$750 in any 12 month period, in relation to a policy under which only one person is insured; and

$1,500 in any 12 month period, in relation to any other policy.

the age of a person, except to the extent allowed under:

Part 2-3 (lifetime health cover); or

subsection 63-5(4); or

section 66-5, because of the reason mentioned in paragraph 66-5(3)(ea); or

because a person insured under the policy is entitled to an age-based discount in the circumstances set out in the Private Health Insurance (Complying Product) Rules;

at any reasonable time of the day, enter:

a place occupied by a private health insurer or private health insurance broker; or

a place occupied by a person predominantly for the purpose of performing services for, or on behalf of, a private health insurer or private health insurance broker; or

a place where documents or other records relating to a private health insurer, a private health insurance broker or the carrying on of health insurance business are kept; and

may exercise the following powers in relation to the place:

the power to inspect any documents or other records to verify evidence provided in relation to a complaint made under Division 3;

the power to take extracts from, or make copies of, any such document or other record.

to a private health insurer, that the insurer take a specific course of action or make changes to its rules, or both;

to a health care provider or private health insurance broker, that the provider or broker take a specific course of action.

report to the Health Minister on any recommendations made to a private health insurer or private health insurance broker and any responses to those recommendations; or

report to the Health Minister on any recommendations to general changes in regulatory practice or industry practices relating to the kind of issues raised as a result of the exercise of those powers.

the report must refer to the Private Health Insurance Ombudsman’s exercise of powers under section 20SA; and

the Private Health Insurance Ombudsman must notify any private health insurer or private health insurance broker named in a report provided to the Health Minister of that fact, unless doing so would, or could be reasonably expected to, prejudice the conduct of a current or pending investigation.

at any reasonable time of the day, enter:

a place occupied by a private health insurer or private health insurance broker; or

a place occupied by a person predominantly for the purpose of performing services for, or on behalf of, a private health insurer or private health insurance broker; or

a place where documents or other records relating to a private health insurer, a private health insurance broker or the carrying on of health insurance business are kept; and

exercise the following powers:

the power to inspect any documents or other records;

the power to take extracts from, or make copies of, any such document or other record.

a summary of the exercise of powers during the period by the Private Health Insurance Ombudsman under section 20SA;

enters a place mentioned in paragraph 20SA(a) for the purposes of conducting an inspection and audit; or

enters a place mentioned in paragraph 20TA(a) for the purposes of conducting an investigation under section 20T.

the person is the occupier of, or is in charge of, a place mentioned in paragraph 20SA(a); and

the Private Health Insurance Ombudsman exercises, or purports to exercise, the powers mentioned in paragraph 20SA(b) in relation to the place; and

the person does not provide the Private Health Insurance Ombudsman with reasonable facilities and assistance for the effective exercise of those powers.

the person is the occupier of, or is in charge of, a place entered mentioned in paragraph 20TA(a); and

the Private Health Insurance Ombudsman exercises, or purports to exercise, the powers mentioned in paragraph 20TA(b) in relation to the place; and

the person does not provide the Private Health Insurance Ombudsman with reasonable facilities and assistance for the effective exercise of those powers.

be in the form approved by the Private Health Insurance Ombudsman; and

contain a photograph that is no more than 5 years old of the person to whom it is issued.

the person ceases to be:

a member of staff mentioned in section 31; or

a person to whom the Private Health Insurance Ombudsman has delegated powers under section 34 in relation to section 20SA or 20TA; and

the person does not, within 14 days of so ceasing, return the person’s identity card to the Private Health Insurance Ombudsman.

beginning at the start of 1 April 2007; and

ending at the end of 30 June 2018.

(a) a body that is or was registered under Private Health Insurance (Prudential Supervision) Act 2015; orDivision 3 of Part 2 of the

(b) a person who was registered under repealed Private Health Insurance Act 2007; orPart 4-3 of the

(c) an organisation that was covered by subsection 18(1) of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007.

beginning at the start of 1 April 2007; and

ending at the end of 30 June 2018;

the insurance policy includes one or more benefit limitation periods; and

(d) the insurance policy is not a complying health insurance policy (within the meaning of the Private Health Insurance Act 2007); and

the insurance policy would be a complying health insurance policy (within the meaning of that Act), if:

the waiting period requirements in Division 75 of that Act; and

the portability requirements in Division 78 of that Act;

at a particular time during the period:

beginning at the start of 1 April 2018; and

ending at the end of 30 June 2018;

hospital treatment that is psychiatric care; or

hospital-substitute treatment that is psychiatric care; and

(b) as a result, the policy is not a complying health insurance policy (within the meaning of the Private Health Insurance Act 2007) at that time;

(a) the Private Health Insurance Act 2007; and

any other law of the Commonwealth;

beginning at the start of 1 April 2007; and

ending at the end of 30 June 2018;

(a) in determining whether a person has committed an offence against Private Health Insurance Act 2007; orsection 84-1 of the

in determining the obligation of a court under subsection 84-1(2) of that Act; or

in determining, for the purposes of subsection 84-10(1) of that Act, whether a private health insurer has engaged, is engaging, or is proposing to engage, in conduct:

that contravenes or would contravene section 63-1 of that Act; or

that is or that would be an offence against section 84-1 of that Act; or

in determining, for the purposes of subsection 84-10(2) of that Act, whether a refusal or failure:

contravenes or would contravene section 63-1 of that Act; or

is or would be an offence against section 84-1 of that Act; or

in determining, for the purposes of paragraph 84-15(a) of that Act, whether a private health insurer has engaged in conduct that contravenes section 63-1 of that Act or is an offence against section 84-1 of that Act; or

in determining, for the purposes of paragraph 84-15(b) of that Act, whether a refusal or failure contravenes section 63-1 of that Act or is an offence against section 84-1 of that Act; or

in determining the scope of a jurisdiction or power conferred on the Federal Court by section 84-10 or 84-15 of that Act.

(a) in determining, for the purposes of Chapter 5 of the Private Health Insurance Act 2007, whether a private health insurer may have, or has, contravened an enforceable obligation (within the meaning of that Act); or

in determining the scope of a power conferred on the Minister by Chapter 5 of that Act; or

in determining the scope of a jurisdiction or power conferred on the Federal Court by Chapter 5 of that Act.

(a) before the commencement of this item, an amount (the relevant amount) was paid to a private health insurer under, or purportedly under, Subdivision 279-A of the Private Health Insurance Act 2007; and

the private health insurer was not entitled to receive the whole, or a part, of the relevant amount because, during the whole or a part of the period:

beginning at the start of 1 April 2007; and

ending at the end of 30 June 2018;

as a result, the whole, or the part, as the case may be, of the relevant amount became repayable to the Commonwealth.

(a) before the commencement of this item, an amount (the relevant amount) was paid to a person under, or purportedly under, repealed Division 26 of the Private Health Insurance Act 2007; and

the person was not entitled to receive the whole, or a part, of the relevant amount because, during the whole or a part of the period:

beginning at the start of 1 April 2007; and

ending at the end of 30 June 2013;

as a result, the whole, or the part, as the case may be, of the relevant amount became repayable to the Commonwealth.

where a person lives, except to the extent allowed under subsection 66-10(2) or section 66-20 or 66-25; or

the community rating principle in section 55-5; nor

the community rating requirements in section 66-1;

in the *approved form; and

accompanied by any application fee imposed under the Private Health Insurance (Health Insurance Business) Rules.

include the hospital in a class set out in the Private Health Insurance (Health Insurance Business) Rules; and

notify the person, in writing, of:

the hospital’s inclusion in a class set out in the Rules; and

the day that the hospital is included in that class and the day that the hospital’s inclusion in that class ends.

notify the person, in writing, of that fact; and

provide reasons for the decision.

comes into force on the day specified in the notice referred to in subparagraph 121-8A(2)(b)(ii); and

expires on the day specified in that notice, unless it is revoked earlier.

for the purposes of this Part and Division 72—set out one or more classes of *hospital;

impose an application fee for the purposes of section 121-8;

set out assessment criteria for including a hospital in a particular class;

set out matters of a transitional nature relating to the current arrangements for hospitals and the new application process provided for by section 121-8.

prevent a private health insurer from closing a *complying health insurance product, such that the *product will not be available to anyone except those persons, who at the time of closing, are insured under a policy forming part of the product; or

prevent a private health insurer from terminating a complying health insurance product or a *product subgroup of a complying health insurance product, such that:

in the case of a product—the product will not be available to any person insured under a policy forming part of the product; and

in the case of a product subgroup—the product subgroup will not be available to any person insured under a policy that belongs to the product subgroup.

the policy forms part of a *complying health insurance product or belongs to a *product subgroup of a complying health insurance product; and

the *product or product subgroup is being terminated by the private health insurer, and as a consequence, an *adult insured under the policy is to be transferred to a new policy; and

the insurer informs the adult insured under the policy, in writing, of the matters set out in the Private Health Insurance (Complying Product) Rules; and

the adult insured under the policy is informed of those matters a reasonable time before the transfer to the new policy is to take effect.