CTHIn ForceAct
Private Health Insurance (Prudential Supervision) Act 2015
15Deciding the application
Start here
Get a plain-English read of 15
Turn the raw legal text into a practical explanation grounded in Private Health Insurance (Prudential Supervision) Act 2015.
#### 15 Deciding the application
(1) APRA may, in writing, grant the application, subject to such terms and conditions as APRA considers appropriate.
> Note: Refusals of applications, and granting of applications subject to terms and conditions, are reviewable under section 168.
(2) If APRA grants the application:
(a) the applicant is taken to be, or have been, registered as a private health insurer under this Division from the date of effect specified in the instrument granting the application (which may be a date that occurred before the application was made); and
(b) if the grant is subject to terms and conditions—the registration is taken to be subject to those terms and conditions from the day on which the applicant is notified of the granting of the application; and
(c) if the applicant sought to be registered as a for profit insurer—the registration is taken to be registration of the applicant as a for profit insurer; and
(d) if the applicant sought to be registered as a restricted access insurer and the applicant’s constitution or rules satisfy subsection (3)—the registration is taken to be registration of the applicant as a restricted access insurer.
> Note: An insurer’s registration status as being (or not being) a for profit insurer or a restricted access insurer may change after the insurer’s initial registration, but only as provided for in section 19.
(3) For the registration to be taken to be as a restricted access insurer, the applicant’s constitution or rules must:
(a) describe the restricted access group to whom the applicant’s complying health insurance products are, or will be, available; and
(b) prohibit the applicant from issuing a complying health insurance policy to a person who does not belong to the group; and
(c) prohibit the applicant from ceasing to insure a person for the reason that the person has ceased to belong to the group.
(4) A restricted access group is a group of people who all belong to a particular group, based on whether they:
(a) are or were employed in a particular profession, trade, industry or calling; or
(b) are or were employed by a particular employer or by an employer who belongs to a particular class of employers; or
(c) are or were members of a particular profession, professional association or union; or
(d) are or were members of the Defence Force or part of the Defence Force; or
(e) are or were part of any group described in APRA rules made for the purpose of this paragraph.
The partners and dependent persons of people who belong to such a group are also taken to belong to that group.
(5) APRA rules made for the purpose of paragraph (4)(e) may describe a group as consisting of one or more classes of people (whether or not the class or classes are described by reference to matters of a kind referred to in paragraphs (4)(a) to (d)).