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PRIVATE HEALTH INSURANCE (PRUDENTIAL SUPERVISION) ACT 2015 (NO. 85, 2015) - SECT 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 children 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)).



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