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PRIVATE HEALTH INSURANCE (PRUDENTIAL SUPERVISION) ACT 2015 (NO. 85, 2015) - SECT 23

Private health insurers must have health benefits funds

             (1)  A private health insurer must at all times have at least one health benefits fund in respect of:

                     (a)  its health insurance business; or

                     (b)  its health insurance business and some or all of its health-related businesses.

             (2)  A private health insurer may have more than one health benefits fund, but must not have more than one in respect of a particular risk equalisation jurisdiction.

             (3)  Despite subsection (2), a private health insurer may have more than one health benefits fund in respect of a particular risk equalisation jurisdiction if:

                     (a)  each of those funds is a fund (a pre-1 April 2007 fund ):

                              (i)  that existed on 1 April 2007; and

                             (ii)  that, immediately before that day, was conducted by a registered organization (within the meaning of the National Health Act 1953 as in force before that day); or

                     (b)  each of those funds, other than one of them, is a pre-1 April 2007 fund and that one other fund was established in connection with a restructure of funds approved under:

                              (i)  Division 4 of this Part; or

                             (ii)  Division 146 of the Private Health Insurance Act 2007 as in force before the commencement of this section.

             (4)  Despite subsection (2), a private health insurer may have more than one health benefits fund in respect of a particular risk equalisation jurisdiction in circumstances specified in Private Health Insurance (Health Benefits Fund Policy) Rules made for the purpose of subsection 131-20(2) of the Private Health Insurance Act 2007 .



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