rule 6(2)). The report is also required for APRA under s 59 of the Act (rule 9(1)).
Ensure teleconference participants are contacted and can hear and be heard; ensure the specified contact details and participation cost statement are in the notice (rule 6(3); rule 7(3)-(5)).
Preside at the convened meeting and manage adjournments subject to maximum adjournment periods (rule 7(1)-(2), (8)-(10)).
Recommend APRA approval in the section 59 report if creditors resolve that the responsible insurer execute the deed, unless the external manager is not satisfied that a varied deed is protective of policyholders or the deed improperly limits creditor rights unless insolvency is present or likely (rule 9(1)-(3)).
Rights and duties of creditors (including policyholders)
Right to receive written notice and to be included among creditors for convened meetings (rule 6(1)(b)).
Right to participate in-person or by proxy, and by teleconference subject to the notice requirements (rule 6(3)(b); rule 7(3)-(5)).
Voting rights at meetings: resolutions carry only if a majority of creditors voting support it and the debts represented by those voting in favour exceed half of the total debts represented by all creditors voting (rule 7(11)). This creates both a numerical and value test.
Duties/rights of APRA
Must receive notice of meetings at the same time as creditors and be supplied the external manager’s report under section 59 of the Act (rule 6(1)(a); rule 9(1)).
If satisfied that execution of the deed is in the interests of policyholders, APRA must give written approval and request the deed be prepared (rule 10(1)).
If not satisfied, APRA must inform the external manager, request another meeting or further examination and a further report within a specified time (rule 10(2)). APRA’s choice triggers iterative reporting responsibilities on the external manager (rule 10(2)(ii)-(3)).
Administrator of the deed
Where creditors resolve to have a voluntary deed executed, the external manager is to be the default administrator unless creditors appoint another and APRA approves that appointment; the administrator must prepare an instrument setting out the deed if APRA has approved execution (rule 26(1)-(3)).
Execution of documents by non-company insurers
A private health insurer that is not a company may execute a document without a common seal if signed by two directors or two members of its management committee or governing body; if a common seal is used it must be witnessed by two such persons (rule 65, inserting s 129A(1)-(2)). Documents may be assumed duly executed where they appear to comply with these provisions (rule 63-64, inserting ss 129(5A) and 129(6A)).
Modifications that affect duties under applied law
Numerous Corporations Act provisions are applied with modified terminology and with APRA substituted for ASIC in some roles (rules 11-12 and numerous specific modifications across Parts 3-5). Practitioners must therefore treat certain Corporations Act duties (e.g. court applications, property orders, notification requirements) as reallocated into the fund and APRA context per the Rules.
Rights reserved to the court
The Rules preserve or adapt court powers in the applied Corporations Act context (e.g. rule 41 substituting a power for courts to order owners/lessors not to recover property used by the fund). Where the Corporations Act references “the company” the Rules often stipulate that the reference is not to be taken as a reference to the fund in specified places (see many "Despite subsection 50(4)..." notes, e.g. rules 14, 27, 31, 36, 37, 39, 42, 43, 55, 56-59), which affects how courts may interpret those applied provisions in the fund context.
Collectively, the Rules place the external manager in the centre of convening, information production and procedural control, require APRA approval as the execution gate, and establish clear meeting and voting mechanics that include policyholders as creditors while preserving adapted court remedies and insolvency machinery.
Penalties and enforcement
The Rules do not create novel criminal offences or specify monetary penalties within the instrument text. Enforcement mechanisms are administrative, procedural and legal rather than penal within these Rules:
APRA as gatekeeper. APRA’s power under the Act is operationalised here: APRA must be given notice and the external manager’s report (rule 6); APRA must issue written approval if it is satisfied a deed execution is in the interests of policyholders (rule 10(1)); and APRA can refuse approval and require further meetings or examination (rule 10(2)). APRA’s written notices and approval steps are the primary enforcement levers in the Rules. APRA can withhold approval, thereby preventing a deed’s execution.
Reporting and recommendation obligations. The external manager is required to recommend APRA approval in the s 59 report unless the external manager considers the deed or its variations are not protective of policyholders, or unless the deed unjustifiably limits creditor rights in a non‑insolvency context (rule 9(1)-(3)). Failure to make the required recommendation as prescribed could affect the validity of subsequent steps under the Act and the Rules, but the instrument does not specify statutory penalties; remedies would arise under the Act or through APRA actions.
Court orders under applied Corporations Act machinery. The Rules modify a suite of Corporations Act provisions that preserve court supervisory powers. For example, substitution in rule 41 (replacing s 444F(4) with a provision allowing the Court to order owners/lessors not to take possession) creates a legal mechanism enforceable by court order. Practitioners seeking to enforce rights or restrain actions would proceed through judiciary mechanisms preserved or adapted by the applied provisions.
Administrative consequences of non‑compliance. Non-compliance with notice and procedural requirements (e.g. failure to give notice to APRA and creditors as required by rule 6) could void procedural steps or provide grounds for APRA or court intervention, though the Rules themselves do not list sanctions. Remedies and enforcement options would originate in the Act, the applied Corporations Act provisions (as modified), or through judicial relief.
Replacement of ASIC functions with APRA. Several Corporations Act references to ASIC are omitted and replaced with APRA (rules 46, 49, 50, 51), shifting regulatory enforcement and oversight responsibilities into APRA’s administrative domain where APRA has statutory powers under the Act.
Document execution evidentiary effect. Rules 63-65 provide that documents that appear to be executed in accordance with the new ss 129A(1)-(2) are presumed duly executed. This creates an evidentiary pathway simplifying enforcement of obligations where appearance meets the prescribed test, while also potentially limiting disputes over execution where the criteria appear satisfied.
In sum, enforcement under these Rules is procedural and administrative, centred on APRA’s approval power, the external manager’s compliance with notice and reporting duties, and the availability of court orders via modified Corporations Act provisions. The instrument does not itself attach fines or criminal penalties; it instead modifies the mechanics by which statutory administrative and judicial remedies attach to fund insolvency and arrangement processes.
How it interacts with other laws
The Rules are explicitly designed to operate in tandem with, and to adapt, provisions of the Corporations Act 2001 and the Private Health Insurance (Prudential Supervision) Act 2015 (the Act). Key interaction points are:
Private Health Insurance (Prudential Supervision) Act 2015. The instrument is made under s 174(1) of the Act and repeatedly references duties and processes under that Act (preamble; rules 3; rule 10; rule 26). The external manager’s reports are to be made to APRA under section 59 of the Act (rule 9(1)). The Rules treat lodging as including simultaneous lodgement with APRA (rule 12(1)(6)). Subsection 50(4) of the Act (which affects how applied Corporations Act terms referring to “company” are treated) is directly invoked in multiple Notes and substitutions throughout these Rules (see numerous “Despite subsection 50(4) of the Act…” comments in rules 14, 27, 31, 36, 37, 39, 42-44, 55-59, etc.). Practitioners must therefore read the Rules in conjunction with the Act.
Corporations Act 2001. The Rules explicitly apply many Corporations Act provisions to the fund context, but with modifications. Rules 11-12 establish that applied Corporations Act provisions that include specified terms are to be read as if the specified terms were replaced or modified. Rule 12 lists the term substitutions: “board of the company” becomes the insurer’s governing body, “company” becomes the responsible insurer, “creditor” includes policyholders, “deed of company arrangement” is taken to mean a VDA under these Rules, “lodge” includes simultaneous lodgement with APRA, and “officer” is defined by the Act’s meaning (rule 12(1)). The instrument then proceeds to omit, replace or modify numerous Corporations Act sections (Parts 3-5 of the Rules). These modifications tailor insolvency court powers, administrator roles, property definitions, and notification requirements into the fund context. For example, section 444A of the Corporations Act is substituted with a version tailored to a fund’s creditor meeting outcomes and administrator appointment (rule 26).
Acts Interpretation Act 1901 and Legislation Act 2003. The preamble notes reliance on the Acts Interpretation Act 1901 (subsection 33(3)) and the Rules rely on the Legislation Act 2003 s 13 to import defined terms used in the Act (rule 3: “Terms used in these Rules have the same meaning as in the Act , see section 13 of the Legislation Act 2003”).
Court and property law interaction. Several modifications affect how property used for the business of a fund is treated in court orders (rule 38 modifies s 444E(4) so “property, in relation to the fund, includes property used for the purposes of the business of the fund”; rule 41 substitutes a court power to order owners/lessors not to recover possession). These changes intersect with landlord-tenant and property rights, but they operate through court orders under modified Corporations Act provisions.
Administrative regulators. References to ASIC in various Corporations Act provisions are replaced by APRA in this instrument (e.g. rule 46, rule 49, rule 50, rule 51). This shifts the locus of administrative interactions from Australian Securities and Investments Commission to APRA where the applied provisions are engaged in the fund context.
Evidence and execution of documents. Rules 63-65 insert execution and evidentiary rules for private health insurers that are not companies. These provisions interact with document execution standards under the Corporations Act (ss 128-129) but provide alternative means of execution for non-company insurers.
Overall, the Rules function as a crosswalk: they adapt corporate insolvency and deed-of-arrangement processes to the health benefits fund environment by modifying terms and substituting APRA where appropriate. Practitioners must therefore read applied Corporations Act provisions in their modified form as set out in this instrument and coordinate that reading with the Act’s supervisory framework (section 59 reporting, APRA approval, external manager powers) and the Legislation Act’s interpretation rules.
Amendment history
The instrument records a simple amendment history in its preamble: it revokes the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2015 (the 2015 Rules) made on 26 June 2015 and replaces them with the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025 (preamble). The making and revocation powers are stated as being exercised by Suzanne Smith, a delegate of APRA, under subsection 174(1) of the Act and subsection 33(3) of the Acts Interpretation Act 1901 (preamble). The instrument is dated 11 September 2025 and commences on 30 September 2025 (preamble; Rules 1-2).
Mechanically, the amendment history is therefore:
Revocation: Private Health Insurance (Health Benefits Fund Enforcement) Rules 2015 revoked (preamble). The text does not reproduce the 2015 Rules or provide a schedule of differences; it simply revokes and replaces. Practitioners must therefore compare the 2015 Rules to the 2025 Rules directly if they need a line-by-line change history, as the instrument itself does not include a commensurate explanatory schedule.
Replacement: New Rules commence 30 September 2025 (Rule 2). The 2025 Rules include numerous substantive structural changes, notably the insertion and modification of applied Corporations Act provisions and clarified roles for APRA and the external manager. Because the instrument is a complete set of Rules rather than an amending instrument with tracked changes, the statutory text of the 2025 Rules is the operative source from the commencement date.
Instrument provenance: made by a delegate under the Act (preamble). The instrument does not indicate any transitional provisions or savings clauses in respect of acts done under the 2015 Rules; none are contained in the text provided. Practitioners should therefore verify whether the Act or an external APRA instrument provides transitional arrangements for matters in progress at the commencement date; such transitional mechanisms are not present in the Rules as supplied.
No other amendments, schedules, or further modification dates are recorded in the instrument text provided. The instrument therefore represents a clean replacement effective 30 September 2025, with revocation of the 2015 Rules as its sole immediate prior-history element in the instrument itself.
Litigation history
The instrument text does not name, reference or attach any judicial decisions, precedents, or litigation history. It contains no statements of judicial interpretation, no references to cases, and no litigation background for the Rules. Consequently:
There is no litigation history embedded in the Rules to analyse. The text includes no cases and makes no claim about prior judicial treatment (the text is purely regulatory and prescriptive).
Practitioners seeking litigation history must therefore look outside this instrument to proceedings under the Act, any disputes stemming from the 2015 Rules, or court cases that applied the Corporations Act provisions that are being adapted here. The Rules themselves contain a substantial number of modifications to Corporations Act provisions that have an existing body of case law; however, the instrument does not recite that material or specify how courts should apply precedent in the modified context.
The absence of litigation references in the instrument means that uncertainty about how a court will interpret modified provisions such as substituted s 444A or the various omitted subsections will persist until courts apply the modified mechanics. The Rules often include notes saying “Despite subsection 50(4) of the Act, the reference in [Corporations Act section] to ‘the company’ is not to be taken as a reference to ‘the fund’,” (see multiple rules, e.g. 14, 27, 31, 36, 37, 39, 42-44, 55-59). How courts will treat precedent that attaches to the original Corporations Act language when presented with these legislative directions is a matter for judicial interpretation and therefore for future litigation.
For now, litigation history is externally sourced. Users should not expect the instrument to provide case law. Any application to court under the modified provisions will produce the first wave of judicial application of these Rules and the interaction between Corporations Act precedent and the fund-focused modifications.
In short, the instrument itself records no litigation history and provides no judicial gloss; the legal community will need to look to subsequent court decisions for jurisprudential development.
Gotchas
This Rules text contains a number of procedural and structural features that give rise to practical risks and traps for practitioners and administrators. These “gotchas” are mechanical and grounded in the text:
Simultaneous notice to APRA and creditors. Rule 6(1)(a) requires the external manager to give notice to APRA at the same time as giving notice to creditors. Failure to synchronise notices could run procedural risk because APRA’s ability to assess and then approve or require further action is timed off that notice. Practically, external managers must coordinate distribution and proof of service to meet this requirement.
Notice publication and timing requirements. Rule 6(1) requires written notice to as many creditors as reasonably practicable and publication in either a national paper or daily newspapers in jurisdictions where the business is carried on, at least 14 business days before the meeting. “Reasonably practicable” is a factual test, but missing the 14-business-day window can invalidate a meeting or provide grounds for challenge. The external manager must plan lead times for advertisement placement and creditor list collation.
Teleconference participation cost allocation. Rule 6(3)(b)(ii)(E) explicitly states telephone participants must pay their own costs and are not entitled to reimbursement from fund assets. External managers must include this in the notice and ensure consent statements, and creditors may object because costs could materially affect participation by some policyholders.
Voting mechanics , dual tests. Rule 7(11) requires both (a) a majority of creditors voting and (b) that the debts owed by those voting in favour represent more than half the total debts owed to creditors voting. This dual numerical and value test can produce counterintuitive outcomes, for example a majority by number but not by debt value will defeat a resolution. Because policyholders are “creditors” but may have low debt value relative to larger creditors (service providers, suppliers, banks), the mechanics can limit the practical influence of numerically numerous but low-value policyholders. The Rules do not provide a specific mechanism for weighting policyholder votes differently; they simply apply the dual test.
External manager’s duty to recommend and its exceptions. Rule 9(1) mandates that if creditors resolve in favour the external manager must recommend APRA approve the deed in the section 59 report, “unless subrule (2) applies.” Subrule (2) contains two exceptions: variation that external manager considers not protective of policyholders (rule 9(2)(a)); or deeds that limit creditor rights unless the fund is insolvent or likely to become insolvent (rule 9(2)(b)). The external manager therefore has a gatekeeping evaluative duty and potential exposure to dispute if creditors believe the external manager should recommend despite their concerns.
APRA’s approval is mandatory and prerequisite. Rule 10(1) requires APRA write and approve execution if satisfied; execution without APRA approval would be inconsistent with the Rules. If APRA refuses under rule 10(2), the external manager must reconvene or further examine and report within a specified timetable. Practitioners must ensure APRA correspondence and approvals are obtained and retained before executing deeds.
“Lodge” redefined to require simultaneous lodging with APRA. Rule 12(1)(6) modifies “lodge” in applied provisions to require lodging at the same time with APRA. This increases administrative load and creates a single point of failure: missing APRA lodgement may render a lodgement defective.
Replacements and omissions of Corporations Act sections. A large number of Corporations Act subsections are omitted or replaced (e.g. rules 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, etc.). Practitioners cannot assume full parity with corporate insolvency mechanics; they must check each modified or omitted provision carefully. Absent express transitional directions, actions taken under those Corporations Act sections in their original form may not operate as expected in the fund context.
Evidence of execution for non-company insurers. New ss 129A(1)-(2) (rule 65) allow execution without a seal where two directors or two committee members sign. Related new ss 129(5A) and 129(6A) (rules 63-64) create assumptions for validity if the document appears to comply. However, appearance-based presumptions can be challenged and the Rules do not set out a safe-harbour verification process beyond the appearances test.
Time limits for adjourned meetings. Rule 7(2) limits the ability to adjourn a meeting to no more than 30 days after the first day, and rule 7(8) requires certain adjournments to be to a date between 7 and 21 days later. Mis-administration of adjournments can result in lapsing under rule 7(10), potentially frustrating creditor consideration and leading to repeated convening costs.
No explicit penalties in the Rules. Because the Rules do not specify penalties, remedies for procedural errors fall back to the Act, modified Corporations Act provisions, or court relief. That can increase litigation risk and uncertainty as to outcomes where procedural non-compliance is alleged.
Each of these points is a concrete procedural or interpretative issue drawn from the Rules’ text that administrators, insurers and advisers should address in planning meetings, drafting deeds and interacting with APRA.
How to comply
Below is a practicable compliance checklist and recommended processes derived strictly from the Rules’ text for external managers, responsible insurers and advisers preparing for a potential voluntary deed of arrangement under these Rules. The checklist follows the Rules’ order of operations and highlights documentation and timing requirements.
Confirm authority and statutory basis
Verify that an external manager has the power to convene a meeting under rule 5 and that the manager’s appointment is current under the Act. Ensure the manager understands the reporting obligations under s 59 of the Act (rule 9(1)).
Prepare initial materials and timeline
Draft the external manager’s report covering the business, property, affairs and financial circumstances of the fund to accompany the meeting notice (rule 6(2)(a)).
Draft a clear statement detailing the proposed voluntary deed of arrangement (rule 6(2)(b)).
Prepare the external manager’s opinion as to why the deed would be in creditors’ interests (rule 6(2)(c)). These three documents will be attached to notices and supplied to APRA.
Plan notice and publication logistics
Prepare written notices to as many creditors as reasonably practicable and ensure simultaneous notice is ready for APRA (rule 6(1)(a)-(b)). Keep records proving simultaneous dispatch to APRA and creditors.
Arrange newspaper publication: choose either a national newspaper or, in each jurisdiction where the fund carries on business, a daily newspaper of general circulation; publish at least 14 business days before the meeting (rule 6(1)(c)). Allow lead time for insertion deadlines.
Ensure the notice contains teleconference information if telephone/electronic facilities will be available and the detailed contact and consent information required by rule 6(3)(b)(ii)(A)-(E). Include the explicit statement that telephone participants must bear their own participation costs (rule 6(3)(b)(ii)(E)).
Coordinate APRA engagement
Lodge the external manager’s report and all required documents with APRA at the same time as issuing notices (rule 6(1)(a); rule 12(1)(6)). Create proof of lodgement and a point of contact at APRA to confirm receipt.
Anticipate APRA timelines: APRA must respond in writing if satisfied (rule 10(1)) or request further meetings/examination and a further report with a specified time frame (rule 10(2)). Prepare to respond quickly if APRA requests further information.
Manage meeting logistics and participation
Confirm the external manager will preside (rule 7(1)). Schedule the meeting so adjournments comply with the 30-day outer limit (rule 7(2)) and adjourned meeting timing rules (rule 7(8)).
Implement telephone/electronic facilities procedures: collect written statements from telephone participants by the second-last working day prior to the meeting (rule 6(3)(b)(ii)); ensure personnel and systems can call and allow two-way audio so participants can be heard and can hear proceedings (rule 7(3)-(5)).
Ensure proxy forms and voting procedures are clear and capture the necessary information to establish debt values for the voting test under rule 7(11).
Calculate quorum and voting outcomes
Establish the list of creditors entitled to vote and determine the number/identity needed for quorum (rule 7(6)). For funds with many policyholders, prepare an approach to aggregate and value policyholder debts for the value test.
Apply rule 7(11) precisely: a resolution requires both a majority of creditors voting (numerical) and that those in favour represent more than half of the total debt value of all creditors voting. Document the arithmetic and preserve audit trails for vote counting and debt valuations.
Post-meeting steps and APRA reporting
If creditors resolve that the responsible insurer execute the deed (rule 8(1)(i)-(ii)), prepare the section 59 report recommending APRA approval unless exceptions apply (rule 9(1)-(2)). Explicitly assess whether any variation adopted by the meeting leaves the deed protective of policyholders or improperly limits creditor rights absent insolvency , document the analysis.
Lodge the report and recommendation with APRA and await APRA’s written notice: approval to execute and request to prepare the deed (rule 10(1)) or a direction to reconvene or further examine (rule 10(2)). Maintain records of APRA correspondence.
Administrator appointment and deed execution
If creditors resolve the deed and APRA approves, default administrator is the external manager unless creditors appoint someone else and APRA approves (rule 26(2)). Ensure APRA’s written approval for any non-default appointment is obtained.
Administrator must prepare an instrument setting out the deed if APRA has approved execution (rule 26(3)). Ensure documentary form aligns with execution rules in ss 128-129 as modified by rules 61-65 for insurers that are not companies. If the insurer is not a company, ensure the deed is signed by two directors or two committee members (rule 65).
Document execution formalities for non-company insurers
For private health insurers that are not companies, implement the execution standards under the newly inserted s 129A: two signatures of directors or two members of the governing body, or fix and witness common seal by two such persons if a seal is used (rule 65). Rely on ss 129(5A) and 129(6A) (rules 63-64) for evidentiary assumptions only where documents appear to comply.
Records and preservation
Keep contemporaneous records of notices sent, newspaper publications, lodgements with APRA, meeting minutes, vote tallies with debt value calculations, external manager reports, APRA correspondence and the final deed and any instrument prepared by the administrator. These records are critical if procedural disputes arise since the Rules attach significance to timing, simultaneity of lodgement and APRA approval.
Legal review and integration with Corporations Act mechanics
Review each applied Corporations Act provision listed in Parts 3-5 as modified, omitted or substituted and assess practical implications for creditor claims, court orders and administrator powers. Because many specific subsections are omitted or modified, do not assume automatic parity with corporate insolvency processes.
Check for APRA guidance and transitional instruments
The Rules do not include transitional provisions. Confirm whether APRA issues guidance, forms or practice notes to operationalise these rules (the Rules themselves do not provide such materials). Seek APRA guidance on lodgement formats and preferred report content to reduce the risk of APRA requesting further examination under rule 10(2).
By following the above steps and documenting compliance with the specific textual requirements of rules 5-10, 12, 26, 61-65, external managers, insurers and advisers can satisfy the principal procedural obligations in the instrument. The Rules’ repeated requirements for APRA simultaneous notice and report lodgement, the detailed notice and teleconference requirements, and the dual voting test warrant particular operational focus.
give notice to APRA at the same time that the manager gives notice to the creditors; and
give written notice of the meeting to as many of the creditors as reasonably practicable; and
cause notice of the meeting to be published:
(i) in a national newspaper; or
(ii) in each jurisdiction in which the business of the fund is carried on – in a daily newspaper that circulates generally in that jurisdiction;
at least 14 business days before the meeting.
(2) The notice given to creditors and APRA under subrule (1) must be accompanied by:
a report by the external manager about the business, property, affairs and financial circumstances of the fund; and
a statement setting out details of the proposed deed of arrangement; and
a statement setting out the external manager’s opinion as to why it would be in the interests of the creditors of the fund for the responsible insurer to execute such a deed of arrangement.
(3) If:
telephone or electronic conference facilities are expected to be available at the place where the meeting is to be held; and
the external manager considers that, having regard to all the circumstances, it will be appropriate to use those facilities, the notice of the meeting must:
(i) set out the relevant telephone number; and
(ii) indicate that a person, or the proxy of a person, who wishes to participate in the meeting by telephone must give to the external manager, not later than the second-last working day before the day on which the meeting is to be held, a written statement setting out:
(A) the name of the person and of the proxy (if any); and
(B) an address to which notices to the person or proxy may be sent; and
(C) a telephone number at which the person or proxy may be contacted; and
(D) a facsimile transmission number (if any) to which notices to the person or proxy may be sent; and
(E) that a person, or the proxy of a person, who participates in the meeting by telephone must pay any costs incurred by the person or proxy in participating and is not entitled to be reimbursed for those costs from the assets of the fund.
7. Conduct of the meeting 7. Conduct of the meeting
7. Conduct of the meeting
(1) The external manager is to preside at a meeting convened under this rule.
(2) Such a meeting may be adjourned from time to time at the discretion of the external manager, but may not be adjourned to a day more than 30 days after the first day on which the meeting was held.
(3) If a person, or a person’s proxy, who wishes to participate in a meeting by means of telephone conference facilities, has given the external manager a statement in accordance with subparagraph 6 (3) (b) (ii), the external manager must take all reasonable steps to ensure that the person, or the person’s proxy, is contacted before the start of the meeting on the telephone number provided by that person.
(4) The external manager must also take all reasonable steps to ensure that the person or proxy can hear the proceedings, and can be heard, by means of those facilities.
(5) A person who, or whose proxy, participates in the meeting by telephone under this rule is taken to be present in person at the meeting.
(6) A quorum for the meeting consists of:
if the number of persons entitled to vote exceeds 2 – at least 2 of those persons; or
if only one person is, or 2 persons are, entitled to vote – that person or those persons,
present in person or by proxy.
(7) A meeting may be held if all the persons who are entitled to attend, and to vote at, the meeting agree, even if it has not been convened in accordance with these Rules.
(8) If, within 30 minutes after the time appointed for a meeting:
a quorum is not present; or
the meeting is not otherwise sufficiently constituted,
the meeting is adjourned:
to the same day in the next week, at the same time and place; or
to the day (not being less than 7 or more than 21 days after the day on which the meeting is adjourned) and at the time and place that the external manager thinks are most convenient for the majority of persons entitled to attend the meeting.
(9) The external manager must, without delay, give written notice of the adjournment to the persons to whom notice of the meeting must be given under rule 6.
(10) If within 30 minutes after the time appointed for the adjourned meeting:
a quorum is not present; or
the meeting is not otherwise sufficiently constituted,
the adjourned meeting lapses.
(11) A resolution is carried if:
a majority of the creditors voting (whether in person or by proxy) vote in favour of the resolution; and
the value of the debts owed by the fund to those voting in favour of the resolution is more than half the total debts owed to all the creditors voting (whether in person or by proxy).
8. Matters that may be decided at the me 8. Matters that may be decided at the meeting
8. Matters that may be decided at the meeting
At meetings convened in accordance with these Rules, the creditors must resolve:
that the responsible insurer execute:
(i) the deed of arrangement proposed by the external manager; or
(ii) a different deed of arrangement from that originally proposed by the administrator; or
to reject the deed.
9. External managers recommendations to 9. External managers recommendations to APRA
9. External managers recommendations to APRA
(1) If the creditors have made a resolution referred to in paragraph 8 (a), the external manager must recommend in the report to APRA under section 59 of the Act, that APRA approve the execution of the deed, unless subrule (2) applies.
(2) The external manager must not recommend that APRA approve the execution of the deed if:
the deed has been varied by the meeting and the external manager is not satisfied that the varied deed is, in the circumstances, still protective of the interests of the policy holders of the fund; or
the deed limits the rights of a creditor or creditors unless, in the opinion of the external manager, the fund is insolvent or likely to become insolvent at some future time.
(3) For paragraph (2) (b), a deed will be taken to limit the rights of a creditor or creditors if it involves:
removing or limiting the right of a creditor to the payment of a debt or other liability, or removing or limiting a creditor’s entitlement to an asset; or
delaying the right of a creditor to make or enforce a claim for the payment of a debt or other liability, or delaying the right of a creditor to make or enforce the creditor’s entitlement to an asset.
10. Actions APRA may take 10. Actions APRA may take
10. Actions APRA may take
(1) If APRA is satisfied that the execution of the deed as recommended in the report of the external manager will, in the circumstances, be in the interests of policy holders of the fund, APRA must, by written notice:
inform the external manager that it approves the execution of the deed; and
request the preparation of the deed for execution.
(2) If APRA is not satisfied that the execution of the deed as recommended in the report of the external manager will be, in the circumstances, in the interests of policy holders of the fund, APRA must, by written notice:
inform the external manager to that effect; and
request that the external manager:
(i) seek another meeting of the creditors to consider a further voluntary deed of arrangement; or
(ii) examine other possible courses of action,
and, on the basis of that further meeting or examination, to make a further report to APRA under section 59 of the Act within a time specified by APRA.
(3) If the external manager provides a further report to APRA in accordance with paragraph (2) (b), this rule, other than subparagraph (2) (b) (i), applies in respect of that report as if it were the original report of the external manager.
Part 3 – Modifications of terms in applied Corporations Act provisions
11. Modifications 11. Modifications
11. Modifications
For subparagraph 50 (1) (b) (ii) and subsection 55 (2) of the Act, if an applied Corporations Act provision includes a term specified in rule 12 the provision applies as if a reference to the specified term were a reference to the term as modified by rule 12.
12. Specified terms 12. Specified terms
12. Specified terms
(1) The following terms are modified as set out in this rule:
board of the company, in relation to a responsible insurer, is modified to mean, as the case may be for a particular insurer:
(i) the board of directors; or
(ii) committee of management; or
(iii) other governing body; and
company is modified to mean the responsible insurer; and
company secretary is modified to mean in relation to a responsible insurer that is not a company within the meaning of the Corporations Act, the secretary of the insurer or person who carries out the role similar to a company secretary; and
creditor, in relation to a fund, is modified to include a policy holder of the fund; and
director or director of a company or of a fund, for a responsible insurer that is not a company within the meaning of the Corporations Act, is modified to include a member of the committee of management, or other governing body, of the insurer; and
deed of company arrangement is modified to mean a voluntary deed of arrangement agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025; and
lodge is modified to include that the document to be lodged must be lodged at the same time with APRA; and
officer is modified to mean an 'officer' within the meaning of that word in the Private Health Insurance (Prudential Supervision) Act 2015; and
resolution, in relation to creditors and policy holders, is modified to mean a resolution agreed on at a meeting convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
(2) References in an applied Corporations Act provision to Parts or Divisions of the Corporations Act are taken to also include a reference to the Private Health Insurance (Prudential Supervision) Act 2015 and the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025.
Part 4 – Modifications of Part 5.3A and Division 7A of Part 5.6
13. Modifications for subparagraph 50 (1 13. Modifications for subparagraph 50 (1) (b) (ii) of the Act
13. Modifications for subparagraph 50 (1) (b) (ii) of the Act
For subparagraph 50 (1) (b) (ii) of the Act, the applied Corporations Act provisions mentioned in this Part are modified as set out in this Part.
14. Subsection 440D (1) 14. Subsection 440D (1)
14. Subsection 440D (1)
Despite subsection 50 (4) of the Act, the reference in subsection 440D (1) of the Corporations Act to 'the company' is not to be taken as a reference to 'the fund'.
Note: Subsection 56 (2) of the Act provides for the matters to which the external manager or the Court must have regard.
15. Subsections 440J (2) and (3) 15. Subsections 440J (2) and (3)
15. Subsections 440J (2) and (3)
omit the subsections
16. Subsection 441B (2) 16. Subsection 441B (2)
16. Subsection 441B (2)
omit
198G, 440B, 440F or 440G
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
17. Subsection 441B (3) 17. Subsection 441B (3)
17. Subsection 441B (3)
omit
437D
insert
75 of the Private Health Insurance (Prudential Supervision) Act 2015,
18. Section 441C 18. Section 441C
18. Section 441C
omit the section
19. Section 441E 19. Section 441E
19. Section 441E
omit
198G or 440B
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
20. Subsection 441F (2) 20. Subsection 441F (2)
20. Subsection 441F (2)
omit
198G or 440B
insert
440B, or section 71 of the Private Health Insurance (Prudential Supervision) Act 2015,
21. Subsection 441F (3) 21. Subsection 441F (3)
21. Subsection 441F (3)
omit
437D
insert
75 of the Private Health Insurance (Prudential Supervision) Act 2015,
22. Subsection 441G (2) 22. Subsection 441G (2)
22. Subsection 441G (2)
omit the subsection
23. Subsection 442D (2) 23. Subsection 442D (2)
23. Subsection 442D (2)
omit the subsection
24. Subsection 442F (1) 24. Subsection 442F (1)
24. Subsection 442F (1)
omit
this Act
insert
the Private Health Insurance (Prudential Supervision) Act 2015 and any applied Corporations Act provision as modified.
25. Subsection 442F (2) 25. Subsection 442F (2)
25. Subsection 442F (2)
omit the subsection
26. Subsections 444A (1), (2) and (3) 26. Subsections 444A (1), (2) and (3)
26. Subsections 444A (1), (2) and (3)
omit the subsections
substitute
(1) This section applies where, at a meeting of creditors convened under the Private Health Insurance (Health Benefits Fund Enforcement) Rules 2025, a fund’s creditors resolve that the responsible insurer execute a voluntary deed of arrangement.
(2) The external manager of the fund is to be the administrator of the deed, unless the creditors, by resolution passed at the meeting, appoint someone else to be administrator of the deed, and APRA, by notice in writing, approves the resolution.
(3) If APRA, by notice in writing, has approved the execution of the deed, the administrator of the deed must prepare an instrument setting out the terms of the deed.
Despite subsection 50 (4) of the Act, the second occurring reference in paragraph 444A (4) (b) of the Corporations Act to 'the company' is not to be taken as a refere
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